RETURN TO VA DATE STAMP DO NOT WRITE IN THIS SPACE NOTE: You can either complete the form online or by hand. VA FORM SEP 2017 21-4192 SUPERSEDES VA FORM 21-4192, JUL 2015, WHICH WILL NOT BE USED. 2,104 43.VA Form 21-4192: Request for Employment Information In Connection With Claim For Disability Benefits Whenever a veteran decides to apply for a Total Disability Rating Based on Individual Unemployability (TDIU), they will need to complete a VA Form 21-8940. Thank you, somehow I put the wrong form number in the title and just corrected it. That will provide the VA with the information required for an IU claim from a self-employed veteran.

ThanksThe best thing to do is complete and submit a VA Form 21-4192 with your claim.

Where it says 'last' do they mean just the last employer? Still waiting on my VSO to give me a call on this, so if anyone in the know feels like replying, I'd appreciate it. On Ebenefits, it states, ' Ask your last employer to complete and return the enclosed VA Form 21-4192, Request for Employment Information' under request 1.

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