VA Form 10-10d. Application for CHAMPVA Benefits

VA Form 10-10d, Application for CHAMPVA Benefits, is a form used to apply for health care benefits for the spouse or child of a veteran who has been rated permanently and totally disabled for a service-connected disability.

The form consists of several parts, including personal information about the veteran and their spouse/child, information about the veteran's disability and military service, and information about the spouse/child's health insurance coverage.

Important fields on the form include the veteran's name, social security number, and disability rating, as well as the spouse/child's name, social security number, and health insurance coverage information.

The parties involved in completing the form are the veteran and their spouse/child. It is important to consider that the veteran must have a permanent and total service-connected disability in order for their spouse/child to be eligible for CHAMPVA benefits.

When compiling the form, the veteran will need to provide personal information and documentation related to their disability and military service, as well as information about their spouse/child's health insurance coverage.

Additional documents that must be attached to the form include a copy of the veteran's DD-214, a statement from a physician verifying the veteran's disability, and proof of the spouse/child's health insurance coverage.

Examples of application cases include a veteran who has a permanent and total service-connected disability and wishes to enroll their spouse/child in CHAMPVA health care benefits.

Strengths of the form include providing health care benefits to the spouse/child of a disabled veteran, while weaknesses may include the complexity of the form and the additional documentation required.

Related and alternative forms include VA Form 10-10ez, Application for Health Benefits, which is used by veterans to apply for health care benefits for themselves.

To fill and submit the form, the veteran and their spouse/child will need to complete the form and attach the necessary documentation. The form can be submitted online, by mail, or in person at a VA medical center.

The completed form and attached documentation will be stored in the veteran's medical records.