Homepage Fill Out Your Va 28 1905M Form
Article Structure

The VA Form 28-1905M, known as the Request for and Receipt of Supplies, serves a critical role in the Vocational Rehabilitation program offered by the Department of Veterans Affairs (VA). Designed to facilitate the provision of necessary supplies for veterans engaged in rehabilitation, independent living, or employment assistance programs, this form is essential for ensuring that veterans receive the tools they need to succeed. It's important to remember that the VA will only provide supplies if certain conditions are met, such as the requirement that all trainees or employees in the same program possess identical items, and if the veteran has confirmed they do not already own these tools or materials. The form also requires various personal details, including the veteran’s name, address, and VA file number, to effectively track and allocate resources. Additionally, the form includes provisions to report the condition of received items and allows veterans to certify that they have received supplies in good condition. With a respondent burden estimated at one hour, filling out the VA Form 28-1905M correctly is urgent for those seeking to ensure their eligibility for these vital resources. Understanding the importance of this form can make a significant difference in a veteran's rehabilitation journey, so completing it accurately and promptly is crucial.

Va 28 1905M Example

OMB Approved No. 2900-0061

Respondent Burden: 1 hour

Expiration Date: 3/31/2018

REQUEST FOR AND RECEIPT OF SUPPLIES

(Chapter 31 - Vocational Rehabilitation)

PRIVACY ACT INFORMATION: No benefits may be paid unless a completed application form has been received (38 C.F.R. 21.212 and 21.224). The information requested on this form is necessary to determine your entitlement to the benefit for which you have applied. The responses you submit are considered confidential, (38 U.S.C. 5701), formerly 3301. They may be disclosed outside the Department of Veterans Affairs (VA) only if the disclosure is authorized under the Privacy Act, including the routine uses identified in the VA system of records, 58VA21/22/28 Compensation, Pension, Education and Vocational Rehabilitation Records - VA, published in the Federal Register. The requested information is considered relevant and necessary to determine maximum benefits under the law. Information submitted is subject to verification through computer matching programs with other agencies.

RESPONDENT BURDEN: VA may not conduct or sponsor, and respondent is not required to respond to this collection of information unless it displays a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have comments regarding this burden estimate or any other aspect of this collection of information, call 1-800-827-1000 for mailing information on where to send your comments.

SECTION A: TO BE SUBMITTED TO THE DEPARTMENT OF VETERANS AFFAIRS

FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN

REHABILITATION GOAL

VA FILE NUMBER

ADDRESS TO WHICH SUPPLIES MAY BE DELIVERED TO VETERAN (Number and Street or Rural Route, City or P.O., State and Zip Code)

 

INSTRUCTIONS

REHABILITATION PROVIDER

REHABILITATION PROVIDER (Continued)

A.The Department of Veterans Affairs (VA) may furnish supplies to the veteran named above, who is entering into or is already taking part in a VA rehabilitation, independent living, or employment assistance program, if all of the following conditions are met:

1. The facility/employer requires all persons being trained for or employed in the same occupational or independent living goal to personally possess the same books, tools, and other supplies; and

2. The veteran does not already possess the required items; and

3. The VA case manager has determined the supplies may be provided in accordance with limitations and restrictions found in 38 U.S.C. and applicable federal regulations.

B.VA will not furnish tools or other supplies which commonly are on hand for use of all trainees or employees or which the veteran already owns.

C. If items are required under the conditions stated in A, and are not being requested merely because the veteran desires them, request these supplies by completing the section immediately following these instructions. You may continue to list required items on another VA For 28-1905m. Additional pages may be used if necessary.

D. In Section B, please sign and complete the Request and Certification of Establishment section.

VETERAN

A.In Section B, the veteran's signature acknowledges that he or she does not already possess the required items.

B.The veteran must complete Section C of this form and return it to the VA case manager to report receipt of items.

SECTION B: REQUEST AND CERTIFICATION OF FACILITY OR ESTABLISHMENT

TYPE OF PROGRAM

 

 

 

 

 

On-Job Training

 

Educational or Vocational Training

 

Independent Living

 

Employment

 

Other (Specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

()

ITEM NO.

 

NAME OF ARTICLE AND DESCRIPTION

 

QUANTITY

ESTIMATED

(If applicable)

 

(Catalog identification, size, etc.)

 

(Set, pair, etc.)

COST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE AND TITLE OF OFFICIAL

DATE

NAME AND ADDRESS OF FACILITY OR ESTABLISHMENT (Number and street or rural route, city or P.O., state and Zip Code)

SIGNATURE OF VETERAN (Please sign in ink.)

DATE

SIGNATURE OF CASE MANAGER (Please sign in ink.)

DATE

VA FORM

28-1905m

SUPERSEDES VA FORM 28-1905M, NOV 2011,

APR 2015

WHICH WILL NOT BE USED.

