VA Form 21-0819

VA/DoD Joint Disability Evaluation Board Claim

IDES (Active Duty Separation)Official VA form on VA.gov

Who fills it

service-member-active

Journey phase

Filing Your Claim

Estimated time

30-45 minutes. Work with your Physical Evaluation Board Liaison Officer (PEBLO) for assistance.

When to file

As early as possible after MEB referral. IDES is designed to have VA rating ready by the time DoD PEB proceedings conclude.

You are on active duty and have been referred to a Medical Evaluation Board (MEB) because a condition may prevent continued military service. Filing this form initiates your VA claim concurrently.

Gather before you start

—DoD MEB referral documentation

—List of conditions referred to MEB

—Service treatment records for each referred condition

—PEBLO contact information

—Your service information (branch, SSN, unit)

Attach with the form

—MEB referral documentation

—Service treatment records for conditions being claimed

—Supporting medical records

Section I - Service Member Identification

1 field

Blocks 1-7Name, SSN, DOB, branch, unit, duty station, rankPII

Your active-duty identifying information. Include your rank and current unit for DoD-VA coordination. Your PEBLO should be involved in this filing.

Example

(your legal name, SSN, branch, rank, unit)

Common mistakes

Not involving your PEBLO - the PEBLO coordinates VA-DoD communication and is your main resource during IDES.
Waiting until separation to file - IDES only works while you are still on active duty; filing after separation means the standard VA claims process.

Section II - Conditions Being Claimed

1 field · 1 citation

Blocks 8-14All conditions being claimed through IDES and any additional VA claims

List ALL conditions being referred by the MEB. ALSO list any additional conditions you want VA to evaluate that are NOT part of the MEB referral. The VA evaluation in IDES includes both the MEB-referred conditions and any additional conditions you add. Additional conditions are evaluated by VA as separate disability claims.

Example

MEB-referred: Right knee instability (from fall in training). Additional VA claims: PTSD from deployment 2021, tinnitus from weapons qualification.

Common mistakes

Only listing MEB-referred conditions - any service-connected condition can be added; this is your best window since IDES gives priority processing.
Not claiming PTSD or other mental health conditions if they exist - mental health often causes MEB referrals but may not be the primary reason.

Authority

38 USC 1110 - Service-connected compensation for wartime veterans.

Related ClaimRecon tools

Secondary Finder - Identify secondary conditions to add to your IDES claim.

Section III - Certification

1 field

Blocks 15-16Service member signature and datePII

Sign and date. Your PEBLO typically coordinates the submission through the IDES system.

Example

(signature/date)

Common mistakes

Not understanding that IDES results in both a DoD disability determination (for military retirement/separation purposes) and a VA rating (for ongoing compensation) at the same time.

Statutory & regulatory authority

38 USC 1110 - Service-connected compensation for wartime veterans.

38 USC 5101 - Standardized form requirement.

VA Form 21-0819

VA/DoD Joint Disability Evaluation Board Claim

IDES (Active Duty Separation)Official VA form on VA.gov

Who fills it

service-member-active

Journey phase

Filing Your Claim

Estimated time

30-45 minutes. Work with your Physical Evaluation Board Liaison Officer (PEBLO) for assistance.

When to file

As early as possible after MEB referral. IDES is designed to have VA rating ready by the time DoD PEB proceedings conclude.

You are on active duty and have been referred to a Medical Evaluation Board (MEB) because a condition may prevent continued military service. Filing this form initiates your VA claim concurrently.

Gather before you start

—DoD MEB referral documentation

—List of conditions referred to MEB

—Service treatment records for each referred condition

—PEBLO contact information

—Your service information (branch, SSN, unit)

Attach with the form

—MEB referral documentation

—Service treatment records for conditions being claimed

—Supporting medical records

Section I - Service Member Identification

1 field

Blocks 1-7Name, SSN, DOB, branch, unit, duty station, rankPII

Your active-duty identifying information. Include your rank and current unit for DoD-VA coordination. Your PEBLO should be involved in this filing.

Example

(your legal name, SSN, branch, rank, unit)

Common mistakes

Not involving your PEBLO - the PEBLO coordinates VA-DoD communication and is your main resource during IDES.
Waiting until separation to file - IDES only works while you are still on active duty; filing after separation means the standard VA claims process.

Section II - Conditions Being Claimed

1 field · 1 citation

Blocks 8-14All conditions being claimed through IDES and any additional VA claims

Example

MEB-referred: Right knee instability (from fall in training). Additional VA claims: PTSD from deployment 2021, tinnitus from weapons qualification.

Common mistakes

Only listing MEB-referred conditions - any service-connected condition can be added; this is your best window since IDES gives priority processing.
Not claiming PTSD or other mental health conditions if they exist - mental health often causes MEB referrals but may not be the primary reason.

Authority

38 USC 1110 - Service-connected compensation for wartime veterans.

Related ClaimRecon tools

Secondary Finder - Identify secondary conditions to add to your IDES claim.

Section III - Certification

1 field

Blocks 15-16Service member signature and datePII

Sign and date. Your PEBLO typically coordinates the submission through the IDES system.

Example

(signature/date)

Common mistakes

Not understanding that IDES results in both a DoD disability determination (for military retirement/separation purposes) and a VA rating (for ongoing compensation) at the same time.

