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The VA Disabled 28-8890 form is a vital resource designed to assist claimants with service-connected disabilities in accessing vocational rehabilitation services. This form, formally known as the Application for Vocational Rehabilitation for Claimants with Service-Connected Disabilities, serves a crucial purpose: helping individuals gain and maintain suitable employment or, if that’s not feasible, achieving greater independence in daily living activities. The process of filling out this form might seem daunting, but its objective is straightforward—gather necessary information to evaluate eligibility for benefits under Chapter 31 of Title 38, U.S.C. Key details needed include the claimant's name, social security number, VA file number, contact information, and education history. Before diving in, it’s essential for applicants to carefully review the information provided on the second page of the form. Once submitted, the VA will conduct a comprehensive assessment, which includes determining whether the claimant meets the entitlement requirements and is within the time limits for these benefits. Through supportive services, vocational rehabilitation counselors (VRCs) provide personalized plans, helping individuals navigate their career paths and overcome barriers they may face. From job training to educational support, these services aim to empower veterans and service members to achieve their goals. Whether you're just starting on this journey or seeking to understand what the form entails, grasping its importance can open doors to invaluable assistance in pursuing a fulfilling career.

Va Disabled 28 8890 Example

OMB Approved No. 2900-0009 Respondent Burden: 15 minutes Expiration Date: 11/30/2022

APPLICATION FOR VOCATIONAL REHABILITATION FOR CLAIMANTS

WITH SERVICE-CONNECTED DISABILITIES

(Chapter 31, Title 38, U.S.C.)

PURPOSE OF VOCATIONAL REHABILITATION: Vocational Rehabilitation and Employment provides services that will assist certain claimants with disabilities in obtaining and maintaining suitable employment. If employment is not an option because of the severity of the claimants' disability conditions, services to assist them to achieve maximum independence in their daily living activities may also be provided. IMPORTANT: To decide if you should fill out this form, please read the information on page 2 of this form.

DO NOT WRITE IN THIS SPACE

(VA DATE STAMP)

1. FIRST, MIDDLE, LAST NAME OF CLAIMANT

2. SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

3. VA FILE NUMBER (If different from Item 2)

4. DATE OF BIRTH (MM-DD-YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. MAILING ADDRESS (Number and street or rural route, City, State and ZIP Code, OR write "None," if no mailing address)

6.MAIN TELEPHONE NUMBER (Include Area Code, or write "None" if no available telephone number)

7.E-MAIL ADDRESS OF CLAIMANT

8.CELL PHONE NUMBER (Include Area Code or write "None" if no available cell phone number.)

9.IF YOU ARE MOVING WITHIN THE NEXT 30 DAYS, PROVIDE YOUR NEW ADDRESS BELOW:

10. NUMBER OF YEARS OF EDUCATION

I HEREBY CERTIFY THAT the information I have entered on this form is true and complete to the best of my knowledge and belief. I realize that making willful false statements concerning a material fact in a claim of vocational rehabilitation benefits is a punishable offense that may result in a fine or imprisonment, or both. (Reference: 38 U.S.C. 3802(a))

11A. SIGNATURE OF CLAIMANT

11B. DATE SIGNED (MM-DD-YYYY)

NOV 2019 28-1900

WHICH WILL NOT BE USED.

PAGE 1

VA FORM

SUPERSEDES VA FORM 28-1900, SEP 2014,

 

INSTRUCTIONS FOR APPLYING FOR VOCATIONAL REHABILITATION SERVICES

TO APPLY OR RECEIVE INFORMATION AND ASSISTANCE:

To apply, you may submit the completed application to the nearest VA office or apply online at www.va.gov.

You may obtain information and assistance from any VBA office or online at http://www.vba.va.gov/bln/vre/index.htm.

Local representative of claimant's service organizations and the American Red Cross also have information and forms available.

