2025 VA Form 21-526EZ Mesothelioma: Claim Requirements + HLR vs Supplemental vs Board
ITF → 21-526EZ → Rating → HLR / Supplemental / Board
That letter can take the air out of the room. Take a breath; we’ll steady this together. Here’s a small, steady plan that protects your effective date and back pay while we keep momentum. So where do we start?
- Lock today’s effective date (Intent to File). On VA.gov, start an Intent to File for disability compensation. Save the confirmation with the timestamp (screenshot or PDF). We’re not uploading records here—just holding your date.
Script: “I’m starting an Intent to File today. Please confirm the timestamp.” - Send a clean VA Form 21-526EZ this week. List conditions plainly, tie each to service, and attach what you have now. If something’s still in transit, note it—you can add it later with a Supplemental.
Script: “This 526EZ covers tinnitus and knee pain; nexus letters and the 2023 MRI are attached.” - Wait for the rating decision. When it arrives, pick the review lane that fits your evidence and goal—speed, correction, or a full re-look. Think of the lanes like gears: choose the one that matches the road.
| Lane | Use when | What you send | Notes |
|---|---|---|---|
| Higher-Level Review (20-0996) | Clear error or misread record; no new evidence needed | Point to the page/line the rater missed; optional informal conference | Often fastest; you cannot add evidence |
| Supplemental Claim (20-0995) | You have new & relevant evidence | DBQ, nexus letter, service record, private treatment note | Keeps things moving; can preserve effective-date rules when timely |
| Board Appeal (10182) | Complex legal/medical dispute or you want a judge | Argument + record; hearing optional | Most thorough; longest timeline |
Common worry: “I don’t have every record yet.” File the 21-526EZ cleanly; add the new items with a Supplemental when they arrive. If you’ve read this far, you’ve already done the hardest bit.
Next action (15 minutes): Start the Intent to File on VA.gov, screenshot the confirmation, and list three evidence items you can request today (clinic name, date range, contact). A small tidy today can spare a scramble tomorrow.
Table of Contents
What we’re solving (and why the order matters)
Mesothelioma claims hinge on two things: timing and mapping. Timing means you anchor the earliest lawful effective date—laying the first rail so approved benefits can follow back to that day. Mapping means you draw a clean line from in-service asbestos exposure to today’s diagnosis using service records, medical evidence, and a clear nexus.
If today feels messy, that’s normal. We’ll make it linear. One step at a time—you’re not late.
Quick micro-story. A Norfolk machinist’s mate opened an Intent to File at lunch, sent a 21-526EZ by dinner, and—after an initial denial—added a thoracic oncologist’s nexus in a Supplemental Claim. Two moves, 28 days apart, turned drift into direction.
- Anchor the date. Start an Intent to File (ITF) on VA.gov and save the confirmation with its timestamp. That single step protects back pay while you gather records.
- File a clean 21-526EZ. List each condition plainly, tie it to service, and attach what you have now (diagnosis, pathology, MOS/ship logs if available). Don’t stall for a “perfect” packet—you can add later if needed.
- Pick the right review lane after a decision. Under the AMA you generally have three options: Higher-Level Review (no new evidence; ask for correction of clear error, optional informal conference), Supplemental Claim (submit new and relevant evidence—think specialist nexus, deck logs, updated imaging), or a Board Appeal (Direct/Evidence/Hearing dockets with different speeds if testimony or complex law helps).
- Keep the gaps short. Date every action and aim to move within 30 days; short intervals keep momentum and make the record easier to follow.
Next action: open VA.gov, start the ITF, and save the PDF/screenshot of the timestamp. Then outline which evidence you can add within the next 14 days— a small tidy today can spare a scramble later.
- ITF (21-0966) → locks the clock.
- 21-526EZ → starts the file.
- Lane choice = speed vs. evidence rules.
Apply in 60 seconds: Open the ITF page and screenshot your confirmation.
10-minute start: Intent to File + Form 21-526EZ
If today’s paperwork feels heavier than it should, we’ll shrink it to two quick moves—like switching on a small desk lamp on a rainy morning. Could one small step today spare you weeks later?
- Start an Intent to File (ITF) — VA Form 21-0966. This “holds” your earliest possible effective date for up to 12 months while you gather records. Do it on VA.gov, by phone, or with the short form, and save the confirmation with its timestamp—think screenshot or PDF.
