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Va 21P-8416 Form: What You Should Know
Include all medically related expenses. Also include any costs related to your active duty status. Include your employer's share of these expenses. In addition, be sure to pay interest to the government for any charges that exceed your allowable medical expense limit. NOTE: The medical expenses reported must relate to medical care provided by a health care provider. Your health care provider must be listed on the report. Report your health care provider and the actual cost of your medical care. Do not include: -- Expenses for any services you provided in or from the military or Veterans Administration facilities; or -- Inpatient care. Do include: Medical expenses paid for yourself or relatives who are members of your household. In addition, you must include any costs for military service to provide assistance to someone with a disability. It does not matter whether you have worked for the VA or worked directly for the person with a disability. Any claims for expenses under the Family and Medical Leave Act (FMLA), the Disability Allowances for the Blind and Visually Impaired (DAVIS), or the Special Sick Leave for Civil Service Members (SS CMS) must also be included. If you have not worked or worked directly for someone with a disability before, your report may include work-related expenses. Report your health care provider and the actual cost of your medical care. In addition, report any costs related to your VA disability rating, including any costs of receiving disability benefits. You do not have to complete the report within 45 days of your expenses, but some expense reports are required in 30-day increments. Your medical expenses report must be completed online. If you decide to submit more than one report, you must complete a paper report, including the following information and attachments: -- Report covering the entire time period within which your expenses are incurred. -- All health care-related information for all medical services rendered before, during and after your disability. -- Your employer's share of your actual medical expenses and any costs that exceed the medical expense limit. -- The final statement of your medical expenses, including the medical records. Your report must include all allowable expenses. Do not include medical services and equipment listed in your medical records, or costs that exceed your allowable medical expense limit. Report your health care provider and the actual cost of your medical care.
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