SIGNATURE OF VETERAN (Please sign in ink.)
VA FORM 28-1905m, APR 2015

SECTION C: RECEIPT OF SUPPLIES

CERTIFICATION OF VETERAN

TO THE DEPARTMENT OF VETERANS AFFAIRS (Veteran should check all that apply):

A. Any items that were requested in Section A but not received are listed below B. Any items received in damaged or unacceptable condition are listed below. C. I certify that all the supplies I received are in good condition.

WAS ITEM

RECEIVED?

NAME OF ARTICLE AND DESCRIPTION

(Catalog identification, size, etc.)

QUANTITY

(Set, pair, etc.)

DATE OF RECEIPT

COMMENTS ON ITEM DAMAGED

OR UNACCEPTABLE

NOTE: Complete the certification of receipt of supplies by dating and signing the form below and returning it to your VA case manager.

DATE

Page 2

Form Characteristics

Fact Name Description
OMB Approval The form 28-1905M is approved by the Office of Management and Budget (OMB), with control number 2900-0061.
Expiration Date The expiration date for this form is March 31, 2018.
Purpose This form is a request and receipt for supplies under Chapter 31, which covers vocational rehabilitation for veterans.
Privacy Act Information on this form is confidential and is protected under the Privacy Act, specifically 38 U.S.C. 5701.
Eligibility Requirements The VA can supply materials if specific conditions are met, including the absence of prior ownership of required items.
Respondent Burden Completing this form is estimated to take about one hour, which includes gathering information and reviewing instructions.
Governing Laws The form follows regulations set forth in 38 C.F.R. 21.212 and 21.224, which govern vocational rehabilitation benefits.

Guidelines on Utilizing Va 28 1905M

Completing the VA 28 1905M form is essential for requesting supplies related to vocational rehabilitation. By following the steps outlined below, you can accurately fill out the necessary sections to ensure your request is processed efficiently. Keep all required details at hand to streamline the process.

  1. Begin with Section A. Fill out your first name, middle name, and last name.
  2. Provide your rehabilitation goal and VA file number.
  3. Enter the address where supplies should be delivered, including street number, city, state, and zip code.
  4. In Section B, indicate the type of program you are enrolled in: On-Job Training, Educational or Vocational Training, Independent Living, or Employment. Check the appropriate box.
  5. List each item you are requesting in the ITEM NO., NAME OF ARTICLE AND DESCRIPTION section. Include the quantity and, if applicable, estimated cost.
  6. Signature and title of an official from your facility or establishment must be provided. Write the date next to it.
  7. The veteran should then sign the form in the SIGNATURE OF VETERAN section, including the date.
  8. A case manager must also sign in the designated area. Include the signature date.
  9. In Section C, certify your receipt of supplies. Check off any items that were not received or arrived in damaged condition.
  10. Complete the remaining details in Section C, including the name and description of the items, quantity, and any additional comments. Finally, sign and date this section.

Once fully completed, submit the VA 28 1905M form to your VA case manager. They will process your request for supplies in line with the vocational rehabilitation program guidelines. Keep a copy of the submitted form for your records.

What You Should Know About This Form

What is the VA Form 28-1905M used for?

The VA Form 28-1905M is a request for and receipt of supplies related to vocational rehabilitation and employment programs. Veterans can use this form to request specific supplies needed for training or employment as part of their rehabilitation goals under Chapter 31. Completing this form is essential for the VA to determine eligibility for these items.

Who is eligible to submit the VA Form 28-1905M?

This form is intended for veterans who are participating in a VA rehabilitation, independent living, or employment assistance program. The veterans must not already possess the requested items and should ensure that the supplies are necessary for their training or job requirements.

What items can be requested using the VA Form 28-1905M?

Veterans can request supplies such as books, tools, and other training materials that are required for their specific occupational goals. However, items that are commonly available for all trainees or those the veteran already owns cannot be requested. It's crucial that the needs align with the training program's requirements.

What steps should I take to fill out the VA Form 28-1905M?

First, provide your personal information, including your name and VA file number. Next, specify the rehabilitation goal, and list the items you need in Section A. Be sure to complete the Request and Certification section with signatures from both the veteran and case manager. Finally, return the completed form to your VA case manager.

What if I receive damaged items?

If you receive any items that are damaged or in unacceptable condition, you should note these in Section C of the form. It's important to report these issues as part of your certification of receipt. This helps ensure that corrective actions can be taken by the VA.

How long does it take to process the VA Form 28-1905M?

The time it takes for the VA to process this form may vary, but veterans should allow sufficient time for processing and delivery of requested supplies. If there are concerns about delays, it’s advisable to contact the VA case manager directly for updates.

