Who needs VA Form 21-0958?
Every veteran who has a need to appeal from a decision concerning his claim for disability compensation should use this form as far as it is the only way express your disagreement.
What is VA Form 21-0958 Used For?
VA Form 21-0958 is a Notice of Disagreement. Whenever you disagree with some statement or decision regarding your claim for disability compensation made by your Regional Office, you should use this form to indicate your disagreement. In fact this form is the only way to initiate an appeal from a decision described above.
Is VA Form 21-0958 Accompanied by Other Forms?
This form doesn’t require any other forms to accompany it. However, you may add some extra sheets if you lack space while filling in the last field. You also should attach any materials that support and explain your Note of Disagreement.
What Information should be Provided in VA Form 21-0958?
While filling out VA Form 21-0958 you should mention the following information:
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Veteran’s name
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Veteran’s social security number
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Claimant’s name
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Mailing address
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Telephone contacts
For each issue:
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Specific issues of disagreement
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Area of disagreement
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Percentage Evaluation Sought (if known)
After filling out the form you should provide a signature on the bottom of it. Otherwise, you will get it back to be signed. This will make the processing of your form much longer.
Where do I Send VA Form 21-0958?
You should send or take VA Form 21-095 to the Regional Office that issued the decision, statement or notification you disagree with.