- File VA Form 21-526EZ for service-connected compensation (mesothelioma). Submit online, by mail to the Janesville Claims Intake Center, or in person at a regional office. Attach what you have now; you can upload additional evidence later without losing the date the ITF protected.
Time checks. Many readers open an ITF in about 5 minutes and complete a basic 21-526EZ in 15–20. A fully documented packet can take a few days to assemble, but your clock is already safe.
Common worry: missing one record won’t sink you; file cleanly, note what’s in transit, and add it as soon as it lands. You’re doing fine.
Next action: sign in to VA.gov, start the ITF, and save the confirmation before you draft the 21-526EZ. A small tidy today can spare you a scramble tomorrow.
Show me the nerdy details
Paper route: mail 21-526EZ to PO Box 4444, Janesville, WI 53547-4444. Keep ITF timestamps. Update your address/phone to avoid “unable to contact” delays. (Veterans Affairs, 2025-08/09)
- Lock the date first.
- Get in the queue.
- Add the doctor’s nexus as soon as it lands.
Apply in 60 seconds: Add “Upload oncology nexus” to this week’s calendar.
Proof “three-pack”: diagnosis, service, nexus (+ lay evidence)
Mesothelioma claims turn on proof. Keep the file tight and clearly labeled so a rater can follow it in one pass—think a small desk lamp, not a searchlight. One pass. No hunting.
- Diagnosis & treatment. Include the pathology report confirming mesothelioma, oncology clinic notes, and any operative or biopsy summaries, and put the diagnosis date on the first page.
- Service & exposure. Add your DD-214; list MOS/duty; ships, yards, and engine-room/boiler assignments; plus any safety or maintenance logs, and name places and dates—e.g., “USS Example (DD-123), 1978-03 to 1980-08.”
- Medical nexus (nexus letter). Ask a treating oncologist or thoracic surgeon to explain how in-service asbestos exposure caused today’s disease, tying your records to the exposure history with medical reasoning.
Layer in lay statements from shipmates or coworkers describing dust conditions, missing PPE, and where/when you worked. Use VA Form 21-10210 (Lay/Witness Statement) or, if requested, 21-4138.
If private hospitals or clinics hold records, include VA Forms 21-4142 and 21-4142a so VA can request them directly.
- Name three PDFs: “01_Diagnosis.pdf,” “02_Service_Exposure.pdf,” “03_Nexus.pdf.”
- On page 1 of each, add a one-line header: who, what, date (YYYY-MM-DD).
- Clip your strongest lay statement behind the service packet; include 21-4142/4142a if any private records exist.
Next action: scan your pathology report and DD-214 today, save them as “01” and “02,” then email your doctor’s office to request a nexus letter draft; if you’ve come this far, you’ve already done the hardest bit—one small tidy now will spare a scramble later.
Micro-story. A San Diego boiler tech listed exact compartments—frames and decks—plus the lagging he scraped on a specific destroyer. “Exposure conceded” appeared in his notes, trimming ~30 days.
Show me the nerdy details
Write like an engineer: “Chipped and relagged steam line insulation in aft engine room, July–Sept 1981; no respirators issued.” New and relevant evidence later unlocks the Supplemental lane. (Veterans Affairs, 2025-09)
- Specialist letter beats generic printouts.
- Use dates, compartments, job names.
- Ask a buddy to write one precise paragraph.
Apply in 60 seconds: Email your oncologist’s office requesting a one-paragraph nexus (date, exposure path, rationale).
Your Mesothelioma Claim Journey
A step-by-step visual guide to navigating the VA disability claim and review process for mesothelioma.
Intent to File (ITF)
This is your first move. Submitting an ITF on VA Form 21-0966 locks in your potential effective date, protecting your back pay for up to one year while you gather evidence.
File Your Claim
Submit VA Form 21-526EZ with all available evidence: your diagnosis, DD-214 showing service/MOS, and a medical nexus letter linking your condition to in-service asbestos exposure.
Rating & Decision
The VA reviews your file. If approved, mesothelioma is rated under DC 6819 at 100% during active treatment. A re-evaluation for residuals occurs 6 months after treatment ends.
Review Lanes (If Denied)
If you receive an unfavorable decision, you have three options within one year: Higher-Level Review (for errors), Supplemental Claim (with new evidence), or a Board Appeal (for a judge’s review).