Where do I submit the completed VA Form 28-1905M?

Once you have completed the VA Form 28-1905M, submit it to your designated VA case manager. They will then review your request and take the necessary steps to fulfill it based on the VA's policies and regulations.

Common mistakes

Filling out the VA Form 28-1905M can be a straightforward process, but many people stumble due to common mistakes. Awareness of these pitfalls is crucial to ensure a smooth application process and to avoid unnecessary delays. Here are nine mistakes to watch out for.

One of the most frequent errors occurs in Section A, where applicants often fail to provide their complete name. Missing middle names or incorrect spellings can lead to confusion and miscommunication with the Department of Veterans Affairs. Be meticulous when entering this vital information. Double-check against official documents to ensure accuracy.

Another mistake involves the rehabilitation goal. Some individuals neglect to specify their rehabilitation goal or misunderstand what it entails. Clearly stating a goal helps the VA determine eligibility for supplies effectively. Think carefully about your objectives and clearly articulate them on the form.

In addition, many people do not provide a valid VA File Number. This number is essential for linking your request to your records. If this number is absent, it can undoubtedly delay the processing of your request. Take the extra moment to locate this number before submitting your form.

Additionally, applicants sometimes forget to list all items in detail. In Section B, it's crucial to include specific names, descriptions, and quantities of the items needed. Vague descriptions can lead to misunderstandings about what you are requesting. Use precise language to describe items thoroughly to avoid any unnecessary complications.

Submitting the form without necessary signatures is another common misstep. Every area requiring a signature must be signed by the relevant parties, including the veteran, the case manager, and any official representative. Failing to secure these signatures can result in the form's rejection.

Moreover, applicants may not report items received in damaged condition or neglect to list missing items in Section C. This section is vital for confirming the receipt of supplies. If you overlook documenting issues with received items, it might become challenging to claim replacements or report concerns later.

Some users mix up the purpose of the form, leading to inappropriate requests. The VA Form 28-1905M is strictly for specific supplies related to vocational rehabilitation. Attempting to request non-eligible items can frustrate both you and the VA, causing delays.

In addition, forgetting to review the form before submission can lead to multiple mistakes going unnoticed. Taking a few moments to check your entries ensures that you haven’t overlooked any critical information or made any errors.

Finally, failing to meet the submission deadline is a mistake you cannot afford to make. Timeliness is essential. If you miss the deadline, you may need to start the application process again. Keep track of any due dates associated with your application to avoid setbacks.

By being aware of these common mistakes and taking the time to review your application thoroughly, you can increase your chances of a successful and swift process. Remember, getting it right the first time saves time and effort down the line.

Documents used along the form

The VA 28 1905M form is a vital document for veterans seeking assistance with vocational rehabilitation by outlining requests for necessary supplies. Alongside this form, several other documents are often utilized to support the process or provide additional information. Here’s a brief overview of these related forms and documents.

  • VA Form 28-1900: This is the application for Vocational Rehabilitation and Employment (VR&E) services. Veterans use this form to apply for benefits and outline their eligibility for the program.
  • VA Form 28-1902: Also known as the Counseling Record – Narrative Report, this form provides detailed information about the veteran's rehabilitation needs, goals, and the service plan developed in collaboration with the case manager.
  • VA Form 28-1903: This form is the Employment History, which veterans complete to provide their employment background. It helps case managers understand the veteran's work experience and fits into their rehabilitation plan.
  • VA Form 28-1905A: Used for requesting additional supplies, this form serves as a supplemental request when the supplies indicated on the 28 1905M are insufficient or additional items are required.
  • VA Form 21-526EZ: This is the application for disability compensation and related benefits. It assists veterans in obtaining necessary financial support while undergoing rehabilitation.
  • VA Form 21-4180: Known as the Report of Contact, this document records communication between the veteran and the VA. It serves to clarify discussions regarding the veteran’s rehabilitation needs and any assistance being provided.
  • VA Form 28-8832: This is the Employment Services Report, which details the veteran’s job placement services. The report aids in tracking employment outcomes and effective service delivery.
  • VA Form 22-1990: As the Application for VA Education Benefits, this form complements the VA 28 1905M by allowing veterans to apply for educational benefits which may be necessary for their rehabilitation process.

These documents play essential roles in the vocational rehabilitation process and enhance the efficiency of service delivery for veterans. Together, they create a cohesive framework that supports veterans in achieving their rehabilitation goals and securing the necessary resources to succeed.

Similar forms

  • VA Form 28-1905: This form is used to request supplies for veterans in vocational rehabilitation programs. Similar to the VA 28-1905M form, it facilitates the process of obtaining necessary tools, books, and materials but may not include the certification aspect found in the 28-1905M.

