VA Form 21-686c: Declaration of Status of Dependents

Before a living veteran can sponsor his or her family for CHAMPVA benefits, the veteran must get a permanent and total disability rating from the Department of Veterans Affairs.  And that means being entitled to receive a monthly disability compensation which can be increased based on the number of one’s dependents.  To declare one’s qualifying dependents, the veteran should sue VA Form 21-686c.  This same form is used to update one’s list of dependents whenever there is a change, such as a divorce, a new marriage or a new birth.


End of Advertisement

About VA Form 21-686c

This form is fairly self-explanatory. The top group of items seeks information about the veteran including name, SSN and VA claim number if there is one; and name, SSN and address of the claimant if other than the sponsoring veteran.

Section I is to list the veteran’s current and previous marriages (if any).  The current marriage goes at the top of the list. The names of each current or former spouse, date and place of marriage, and date and place where it was terminated, must be provided.  Only the present spouse’s SSN is required.

Section II is devoted to the spouse’s previous marriages, and whether or not the spouse is also a veteran.

Section III is for the veteran’s children.  Each child’s name, date and place of birth and SSN are required.  You must also specify whether the child is a biological child, adopted child, step child, a child between 18-23 and enrolled in school, a “seriously disabled” child or one who was previously married.  If you claim the child as seriously disabled – that is, a “helpless child” – you must attach supporting evidence such as the physician’s statement, medical diagnosis, etc.

The claimant signs the fom, to be submitted to one’s local VARO or VA Regional Office.

When to Use VA Form 21-686c?

This VA form can be used whenever you need to update your status of dependents.  That could mean either adding a new family member – such as a newborn child – or removing one, such as an ex-husband or ex-wife after a divorce.

Some applicants prefer to attach photocopies of civil documents such as marriage certificate and birth certificates of children, even if they have sent these before.

The speed of processing depends on the VA Regional Office that serves the area where the veteran’s family lives.  If adding a dependent, you should get back pay for the months (or years) it took VA to adjudicate your claim.

More Information

To download a fillable version of this form, please click here (VA official page).

If you need more information or a clarification, please contact your local VA Regional Office.

Related Articles:

This website,, is NOT affiliated with the Department of Veterans Affairs or any part of the U.S. government. Please DO NOT send us information about yourself such as your SSN, name, address, etc. for help with CHAMPVA…. The pharmacy network for CHAMPVA now is Catamaran (formerly SXC)…. Further, we cannot guarantee that the information here is accurate and up-to-date. To ensure you have the latest information, please visit the official CHAMPVA home page at Your use of this site means you agree to and understand this disclaimer. Thank you!

Post Footer automatically generated by Add Post Footer Plugin for wordpress.


End of Advertisement


Comments are closed.