Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

VA Form 21-2680 is used to determine eligibility for the aid and attendance and/or housebound benefit. VA Form 21-2680 is being revised to include: • New standardization data points; to include optical character recognition information. This is a non-substantive change. • New data question added; defining which benefit the respondent is applying for. This question does not increase the burden.

The latest form for Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680) expires 2021-09-30 and can be found here.