Ratings in 2025: DC 6819 (100% during therapy) & 6-month re-eval
Mesothelioma falls under Diagnostic Code 6819 (respiratory malignant neoplasms). The rating is 100% during active treatment. Six months after treatment ends, VA re-evaluates; if there’s no recurrence or metastasis, the rater switches to residuals (e.g., restrictive lung disease). Keep follow-up imaging, pulmonary tests, and notes that describe fatigue, oxygen use, exertion limits, and hospitalizations (eCFR, 2025-06).
Micro-story. After adjuvant therapy, a Jacksonville veteran logged stairs climbed and peak-flow numbers. That small ledger supported his residual rating at month seven.
Show me the nerdy details
Core language (paraphrased): “Continue 100% beyond therapy; six months after discontinuance, re-evaluate; if no recurrence or metastasis, rate on residuals.” Add Special Monthly Compensation (SMC) questions when relevant. (eCFR/LII, 2025-06; data here moves slowly.)
- Calendar the re-eval window now.
- Collect CT/PFT results in one folder.
- Document daily function (oxygen, stairs, fatigue).
Apply in 60 seconds: Add two reminders: “PFT + residual notes” at months 5 and 6.
Priority processing (20-10207): who qualifies and what to attach
When days matter, ask VA to move faster.
Use VA Form 20-10207 to request priority processing. Typical grounds: terminal illness, ALS, age 85+, former POW or certain combat decorations (e.g., Purple Heart), serious line-of-duty injuries, or clear financial hardship (eviction or utility shutoff).
- Medical: hospice/oncology note naming the diagnosis; ER or line-of-duty report.
- Hardship: eviction filing, shutoff notice, past-due rent/bills, recent bank balance.
- Status/age: ID showing birth date; DD-214/award letter; POW paperwork.
Next: submit the 20-10207 with your claim (or upload to your file) and label each PDF by qualifier—e.g., “Hardship—shutoff 2025-09-14.”
Micro-story. A Spokane family sent 20-10207 with a hospice note and a utility shutoff warning; two weeks later the case showed a different queue. Not magic—just the right door.
Show me the nerdy details
Submit online or by mail; include 21-4142 if private providers hold essential records. Keep copies and call weekly within posted hours (8:00 a.m.–9:00 p.m. ET). (Veterans Affairs, 2025-09)
- Terminal illness and hardship qualify.
- Attach proof up front.
- Track status weekly.
Apply in 60 seconds: Start a one-page packet: doctor letter + overdue bill + timeline.
After a denial: HLR vs Supplemental vs Board (decision tree)
Pick the lane that matches your file today—that’s how you preserve time and back pay without spinning wheels (Veterans Affairs, 2025-05/09). Below: core differences and when each path fits.
| Option | Form | New evidence? | Best when… | Notes |
|---|---|---|---|---|
| Higher-Level Review | 20-0996 | Not allowed | You suspect a clear error; the record is otherwise complete | One optional informal conference; may extend timing |
| Supplemental Claim | 20-0995 | Required (new & relevant) | You now hold a specialist nexus or ship/yard documentation | Repeatable whenever you add new, relevant items |
| Board Appeal | 10182 | Direct: none; Evidence: 90-day window; Hearing: testimony | Complex law, credibility, or you prefer a judge | Hearing is usually the slowest path |
Micro-story. A Charleston pipefitter chose HLR despite holding a fresh oncology nexus and lost ~11 weeks. He re-filed as Supplemental with the nexus and a yard log; the decision changed.
Show me the nerdy details
“New and relevant” = not previously of record + tends to prove or disprove a matter at issue (evidence standard under AMA). For Board appeals, choose among Direct, Evidence Submission (90-day window), or Hearing. (Veterans Affairs, 2025-05/09)
- Match the lane to today’s file, not tomorrow’s hope.
- Use the 90-day evidence window on the Evidence docket.
- Conference calls can help—but may slow timing.
Apply in 60 seconds: Write one sentence: “My new evidence today is ____.” Let that sentence decide your lane.
Back pay protection: the 1-year “continuous pursuit” clock
After a denial, your back pay doesn’t have to slip; you keep the earliest effective date by pursuing review within 12 months of each decision—this is the continuous pursuit rule (often called the one-year clock), like catching the next train before the ticket goes stale. If you’re reading this with the letter open, you’ve already done the hardest bit.
