Transcription of REQUEST FOR EMPLOYMENT INFORMATION IN …
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REQUEST FOR EMPLOYMENT INFORMATION IN …
SECTION III - RESERVE OR NATIONAL GUARD DUTY STATUS (Only complete if claimant is currently serving in the Reserve or National Guard)SECTION II - EMPLOYMENT INFORMATION (To be completed by employer)SECTION I - IDENTIFICATION INFORMATION 7. BEGINNING DATE OF EMPLOYMENT INSTRUCTIONS: The veteran named in Item 3 has filed a claim for veterans disability benefits and has stated that he/she was recently employed by you. In order to arrive at a fair decision in this case, we need the INFORMATION requested below. Please complete Sections II, III and IV and return to this office at the address below. Please be sure to sign and date this form in Items 23A and 23B. For free help in completing this form, call VA toll-free at 1-800-827-1000.
We need this information to determine eligibility for disability benefits based on unemployability (38 U.S.C. 1521). Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form.
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