Mailing Address: You will not be denied benefits on the basis that you do not have a mailing address under the provisions of 38 U.S.C. 5126. If you do not have a mailing address, please write “none” in response to question 5. However, you must provide an alternative means of contact if you are unable to provide an address or telephone number, so we can schedule your initial evaluation appointment.

EVALUATION: A combined and compensable service-connected disability rating of 10 percent or more by VA is required for you to apply for vocational rehabilitation services. Once your application is received, we will provide you a comprehensive evaluation, where a VA Vocational Rehabilitation Counselor (VRC) will work with you to determine:

1.If you meet the requirements for entitlement Chapter 31 benefits.

2.If you are within the time limit for receiving this benefit, which is generally 12 years from the date VA notified you of your compensation rating for at least a 10% service-connected disability.

PLANNING AND COUNSELING: After a VRC determines that you meet the entitlement requirements, your assigned VRC will assess your vocational rehabilitation and employment needs with you. Subsequently, your VRC will develop a plan of services and assistance with you to help you reach your employment goal. Counseling will be available throughout your program to help you when problems arise.

REHABILITATION SERVICES: Vocational rehabilitation programs do not always require training. You may only need employment services to help you get a suitable job. If your VRC determines that you need training to reach your vocational goal, he or she will also determine the number of months needed to complete your training. You may train in a vocational school, a specialized rehabilitation facility, an apprenticeship program, other on-job training position, a college, or a university.

If training is necessary, VA will provide medical and dental care treatment, assistance to get and keep suitable employment, and other services you may need. If employment is not currently feasible for you, VA may provide services and assistance to improve your ability to live independently.

SUPPORT: VA may pay for tuition, fees, books, equipment, tools, or other supplies you need to succeed in your rehabilitation program. During your training, you may qualify for a monthly subsistence allowance to help you with your living expenses. Payment for subsistence allowance depends on your type of training, rate of attendance, and number of dependents. You will receive this allowance in addition to any VA compensation or military retired pay that you may be receiving.

PRIVACY ACT: The VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e. VA needs the information this form requests to help determine your eligibility to the benefit) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your response is required to obtain benefits (5 CFR 1320.8(b)(3)(iv)). Giving us your Social Security Number (SSN) information is mandatory. Applicants are required to provide their SSN under Title 38 USC 5101 (c) (1). The VA will not deny benefits for any individual refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect.

RESPONDENT BURDEN: We need this information in order for claimants with compensable service-connected disabilities to apply for vocational rehabilitation under title 38, U.S.C. chapter 31. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain.

VA FORM 28-1900, NOV 2019

PAGE 2

 

Form Characteristics

Fact Name Description
Form Purpose The VA Form 28-8890 is used to apply for vocational rehabilitation services for claimants with service-connected disabilities under Chapter 31, Title 38 of the U.S. Code.
OMB Approval This form has been approved by the Office of Management and Budget (OMB) under control number 2900-0009.
Completion Time It is estimated that completing the form will take approximately 15 minutes.
Expiration Date The form is set to expire on November 30, 2022.
Eligibility Criteria A combined service-connected disability rating of at least 10 percent is required to qualify for vocational rehabilitation services.
Time Limit for Benefits Claimants typically have 12 years from the date they were notified of their eligibility for the service-connected disability benefit to apply for vocational rehabilitation.
Privacy Act Compliance The information collected is protected under the Privacy Act of 1974 and can only be disclosed according to the authorized uses outlined.
Support Services If approved, support may include training costs, a monthly subsistence allowance, and other assistance to help claimants achieve their employment goals.

Guidelines on Utilizing Va Disabled 28 8890

Completing the VA Disabled 28 8890 form involves a series of specific steps to ensure that all necessary and accurate information is provided. After filling out this form, applicants may submit it to the nearest VA office or apply online for vocational rehabilitation services. The completion process is crucial for accessing the intended benefits, and careful attention to each detail will aid in a smoother application experience.