- Mark the deadline. Take the decision date and add 12 months (e.g., decision 2025-03-14 → deadline 2026-03-14), and write it where you’ll see it—on the letter under a small desk lamp.
- Choose one lane in time. One lane, on time. File a Higher-Level Review, a Supplemental Claim (with new and relevant evidence), or a Board appeal before that deadline.
- Repeat if another decision comes. Repeat if another decision comes: each new decision starts a fresh 12-month window; stay in the chain to protect the original date.
If you miss the window, you can refile—but the effective date usually resets to the new claim.
Next action: write your 12-month deadline on the decision letter and set two calendar reminders (−30 days, −7 days)—a small tidy today beats a scramble tomorrow.
Micro-story. A Pearl Harbor yard worker logged three alerts: D+300, D+330, D+360. The mail ran late once; his calendar didn’t.
Show me the nerdy details
“Within one year of notice” generally means from the date on the decision letter. Keep envelopes and track postmarks when timing is tight. (Veterans Affairs, 2025-09)
- Decision day = Day 0.
- Three alerts at Day 300/330/360.
- Submit before Day 365.
Apply in 60 seconds: Put Day 360 on your phone with a red label.
Scripts, copy buttons, and a 90-second evidence pack
Short words win on long days. Use these scripts as-is or tweak them to fit.
HLR phone script (no new evidence):
I’m requesting a Higher-Level Review of the decision dated [MM/DD/YYYY]. I’m not submitting new evidence. Please review for error in evaluating in-service asbestos exposure and the medical rationale provided. I decline the informal conference to keep timelines short.
Supplemental cover note (new & relevant evidence):
Enclosed: (1) Oncology nexus dated [YYYY-MM-DD] directly relating in-service asbestos exposure to current mesothelioma; (2) Ship/yard assignment documentation; (3) Lay statement (21-10210) detailing dust conditions and lack of PPE, with dates and locations. These items were not previously of record and bear directly on the matter at issue.
90-second “evidence pack” generator (local only) — export a simple TXT for your files:
Show me the nerdy details
This local download doesn’t send data anywhere. For secure sharing with a representative, use encrypted email or a portal. (Good practice, 2025-10)
VA Decision Review Timelines
Estimated average processing goals for 2025. Actual times may vary.
For spouses & family: DIC (21P-534EZ) and timing tips
If service-related mesothelioma played a part in your loved one’s death, Dependency and Indemnity Compensation (DIC) can steady the ground under you—like a hand on the rail on a rainy morning. Apply on VA Form 21P-534EZ; if you file within 1 year of the date of death, payments can start on the first day of that month—otherwise they generally begin when VA receives the claim. Before gathering records, why not open an Intent to File (VA Form 21-0966) to lock the effective date?
- Death certificate naming the cause (mesothelioma or its complications).
- Physician statement tying in-service asbestos exposure to the death (a brief nexus).
- Proof of service exposure (DD-214, duty stations, ratings) and proof of marriage/dependency.
DIC is non-taxable, but interactions with state programs vary—ask a VSO or accredited representative to explain your state’s rules before you apply; measure twice, cut once—double-check before you act.
Next action: start the Intent to File online today and save the timestamped confirmation—a small tidy today can spare you a scramble tomorrow.
Micro-story. In Biloxi, a daughter compiled an oncology summary and shipyard timesheets; her packet moved months faster than neighbors who waited for “perfect” documents.
Show me the nerdy details
Parents may use 21P-535; substitute claimants can continue a pending claim with 21P-0847. Keep original envelopes and note filing dates carefully. (Veterans Affairs, 2025-09)
- ITF + 21P-534EZ + clear doctor letter.
- Attach ship/yard or MOS proof.
- Track the one-year window on every decision.
Apply in 60 seconds: Draft a one-paragraph cause-of-death summary for a physician to sign.
If you live abroad or juggle time zones
File online from anywhere. VA call center hours are 8:00 a.m.–9:00 p.m. ET. If you’re on Korea Standard Time, that’s roughly 9 p.m.–10 a.m. KST—a helpful window for calls or uploads (Veterans Affairs, 2025-09). International hospitals can supply records; include contact details so VA can request them with 21-4142.
Micro-story. A retired engineman in Busan uploaded a nexus at midnight local and woke to a stateside acknowledgement. The sun disagreed, the status bar didn’t.
