Individual Unemployability application
Supplies employment, education, and disability information for a TDIU request.
Employer employment-information request
Request for Employment Information in Connection with Claim for Disability Benefits
Asks an employer for employment and termination information related to an unemployability claim.
Purpose and use
This is generally completed by the veteran's employer when VA needs employment information for TDIU.
When not to use it
Do not use this form for a different benefit or review path unless current VA instructions identify it for that purpose.
Who completes and signs it?
- Completed by
- employer
- Signed by
- employer
- Availability
- online and pdf
- Submission
- follow current form instructions
Always start with the official page
Open the current VA version.
Check the revision, instructions, signature requirements, and delivery options immediately before use.
Read before use
Important limitations
- Verify the current revision and submission instructions on the official VA page before signing or sending the form.
- This planner identifies forms that may fit a situation; it does not determine eligibility or filing strategy.
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