VAFORMS.NET – VA Form 10-10d – Application for CHAMPVA Benefits – The VA Form 10-10d is the application for CHAMPVA benefits. This form must be completed by all applicants who wish to receive benefits from the VA. The application also requires all applicants to sign it. VA instructions detail who may sign for the veteran. By signing the form, the applicant agrees to pay copayments for VA care and receive communication from the VA. While providing your personal contact information is voluntary, it is a good idea to provide it.
Download VA Form 10-10d – Application for CHAMPVA Benefits
| Form Number | VA Form 10-10d |
| Form Title | Application for CHAMPVA Benefits |
| Edition Date | April 2022 |
| File Size | 832 KB |
What is a VA Form 10-10d?
The VA Form 10-10d is a basic application used to assess third-party liability for healthcare services. It is required by the Federal Medical Care Recovery Act, which requires the VA to recover costs associated with healthcare services. This act is outlined in 42 U.S.C. 2651 to 2653 and 38 CFR 1.900 et seq. It also includes Executive Order 9397, which gives the VA additional authority to recover costs.
This form is used to apply for CHAMPVA Benefits, which are provided by the Department of Veterans Affairs to surviving spouses and children of deceased Veterans. CHAMPVA covers some health care services and supplies for qualifying veterans and surviving spouses and children of deceased veterans. The applicant must disclose other health insurance and report any changes.
The VA Form 10-10d template simplifies the process of filling out and submitting this form. It is available online in a PDF format and is editable. It is also signable electronically. Using an advanced editor will allow you to make changes to the form without any risk of mistakes.
Where Can I Find a VA Form 10-10d?
For those of you who are unable to obtain the VA form 10-10d from your local government, you can find printable forms online. These forms are available in a variety of formats, including PDFs. They can be printed and signed electronically, and you can also customize and personalize them. Once you have found the form you want, it’s easy to download it and fill it out online. Moreover, you can share the form with others as well.
The VA Form 10-10d is a basic document that is used by the government to assess the liability of a third party for medical expenses. This document is required under the Federal Medical Care Recovery Act, which mandates the recovery of costs for healthcare services. This law is found in 42 U.S.C. 2651-2653 and 38 CFR 1.900 et seq. Further, Executive Order 9397 provides additional authority to recover costs for healthcare.
VA Form 10-10d – Application for CHAMPVA Benefits
The VA Form 10-10D is used to apply for CHAMPVA benefits, which are health insurance benefits for eligible veterans and their dependents. The benefits are paid by the Department of Veterans Affairs and include some health care services and supplies. In some cases, these benefits are extended to the spouse or dependent child of a deceased Veteran.
The application for CHAMPVA benefits must include the required documents, as well as the optional documents. Depending on the information submitted, processing may take anywhere from two to eight months. This is because the VA needs to verify information provided by other federal agencies. It will also review the application for accuracy, and if it is incomplete, it will return the application with additional instructions.
The VHA also seeks comments on the proposed collection of information. The agency seeks to determine whether the proposed collection of information is necessary for the proper performance of its functions and whether the burden of information collection is fair and reasonable. By doing so, the agency seeks to increase the quality and utility of the collected information and to minimize the burden on respondents. In some cases, this includes using information technology and automated collection techniques.
VA Form 10-10d Example