  1. Enter your first, middle, and last name in the designated space.
  2. Provide your Social Security number.
  3. If applicable, fill in your VA file number (this number may be different from your Social Security number).
  4. Input your date of birth in the format MM-DD-YYYY.
  5. Indicate your mailing address, including the number and street or rural route, city, state, and ZIP code. If no address exists, write "None."
  6. List your main telephone number including the area code, or write "None" if there is no available telephone number.
  7. Provide your email address.
  8. Supply your cell phone number with the area code, or write "None" if none is available.
  9. If moving within the next 30 days, provide your new address.
  10. State the number of years of education you have completed.
  11. Sign and date the form in the appropriate spaces to certify that the information you have provided is accurate.

What You Should Know About This Form

What is the purpose of the VA Disabled 28 8890 form?

The VA Disabled 28 8890 form, also known as the Application for Vocational Rehabilitation for Claimants with Service-Connected Disabilities, is designed to help veterans access services that support them in achieving gainful employment. In cases where employment is not feasible due to the severity of disabilities, the program aims to foster maximum independence in daily living activities. This form is a crucial step in initiating the process for veterans seeking assistance under Chapter 31, Title 38, U.S.C.

Who is eligible to apply using the VA Disabled 28 8890 form?

To be eligible for vocational rehabilitation services, a claimant must have a combined and compensable service-connected disability rating of at least 10 percent as determined by the VA. In addition, the claimant should be within the time limit for receiving benefits, generally set at 12 years from the date the VA notified them of their compensation rating.

How can I submit the VA Disabled 28 8890 form?

You can submit the completed form to your nearest VA office or opt to apply online at www.va.gov. If you're in need of assistance while filling out the form, local representatives of service organizations or the American Red Cross are available to help. Ensure your submission is complete to avoid delays in processing your application.

What happens after I submit the form?

Once you submit the VA Disabled 28 8890 form, the VA will conduct a comprehensive evaluation to assess your eligibility and vocational rehabilitation needs. A VA Vocational Rehabilitation Counselor (VRC) will reach out to you to discuss whether you meet the requirements for Chapter 31 benefits and to help create a tailored plan that aligns with your employment goals or supports improved independence if employment isn't feasible.

What kind of services can I expect from the vocational rehabilitation program?

Vocational rehabilitation services can vary based on individual needs. Some may require training to reach their employment goals, while others might just need job placement services. If training is deemed necessary, options include vocational schools, colleges, apprenticeship programs, or on-the-job training. The VA also provides medical and dental treatment, as well as help securing and maintaining employment. For those unable to work, assistance for independent living is available.

Will I receive financial support during my rehabilitation program?

Yes, if you qualify, the VA may cover tuition, fees, books, and other necessary supplies for your training. You may also be eligible for a monthly subsistence allowance to help with living expenses. This financial support is in addition to any VA compensation or military retired pay you may already receive.

What should I do if I do not have a mailing address?

If you do not have a mailing address, you can simply write "none" in response to question 5 on the form. However, you must provide an alternative means of contact, such as a phone number or email, to facilitate scheduling your evaluation appointment. The VA does not deny benefits solely based on a lack of mailing address.

How does the Privacy Act affect the information I provide on this form?

Your information will be protected under the Privacy Act of 1974. The VA will only disclose the information collected on the form for purposes authorized by law. It’s important to provide your Social Security Number (SSN) as it is mandatory under specific legislation, but the VA will not deny your application if you refuse to provide your SSN, unless a federal statute specifically requires it.

Common mistakes

Completing the VA Disabled 28-8890 form can be a crucial step for obtaining vocational rehabilitation services. However, many people make common mistakes that can delay their application or lead to complications in the process. Understanding these pitfalls can help ensure a smoother submission.

One frequent mistake is not providing accurate personal information. Claimants might rush through sections like their name, Social Security number, or date of birth. Inaccuracies in these areas can create significant issues, as the VA relies on this information to verify identity. Double-checking all entered data is essential.

