Employment Questionnaire
Use this only when VA asks you to verify employment while receiving Individual Unemployability benefits.
21-4140
After Your Rating
What this form does
Use this only when VA asks you to verify employment while receiving Individual Unemployability benefits.
Responds to a VA request to verify employment status for someone receiving Individual Unemployability benefits.
Official VA title: Employment Questionnaire
VA revision August 2, 2024 · Links verified against VA.gov August 10, 2026
Use it when: Only when VA sends you a notice asking you to verify your employment status. VA uses wage matching and does not require every TDIU recipient to submit this annually.
Preparation route
How to use 21-4140
Every preparation step stays open so you can scan the whole job before starting.
Do now · 01
Before you start
Use this form when: Only when VA sends you a notice asking you to verify your employment status. VA uses wage matching and does not require every TDIU recipient to submit this annually.
Waypoint · 02
Complete the form
- Current employment status
- Any income earned in the past 12 months
- Whether you have started or stopped working
Waypoint · 03
Avoid common mistakes
- Not returning the form — the VA may reduce your TDIU benefits
- Not reporting marginal employment (even small amounts of income)
Go next · 04
Submit the form
Available methods
- Online
- Mail to
- Return to the address listed on the form the VA sends you.
- Submission note
- Submit online or return it to the address in VA’s notice by the stated deadline.
Field note
Follow the deadline in VA’s notice. Current VA guidance says you generally have 65 days from the notice date to return the form or submit it online.
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