Statutory & regulatory authority

38 USC 1110 - Service-connected compensation for wartime veterans.

38 USC 5101 - Standardized form requirement.

VA Form 21-0819

VA/DoD Joint Disability Evaluation Board Claim

IDES (Active Duty Separation)Official VA form on VA.gov

Who fills it

service-member-active

Journey phase

Filing Your Claim

Estimated time

30-45 minutes. Work with your Physical Evaluation Board Liaison Officer (PEBLO) for assistance.

When to file

As early as possible after MEB referral. IDES is designed to have VA rating ready by the time DoD PEB proceedings conclude.

You are on active duty and have been referred to a Medical Evaluation Board (MEB) because a condition may prevent continued military service. Filing this form initiates your VA claim concurrently.

Gather before you start

—DoD MEB referral documentation

—List of conditions referred to MEB

—Service treatment records for each referred condition

—PEBLO contact information

—Your service information (branch, SSN, unit)

Attach with the form

—MEB referral documentation

—Service treatment records for conditions being claimed

—Supporting medical records

Section I - Service Member Identification

1 field

Blocks 1-7Name, SSN, DOB, branch, unit, duty station, rankPII

Your active-duty identifying information. Include your rank and current unit for DoD-VA coordination. Your PEBLO should be involved in this filing.

Example

(your legal name, SSN, branch, rank, unit)

Common mistakes

Not involving your PEBLO - the PEBLO coordinates VA-DoD communication and is your main resource during IDES.
Waiting until separation to file - IDES only works while you are still on active duty; filing after separation means the standard VA claims process.

Section II - Conditions Being Claimed

1 field · 1 citation

Blocks 8-14All conditions being claimed through IDES and any additional VA claims

Example

MEB-referred: Right knee instability (from fall in training). Additional VA claims: PTSD from deployment 2021, tinnitus from weapons qualification.

Common mistakes

Only listing MEB-referred conditions - any service-connected condition can be added; this is your best window since IDES gives priority processing.
Not claiming PTSD or other mental health conditions if they exist - mental health often causes MEB referrals but may not be the primary reason.

Authority

38 USC 1110 - Service-connected compensation for wartime veterans.

Related ClaimRecon tools

Secondary Finder - Identify secondary conditions to add to your IDES claim.

Section III - Certification

1 field

Blocks 15-16Service member signature and datePII

Sign and date. Your PEBLO typically coordinates the submission through the IDES system.

Example

(signature/date)

Common mistakes

Not understanding that IDES results in both a DoD disability determination (for military retirement/separation purposes) and a VA rating (for ongoing compensation) at the same time.

Statutory & regulatory authority

38 USC 1110 - Service-connected compensation for wartime veterans.

38 USC 5101 - Standardized form requirement.

VA Form 21-0819

VA/DoD Joint Disability Evaluation Board Claim

IDES (Active Duty Separation)Official VA form on VA.gov

Who fills it

service-member-active

Journey phase

Filing Your Claim

Estimated time

30-45 minutes. Work with your Physical Evaluation Board Liaison Officer (PEBLO) for assistance.

When to file

As early as possible after MEB referral. IDES is designed to have VA rating ready by the time DoD PEB proceedings conclude.

You are on active duty and have been referred to a Medical Evaluation Board (MEB) because a condition may prevent continued military service. Filing this form initiates your VA claim concurrently.

Gather before you start

—DoD MEB referral documentation

—List of conditions referred to MEB

—Service treatment records for each referred condition

—PEBLO contact information

—Your service information (branch, SSN, unit)

Attach with the form

—MEB referral documentation

—Service treatment records for conditions being claimed

—Supporting medical records

Section I - Service Member Identification

1 field

Blocks 1-7Name, SSN, DOB, branch, unit, duty station, rankPII

Your active-duty identifying information. Include your rank and current unit for DoD-VA coordination. Your PEBLO should be involved in this filing.

Example

(your legal name, SSN, branch, rank, unit)

Common mistakes

Not involving your PEBLO - the PEBLO coordinates VA-DoD communication and is your main resource during IDES.
Waiting until separation to file - IDES only works while you are still on active duty; filing after separation means the standard VA claims process.

Section II - Conditions Being Claimed

1 field · 1 citation

Blocks 8-14All conditions being claimed through IDES and any additional VA claims

Example

MEB-referred: Right knee instability (from fall in training). Additional VA claims: PTSD from deployment 2021, tinnitus from weapons qualification.

Common mistakes

Only listing MEB-referred conditions - any service-connected condition can be added; this is your best window since IDES gives priority processing.
Not claiming PTSD or other mental health conditions if they exist - mental health often causes MEB referrals but may not be the primary reason.

Authority

38 USC 1110 - Service-connected compensation for wartime veterans.

Related ClaimRecon tools

Secondary Finder - Identify secondary conditions to add to your IDES claim.

Section III - Certification

1 field

Blocks 15-16Service member signature and datePII

Sign and date. Your PEBLO typically coordinates the submission through the IDES system.

Example

(signature/date)

Common mistakes

Not understanding that IDES results in both a DoD disability determination (for military retirement/separation purposes) and a VA rating (for ongoing compensation) at the same time.

Statutory & regulatory authority

38 USC 1110 - Service-connected compensation for wartime veterans.

38 USC 5101 - Standardized form requirement.