Another error involves overlooking the certification statement at the end of the form. Claimants sometimes fail to sign or date the form, which can render it incomplete. This simple oversight can lead to delays or even denial of the application. Signing and dating the form confirms that the information provided is truthful and complete.

Some individuals also misinterpret the requirement for a mailing address. While it's acceptable to indicate "none" if someone does not have a mailing address, failing to provide an alternative means of contact is a mistake. The VA needs a way to reach applicants to schedule appointments or communicate important information.

Additionally, claimants might forget to check if they meet the eligibility criteria before applying. For applicants with a service-connected disability rating of less than 10 percent, the application may not be necessary. Being aware of eligibility can prevent wasted time and effort.

Finally, many applicants do not take the time to thoroughly read the instructions on the form. Skimming through the guidelines can lead to filling out the form incorrectly. Paying close attention to the instructions can help clarify how to provide the necessary information accurately.

Avoiding these mistakes when completing the VA Disabled 28-8890 form can increase the chances of a successful application. Attention to detail is essential, as it contributes to a smoother process and ultimately enhances access to vital vocational rehabilitation services.

Documents used along the form

The VA Disabled 28-8890 form, officially known as the Application for Vocational Rehabilitation for Claimants with Service-Connected Disabilities, plays a crucial role in assisting veterans with service-connected disabilities. Alongside this form, several other documents and forms may be required to support the application process or provide additional information. Understanding these accompanying documents is vital to ensuring a smooth experience as you navigate the vocational rehabilitation process.

  • VA Form 21-526EZ: This form is used to apply for compensation and pension benefits. It enables veterans to submit claims for service-connected disabilities, which are often a prerequisite for accessing rehabilitation services.
  • VA Form 28-1905: This document serves as the referral for vocational rehabilitation services. It is completed by the VA counselor and indicates the type of rehabilitation services recommended for the claimant.
  • VA Form 21-4142: This form is used to authorize the VA to obtain private medical records from healthcare providers. Claimants may need to provide this authorization to help establish the severity of their disabilities.
  • VA Form 20-0995: Known as the Supplemental Claim form, this document allows veterans to submit new evidence or information to support previously denied claims. It can be crucial for those seeking to strengthen their case for rehabilitation services.
  • VA Form 28-1900: This is an earlier version of the application for vocational rehabilitation services. While it has been superseded by the 28-8890, it may still contain useful information for claimants navigating their applications.
  • VA Form 11-2680: This form is utilized for requesting a Certificate of Eligibility for a vocational rehabilitation program. It may be required to establish entitlement to services.
  • VA Form 22-1990: This application for educational benefits can support individuals seeking training or education as part of their rehabilitation plan and may help them understand their eligibility for benefits under various VA education programs.
  • VA Form 29-8286: This form is related to the Servicemembers’ Group Life Insurance program. It helps veterans keep their life insurance benefits in good standing, which might be a component of their overall rehabilitation strategy.
  • VA Form 10-10EZ: This application for health benefits ensures that veterans are aware of their medical care options, which could be essential for those in rehabilitation who may require ongoing healthcare services.

By being familiar with these additional documents, claimants can better prepare themselves for the various steps in the vocational rehabilitation process. This preparation ultimately supports a successful navigation of the available resources to achieve maximum independence and suitable employment following service-connected disabilities.