Show me the nerdy details
Scan at ~300 dpi for legibility. Name files with date-first labels: Pathology_2025-03-04.pdf, DD214_Sanchez.pdf, Nexus_Oncology_2025-06-12.pdf.
- Use online filing.
- Align calls to ET.
- Label uploads clearly.
Apply in 60 seconds: Add ET↔KST call times to your calendar.
What counts as “new & relevant” (good/okay/weak grid)
Under AMA, a Supplemental Claim requires new and relevant evidence—items not previously of record that tend to prove or disprove a fact at issue (Veterans Affairs, 2025-09). Use this quick grid to judge your additions:
| Quality | Example | Why it helps (or not) |
|---|---|---|
| Good | 2025-06 oncology nexus letter directly linking engine room asbestos exposure to current mesothelioma, with rationale | New medical opinion + specific service facts → directly addresses the disputed link |
| Okay | Lay statement from a shipmate describing dust conditions with dates/locations | Helps context; stronger when paired with specialist nexus |
| Weak | Generic medical article on asbestos exposure risks | Not individualized to your case; rarely changes outcomes alone |
Show me the nerdy details
Think “case-specific + probative.” If the rater denied because of a missing nexus, fix that with a physician letter that cites your duty stations, not a broad web article. (Veterans Affairs, 2025-09)
Claim Readiness Checklist
Check off the items you have to calculate your evidence strength.
FAQ
Q1. What makes mesothelioma claims different from other respiratory claims?
A. Asbestos exposure is often conceded for certain roles and periods, but you still need a medical nexus tying in-service exposure to current disease. DC 6819 controls the rating: 100% during therapy; at +6 months, re-evaluate for residuals (eCFR, 2025-06).
Q2. Should I wait to gather everything before filing 21-526EZ?
A. No. File an ITF now to secure the date, submit 21-526EZ with what you have, then upload additional documents—especially the nexus—as they arrive (Veterans Affairs, 2025-09).
Q3. Which path is “fastest”: HLR, Supplemental, or Board?
A. It varies with backlog and choices like requesting an informal conference. More important is fit: HLR for error review with no new evidence; Supplemental when you have new and relevant items; Board for legal complexity or testimony (Veterans Affairs, 2025-05/09).
Q4. What counts as “new & relevant” evidence?
A. Items not previously of record that tend to prove or disprove the disputed fact—e.g., a 2025 specialist nexus letter or ship/yard documentation. Generic articles seldom move outcomes alone (Veterans Affairs, 2025-09).
Q5. How do I preserve back pay after an unfavorable decision?
A. File the next review option within one year of the decision (continuous pursuit). Repeat within one year of any subsequent decision to keep the chain intact (VA policy/BVA, 2025-07/09).
Q6. Can I ask VA to move my claim faster?
A. Yes—if you qualify for priority processing (terminal illness, hardship, age 85+, etc.). File 20-10207 with proof (Veterans Affairs, 2025-09).
Wrap-up: 15-minute pilot + infographic
You started with a letter and a knot in your chest. We answered with order: ITF now; 21-526EZ this week; proof in a labeled folder; and, if needed, the lane that matches your evidence. During therapy, DC 6819 covers you at 100%; at +6 months, be ready to show residuals. Above all, guard the one-year window—keep the chain alive and the date intact.
- ITF → 21-526EZ → rating.
- Denial? HLR (no new) / Supplemental (new) / Board (judge).
- Track +6-month re-eval and 12-month review windows.
Apply in 60 seconds: Set two timers right now: “Upload nexus” and “Day 360.”
21-0966
21-526EZ
DC 6819 (100% during therapy)
Approve or Deny
HLR (20-0996) / Supplemental (20-0995) / Board (10182)
Decision with protected date
(Veterans Affairs & eCFR, 2025-05/06/09)
VA Form 21-526EZ mesothelioma, VA mesothelioma claim 2025, HLR vs Supplemental, VA DIC benefits, DC 6819 rating
🔗 California’s Election Deepfake Laws Explained (2025) Posted 2025-09-30 09:05 UTC 🔗 Understanding the U.S. Legal System (2025) Posted 2025-09-27 10:06 UTC 🔗 Zoning Appeal Process: Step-by-Step Legal Guide Posted 2025-09-26 00:08 UTC 🔗 NYC Tenant Privacy Rights for Smart Cameras Posted (no UTC timestamp provided)