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VA Form 21-2680

Aid & Attendance Examination

Apply for extra help if you need daily assistance due to your disabilities.

21-2680

After Your Rating

What this form does

Apply for extra help if you need daily assistance due to your disabilities.

Documents the need for Aid and Attendance or Housebound benefits that may be added to qualifying compensation or pension benefits.

Official VA title: Examination for Housebound Status or Permanent Need for Regular Aid and Attendance

VA revision February 28, 2023 · Links verified against VA.gov August 10, 2026

Use it when: When a Veteran or eligible survivor needs regular help with daily activities or is substantially confined because of permanent disability, and is applying for an added compensation or pension amount.

Preparation route

How to use 21-2680

Every preparation step stays open so you can scan the whole job before starting.

  1. Do now · 01

    Before you start

    Estimated time
    Requires a physician examination

    Use this form when: When a Veteran or eligible survivor needs regular help with daily activities or is substantially confined because of permanent disability, and is applying for an added compensation or pension amount.

  2. Gather · 02

    Gather your documents

    Required

    • Physician's examination and signature — Your doctor must complete the medical portion of this form based on an examination.

    Helpful when available

    • Medical records documenting daily limitations — Records showing the need for regular help with daily activities.
  3. Waypoint · 03

    Complete the form

    • Current medical conditions requiring assistance
    • Specific daily activities requiring help
    • Whether you are able to leave your home
    • Physician's assessment and signature
  4. Waypoint · 04

    Avoid common mistakes

    • Not getting a thorough physician examination
    • Underreporting the level of assistance needed
    • Not describing all daily activities affected
    • Confusing Aid & Attendance with Housebound — you may qualify for either
  5. Go next · 05

    Submit the form

    Available methods

    • Online
    • Mail
    • In person
    Mail to
    Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365
    Submission note
    This form must be completed by a physician. Bring it to your doctor appointment or have them mail it directly.

Field note

Have your doctor fill this out honestly and thoroughly. The more specific the documentation of your daily limitations, the stronger your case.

Continue the route

Forms are just one piece. Make sure your full claim is solid.

Build your next route

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Tell Wayfinder what's going on. It returns a focused route: what to do now, what to gather, and where to go next.

  1. Do now
  2. Gather
  3. Go next