  • VA Form 22-1990: This is an application for veterans’ education benefits. Like the 28-1905M, it requires the veteran to provide personal information and details about their educational goals to receive support.

  • VA Form 21-526EZ: Used to apply for disability compensation, this form shares a common goal with the 28-1905M in that it helps determine eligibility for benefits based on specific criteria.

  • VA Form 28-8834: This form deals with claims for educational assistance under the Vocational Rehabilitation and Employment Program, similar in that it gathers necessary information for benefit eligibility.

  • VA Form 21-4142: This form is for obtaining medical records. It is similar to the 28-1905M in that it ensures the VA has relevant information required to process claims and requests efficiently.

  • VA Form 27-2008: The Application for VA Home Loan Benefits allows veterans to apply for housing assistance. It requires documentation akin to the verification process specified in the 28-1905M.

  • VA Form 21-2008: Used to apply for Eligibility for the Veterans' Group Life Insurance program, this form helps ascertain eligibility, similar to the information verification in the 28-1905M.

  • VA Form 22-1995: The Request for Change of Program or Place of Training is relevant for veterans seeking to adjust their educational benefits. It shares the necessity of demonstrating eligibility and suitability for support.

  • VA Form 22-0994: This form is specifically for vocational rehabilitation services, closely mirroring the process of acquiring the necessary supplies outlined in the 28-1905M.

  • VA Form 10-10EZ: The Application for Health Benefits is another document where veterans must provide personal information to access services, similar to the detailed personal history required in the 28-1905M.

Dos and Don'ts

When filling out the VA Form 28-1905M, there are some important do’s and don’ts to keep in mind. Follow these guidelines to ensure your application is submitted correctly.

  • Do read the entire form carefully before filling it out.
  • Do provide complete and accurate information for all sections.
  • Do double-check your entries for spelling and number errors.
  • Do ensure that your signature is in ink on the designated lines.
  • Do keep a copy of the completed form for your records.
  • Don't leave any required fields blank. Every section must be filled out.
  • Don't request items that you already possess or which are available to all trainees.
  • Don't submit the form without the required signatures.
  • Don't ignore instructions for reporting damaged items; make sure to list them correctly.

Misconceptions

  • Misconception 1: The VA Form 28-1905M is only for veterans in vocational training.
  • This form is used for various rehabilitation programs, including independent living and employment assistance. It applies broadly to any veteran enrolled in a VA-approved rehabilitation program.

  • Misconception 2: Once submitted, the VA automatically provides the requested supplies.
  • Submission of the form is only part of the process. The VA evaluates requests based on specific criteria, including verification that the supplies are not already in the veteran's possession and that they are necessary for the training program.

  • Misconception 3: There is no deadline for submitting the form.
  • While there may be flexibility in some cases, it's crucial to submit the form promptly. Delays may affect the timing of resource allocation and can disrupt the veteran's training or rehabilitation efforts.

  • Misconception 4: Veterans can request any supplies they want.
  • Requests must be justified. The veteran must not already possess the items requested, and the supplies must be essential for the training goal, as verified by the VA case manager.

  • Misconception 5: The VA provides tools and supplies to all veterans without any evaluation.
  • The VA assesses each request individually. Supplies can only be provided if the facility/employer requires all trainees to have the same materials and if they have not been previously owned by the veteran.

  • Misconception 6: The information on the form is not protected.
  • All information collected is confidential and protected under the Privacy Act. Unauthorized disclosures are not permissible unless specifically outlined in the act.

  • Misconception 7: Signing the form means the veteran is guaranteed to get the requested items.
  • Signing the form indicates acknowledgment of the requirements, not a guarantee of approval. All requests are subject to the VA's review and eligibility determinations.

  • Misconception 8: Veterans do not need to report back to the VA after receiving supplies.
  • It's mandatory for veterans to complete Section C of the form to certify the receipt of supplies. This step is crucial for maintaining accurate records and ensuring the VA's compliance with regulations.

Key takeaways

Completing and utilizing the VA Form 28-1905M, also known as the Request for and Receipt of Supplies, is crucial for veterans receiving assistance through vocational rehabilitation programs. Here are some key points to keep in mind when filling out this form:

  • Ensure that all required personal information is accurate, including your full name, VA file number, and address where supplies should be sent.
  • This form is necessary if you are entering a VA rehabilitation, independent living, or employment assistance program, and if the specific supplies requested are required for your training or job.
  • The VA will only provide supplies if it is confirmed that you do not already possess these items and if they are part of the requirements set by your facility or employer.
  • It is important to sign Section B, confirming you do not already have the required items. This ensures a smoother processing of your request.
  • After receiving the items, you must complete Section C to certify that the supplies were received in good condition. Report any damaged items to facilitate replacements.

Taking the time to carefully fill out this form can help streamline your access to essential supplies as you pursue your vocational goals.