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Glossary

Form 21-4140 Definition

CCK Law: Our Vital Role in Veterans Law

Form 21-4140 is an employment questionnaire. This form takes about five to ten minutes to complete.

VA sends Form 21-4140 to veterans with Total Disability Based on Individual Unemployability (TDIU) when it has indication (e.g., Social Security Administration wage reports) that the veteran may have sustained substantially gainful employment in the previous calendar year. VA used to require veterans with TDIU to complete Form 21-4140 annually to verify their employment status, but this is no longer the case. Regardless, it is still important that veterans respond promptly to any Form 21-4140 requests that they do receive.

Why VBA Requires You to Fill Out Form 21-4140

Form 21-4140 is an employment questionnaire. Since entitlement to TDIU is based on a veteran’s inability to secure and maintain substantially gainful employment as a result of their service-connected disabilities, VA uses this form to confirm that they are still unemployed. VA requires veterans fill out and submit Form 21-4140 on request.

Note: Once you have filled this form out for 20 or more consecutive years, or you are over 70 years old, you are no longer required to submit Form 21-4140.

If VA receives evidence that you earned wages above the poverty threshold for a particular year, it will likely send you a letter notifying you that it may discontinue your TDIU benefits. You will be asked to complete both VA Form 21-4140 and VA Form 21-4148, Statement in Support of a Claim. This will be your opportunity to explain mitigating factors such as, e.g., marginal employment or a sheltered work environment (see below). The letter will give you deadlines for submitting evidence and requesting a hearing, if desired.

If VA sends the letter to the wrong address or does not process your evidence in time, your benefits could be affected. Note that VA-accredited agents or attorneys are permitted to assist you with decision reviews, including denials of TDIU benefits. Contact Chisholm Chisholm & Kilpatrick for a free case evaluation: 800-544-9144.

Information You Will Need to Fill Out Form 21-4140

You will need to provide basic identifying information such as:

  • Your name
  • Social Security Number (be sure to put your Social Security Number on each page)
  • Address
  • Date of birth
  • Phone number
  • Email address (if applicable)
  • Your service number (if applicable)

Form 21-4140 then asks you to list current and past employment for the past year. You must write down:

  • The name and address of the employer
  • The type of work
  • The hours you worked per week
  • The amount of time you worked for the employer
  • The amount of time you lost due to illness if any
  • Your highest gross earnings per month

This helps VA ensure you are staying within the eligibility requirements of TDIU.

Protected Employment and What It Means to You

While entitlement to TDIU is contingent on your inability to secure and maintain substantially gainful employment, this does not necessarily mean you are prohibited from working entirely. There are two important terms you should know in regards to working while receiving TDIU benefits:

Marginal Employment

Marginal employment means that you are employed, but making less than the federal poverty threshold. As of January 2024, this threshold is $15,060 for a single-individual household. Note that this threshold does change annually.

Sheltered Employment

Sheltered employment is a bit more complicated. A protected work environment includes:

  • Employment at a job that makes certain accommodations for the veteran that are not provided to other workers: For example, your employer knows you have post-traumatic stress disorder. He knows large crowds often trigger you. If the business becomes too busy, he allows you to leave or wait in the back until the crowd leaves.
  • Employment at a family business: For example, your uncle knows you need a job. While his hardware store does not require extra workers, he hires you and provides accommodations, such as not holding you to any of the employment standards to which he holds other employees.

If You Need Help With Your TDIU Benefits, Call Chisholm Chisholm & Kilpatrick LTD Today: 800-544-9144

The team at Chisholm Chisholm & Kilpatrick LTD may be able to help with your TDIU benefits. Call today for a free case evaluation: 800-544-9144.

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