Similar forms

  • VA Form 28-1900: Like the VA Disabled 28 8890 form, this application is used to apply for vocational rehabilitation services for veterans. It focuses on determining a veteran's eligibility for these benefits based on their service-connected disabilities.
  • VA Form 21-526EZ: This form is for veterans applying for disability compensation, similar to the 28 8890 form in that both require personal information and documentation regarding a service-connected disability to assess eligibility.
  • VA Form 21-4142: Also known as the Authorization to Disclose Information to the VA, this document is utilized to gather relevant medical information from a veteran’s healthcare providers, aiding in the overall evaluation process similar to the 28 8890 form.
  • VA Form 21-534EZ: This form applies when dependents are seeking benefits based on a veteran's service-connected disability. Like the 28 8890, it requires detailed personal and service-related information to establish eligibility.
  • VA Form 22-0994: Intended for veterans applying for educational assistance, this form, similar to the 28 8890, assesses the individual’s needs related to vocational or educational support based on their disabilities.
  • VA Form 27-555: This form is used for veterans seeking assistance for adaptive housing assistance. It shares a common goal with the 28 8890 of improving the quality of life for veterans through tailored services based on their needs.
  • VA Form 28-8832: This document is used to appeal a decision made regarding vocational rehabilitation services. It shares similarities with the 28 8890 as it addresses the outcomes of prior assessments related to service-connected disabilities.
  • VA Form 21-4138: Known as the Statement in Support of Claim, this form allows veterans to provide additional information to support their claims. It operates similarly to the 28 8890 by enhancing the context of the veterans’ situations concerning their disabilities.

Dos and Don'ts

When filling out the VA Disabled 28-8890 form, it is essential to approach the process with care. The following list outlines some key do's and don'ts to keep in mind:

  • Do: Read all instructions carefully before beginning the form.
  • Do: Provide accurate and complete information in each section.
  • Do: Ensure that your signature and date are included at the end of the form.
  • Do: Keep a copy of the completed form for your records.
  • Don't: Leave any mandatory fields blank; incomplete information can delay your application.
  • Don't: Use any form of white-out or correction fluid on the application.
  • Don't: Submit the form without verifying the accuracy of your Social Security Number.
  • Don't: Wait until the last moment to submit your application; allow enough time for processing.

Misconceptions

Misconceptions often surround the VA Disabled 28-8890 form, which is crucial for those seeking vocational rehabilitation services. Addressing these misconceptions can help potential claimants navigate the application process with confidence.

  • Misconception 1: You need to be completely disabled to apply.
  • Many believe that only individuals who are fully disabled can apply for vocational rehabilitation. In reality, a combined service-connected disability rating of just 10% or more qualifies you. The program offers support even if you can still work with accommodations.

  • Misconception 2: This form is only for veterans.
  • While it is true that the form is commonly used by veterans, it also applies to certain service members with service-connected disabilities. You don’t have to be a discharged veteran to take advantage of these services. Active duty members can also apply.

  • Misconception 3: The application process is overly complicated.
  • Though the form may appear lengthy, it’s designed to gather important information efficiently. Most claimants can complete it in about 15 minutes. Additionally, assistance is available from VA offices and various service organizations to help guide you through.

  • Misconception 4: You will be denied if you don’t have a mailing address.
  • Some fear that lacking a mailing address will disqualify them from receiving benefits. However, if you don’t have an address, you can simply state “none” in the relevant section. Just ensure you provide another contact method to facilitate communication.

  • Misconception 5: Vocational training is the only option.
  • While vocational training is a significant part of the program, it isn't the only service offered. If training isn’t necessary for you, the program can provide employment services, independent living support, and other resources to help you achieve your goals.

Key takeaways

Key Takeaways for the VA Disabled 28 8890 Form:

  • This form is for applying to the Vocational Rehabilitation and Employment program for service-connected disabilities.
  • Completion of the form typically takes about 15 minutes.
  • A minimum service-connected disability rating of 10% is required to apply.
  • Provide personal information such as name, Social Security Number, date of birth, and mailing address.
  • If you don't have a mailing address, write "none" in the address field, but provide alternative contact information.
  • After submission, a Vocational Rehabilitation Counselor (VRC) will assess your eligibility and needs.
  • VA may offer assistance with tuition, books, and living expenses during training or rehabilitation services.
  • All information collected is subject to the Privacy Act and will only be disclosed for authorized purposes.