Veterans with legacy Government Life Insurance who become totally disabled file this claim for disability insurance benefits or a premium waiver. Part II is the attending practitioner's report: when the illness began, treatment, objective findings, diagnosis, hospitalization and prognosis, including whether the Veteran can do their own work or any other work. VA's Insurance Center decides the claim.
Part I is completed by the insured Veteran, or someone acting for them. Part II is completed and signed by the Veteran's attending licensed practitioner of the healing arts, acting within their scope of practice, or by the appropriate hospital official.
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Claim for Disability Insurance - Government Life Insurance
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The Veteran's attending licensed practitioner of the healing arts, acting within the scope of their practice, or the appropriate hospital official. Part II covers history, dates of first treatment and of stopping work, objective findings, diagnosis with special studies, hospitalization and prognosis, and is signed with the preparer's title.
It is only for Veterans holding Government Life Insurance, VA's legacy programs such as NSLI, USGLI and S-DVI. Veterans with more than one policy complete a separate form for each policy number. Premium refunds are limited to one year before the claim date unless circumstances beyond the Veteran's control, such as a severe mental disability, prevented earlier filing.
Item 8 asks for the date of the last exam, objective findings and the diagnosis causing disability, whether the Veteran can do all of their own work and whether they can do any other work, the AHA functional class if cardiac, the level of mental or nervous impairment, and whether the condition improved, worsened or stayed the same.