Veterans Affairsmoderate

VA Caregiver Support Application

VA 10-10CG · VA

Application for Program of Comprehensive Assistance for Family Caregivers including stipend, respite care, and health benefits.

Form Details

Total fields: 60
Auto-fillable: 35 (58%)
Time without BeneFill: 40 minutes
Time with BeneFill: 10 minutes
Time saved: 30 minutes
Filled by: both
Frequency: one time

Fill this form with BeneFill

Auto-fill 58% of fields from your profile. Save 30 minutes. Download a real PDF.

35 of 60 fields58% auto-filled

Start Filling Upload Your Copy Instead Download blank official form

Where to Submit This Form

🌐

VA.gov

https://www.va.gov/family-member-benefits/apply-for-caregiver-assistance-form-10-10cg/

Apply online with the veteran present.

📬

Mail

Program of Comprehensive Assistance for Family Caregivers Health Eligibility Center 2957 Clairmont Road NE, Suite 200 Atlanta, GA 30329-1647

Required Attachments

📎 Both veteran and caregiver signatures required
📎 Clinical assessment will be scheduled after submission

Processing Time

90 days. A clinical assessment and home visit will be scheduled.

What Happens Next

VA Caregiver Support team will contact you to schedule a clinical assessment. Both the veteran and caregiver must participate.

You Might Also Need

VA Healthcare Enrollment

VA 10-10EZ · VA

Application for VA health benefits. Requires military service history, current insurance, income/assets, and toxic exposure history.

VA Health Benefits Update

VA 10-10EZR · VA

Health Benefits Update Form for veterans already enrolled in VA health care who need to update personal, insurance, financial, or military service information.

VA Disability Compensation Application

VA 21-526EZ · VA

Application for disability compensation and related benefits for service-connected conditions. Requires linking conditions to military service.

Intent to File a Claim

VA 21-0966 · VA

Preserves the effective date for a VA benefits claim while gathering evidence. Provides 1 year to submit the formal claim.

Authorization to Release Information to VA

VA 21-4142 · VA

Authorization and consent allowing VA to obtain private medical records from non-VA providers for disability claim adjudication.

General Release for Medical Provider Information

VA 21-4142a · VA

Companion form to 21-4142 allowing specific medical professionals to release records to VA for claim processing.

Not sure which forms you need?

Tell our assistant about your situation and we'll find the right forms for you.

Chat with Form Assistant

Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the VA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.