Form VA 10-10CG


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What is VA Form 10-10CG?

The VA Form 10-10CG fillable is an application required for the special assistance program. Certain categories of veterans who need extra help with day-to-day activities may designate a primary caregiver and two additional ones. These people might receive certain benefits from the VA.

Form VA 10-10CG on PDFLiner

What do I need the VA Caregiver Form 10-10CG for?

  • If you are a former military (veteran) who, as a result of military service, has received illnesses or injuries that seriously complicate your peaceful life, you can appoint assistants.
  • To participate in the PCAFC, your overall impairment rate should be 70% or more, which makes you unable to perform daily activities, need regular assistance, and your life will be incomplete without outside supervision.
  • By filling in the VA Form 10-10CG printable, you consent to the program eligibility screening.

How to Fill out VA Form 10 10CG fillable?

  1. First, you need to fill in the details of the veteran: name, birth date, SSN, gender, address, contact details, the health center where they receive care, and the name of the medical institution they last visited. The veteran or their official representative must sign the paper.
  2. Now, fill in the primary caregiver information: full name, SSN, address, date of birth, contact details, relationship to the applicant, and health coverage. The appointed person must put their signature.
  3. You can also designate two additional caregivers by providing the same information about them as the primary one. If you don't need more help, skip these blocks.
  4. You can apply online or bring the file in person to the nearest VA facility.

Form VA 10-10CG on PDFLiner

Organizations that work with VA Form 10-10CG PDF

  • Department of Veteran Affairs
Fillable online Form VA 10-10CG
(5 / 5) 39 votes
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