VA Claim Preparation Worksheet

Organize your conditions and documents before a VSO or VA appointment. The sheet builds live and prints clean.

Educational reference only. The numbers on this page summarize public service regulations for planning purposes. They are not official medical, recruiting, or administrative determinations. Always confirm your status with a recruiter, commanding officer, or hiring agency using the official assessment.

Fill in your conditions and dependents. A clean, printable preparation sheet builds live — bring it (and your documents) to a VSO or VA appointment.

Your name (optional)
State of residence

Service-connected conditions

Condition
Rating % / paired?
Condition
Rating % / paired?
Spouse
Children under 18
Children 18–23 in school
Dependent parents

VA Disability Claim Preparation Sheet

Prepared by VivMetric · 9/5/2026

Estimated combined rating

40%

Estimated 2026 monthly compensation

$882.84 / month (tax-free)

Conditions listed

  • Unnamed condition30%
  • Unnamed condition10%

Documents to bring

  • DD-214 (Certificate of Release or Discharge from Active Duty)
  • Current VA disability rating decision letter
  • Medical records supporting each claimed condition
  • Dependency evidence (marriage certificate, child birth certificates, school enrollment for 18–23)
  • List of medications and treating providers

Estimates only — based on the VA efficiency formula and the 2026 compensation schedule. The official combined rating and payment are determined by the VA. Confirm with a VSO.

Source & verification

  • Combined rating and compensation estimates use 38 CFR § 4.25 / § 4.26 and the VA.gov FY2026 schedule.
  • Retrieved and verified: 2026-08-23. This worksheet is a planning aid, not a filing.

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