Application for Dependency and Indemnity Compensation by Parent(s)
You are the surviving parent (biological, adoptive, foster, or step-parent who stood in loco parentis) of a veteran who died from a service-connected disability.
Gather before you start
Attach with the form
Section I - Parent Identification
Blocks 1-6Parent name, SSN, DOB, address, phone, relationship typePII
Your information. Relationship types: biological parent, adoptive parent, foster parent (if you stood in loco parentis for at least one year before the veteran turned 21), stepparent (only if you were married to the veteran's biological parent). Each qualifying parent files separately.
e.g., Mary Jane Smith, SSN: 567-89-0123, DOB: 12/05/1948; biological mother
- Both parents filing one form - each parent must file separately under their own identity.
- Foster parent not documenting in loco parentis relationship - VA needs evidence you stood as a parent for 1+ years before veteran turned 21.
Section II - Veteran Information
Blocks 7-12Veteran name, SSN, VA File Number, service dates, date and cause of deathPII
Identify the deceased veteran. Include VA File Number from any prior VA correspondence. The cause of death and service-connected conditions are critical for DIC eligibility - the veteran must have died from a service-connected condition.
(veteran's identifying information, VA file number, date and cause of death)
- Not documenting the service-connected cause of death - parents' DIC requires the death was service-connected.
- Omitting VA File Number - delays matching to veteran's existing records.
Section III - Parent's Income and Net Worth
Blocks 13-25All income and assets (parents' DIC is income-tested)
IMPORTANT: Unlike spousal DIC, parents' DIC IS income-tested. The benefit decreases as income increases, to zero above a certain threshold. Report all income: Social Security, pension, wages, interest, dividends, rental income, trust distributions. Report net worth: bank accounts, investments, real estate (excluding primary home). Lower income means higher parents' DIC benefit.
e.g., SSA retirement: $1,200/mo; No other income. Net worth: checking $4,500, savings $12,000, IRA $28,000.
- Not knowing parents' DIC is income-tested - many eligible parents assume it is like spousal DIC (no income test) and skip filing thinking they earn too much.
- Not filing because income is moderate - the calculation tapers gradually; even moderate-income parents may receive meaningful benefits.
- Not reporting your spouse's income if married - household income counts.
Section IV - Certification
Blocks 26-27Parent signature and datePII
Sign and date under penalty of perjury.
(your signature/date)
- Not attaching documentation of parental relationship - VA cannot approve the claim without it.