Priority Processing Request
Your claim is pending and you qualify for expedited processing.
Gather before you start
Attach with the form
Section I - Veteran/Claimant Identification
Blocks 1-5Name, SSN, VA File NumberPII
Match exactly to your VA records as they appear on every prior letter or DD-214 - any mismatch causes intake delays.
(legal name)
- Mismatched name/SSN.
Section II - Eligibility
Block 6Eligibility category
Check ALL that apply: TERMINAL ILLNESS (life expectancy <= 6 months per doctor); FINANCIAL HARDSHIP (eviction, utility shut-off, foreclosure pending); HOMELESS (or at imminent risk); AGE 85+; MEDAL OF HONOR; FORMER POW.
Check all applicable
- Claiming hardship without documentation - VA requires proof (eviction notice, foreclosure filing, utility shut-off letter).
- Claiming terminal illness without doctor letter stating <= 6-month prognosis - VA cannot process expedite without medical certification.
Section III - Supporting Evidence
Block 7Description of attached supporting evidence
Per category: terminal = doctor letter with prognosis; hardship = court/bank docs; homeless = shelter letter or affidavit; 85+ = DOB on file; MoH = citation; FPOW = service records.
e.g., Doctor letter dated 03/15/2026 from Dr. Smith confirming 4-6 month prognosis (Stage IV pancreatic cancer)
- Submitting without supporting evidence - request denied.
- Vague descriptions - examiner can't verify eligibility.
Section IV - Signature
Blocks 8-9Signature and datePII
Sign and date under penalty of perjury. Knowingly false statements are a federal crime.
(signature/date)
- False eligibility claim - federal fraud.
- Forgetting to sign.