What Is VA Form 21-4192 and Why Is It Important for TDIU Claims? 

VA Form 21-4192: A Crucial Step in TDIU Claims 

For Veterans applying for Total Disability Individual Unemployability (TDIU), proving that service-connected disabilities prevent substantial gainful employment is a critical part of the process. 

One document that plays a key role in this verification is VA Form 21-4192, “Request for Employment Information in Connection with Claim for Disability Benefits.” 

Who Completes VA Form 21-4192? 

• The Veteran: Only completes Section 1, which includes basic identifying details. 

• The Veteran’s Prior and/or Current Employer(s): The VA sends this form to the employer to confirm job duties, work limitations, and the reason for separation from the company. 

• The VA: Uses the employer’s response to evaluate work limitations caused by service-connected disabilities. 

If an employer confirms that a Veteran was unable to maintain steady work due to a disability, this strengthens the TDIU claim. However, even if an employer doesn’t respond, the VA may still process the claim using alternative evidence. 

Why Is VA Form 21-4192 Important for a TDIU Claim? 

For TDIU benefits, the VA must determine whether a Veteran’s service-connected disabilities prevent them from working full-time in substantial gainful employment (SGE). 

VA Form 21-4192 provides: 

• Proof of Work Limitations – If an employer states that a Veteran couldn’t work due to a disability, this strongly supports a TDIU claim. 

• Details on Workplace Accommodations – If the employer had to modify job duties but still couldn’t keep the Veteran employed, this is valuable evidence. 

• Confirmation of Employment Termination – If a Veteran was fired or left due to medical issues, it directly links their condition to unemployability. 

Key Takeaway: This form provides objective proof from a third party—the employer—helping the VA verify that a Veteran’s disability prevents them from working. 

What If the Employer No Longer Exists or Doesn’t Respond? 

In some cases, an employer may be unresponsive or out of business, making it impossible to complete the form. If this happens: 

• The VA may still process the claim using other evidence, such as tax returns or lay statements. 

• Veterans can submit alternative proof, such as W-2s, Social Security Disability records, or a vocational expert’s opinion. 

• Self-employed Veterans can provide tax records to demonstrate income below the federal poverty threshold. 

If the VA denies a claim due to a missing VA Form 21-4192, a VA disability attorney can help appeal by gathering alternative evidence. 

Struggling With a TDIU Claim? Get Help From Berry Law 

If the VA has denied or delayed your TDIU claim due to missing employment information, legal assistance can help strengthen your case. Contact Berry Law today for a free case review. 

Frequently Asked Questions (FAQs) About VA Form 21-4192 

1. Do I need to submit VA Form 21-4192 for my TDIU claim? 

No, the VA typically sends this form to your last employer. However, Veterans can submit it themselves to speed up the process. 

2. What if my last employer is out of business? 

If an employer no longer exists, alternative evidence like tax records, W-2s, or lay statements can help verify employment history. 

3. What if my employer refuses to complete the form? 

The VA can still process the claim using medical records, Social Security Disability records, or vocational expert opinions. 

4. Does VA Form 21-4192 apply to self-employed Veterans? 

Yes, but self-employed Veterans must prove that their income falls below the federal poverty level due to disabilities. 

5. How long does it take the VA to process VA Form 21-4192? 

Employers are expected to respond within 30 days, but delays can happen if the VA must request additional information.