VA Form 21-2680 is a physician examination form that helps the VA determine whether a veteran or surviving spouse needs the daily assistance of another person or is substantially housebound. Completing and submitting this form is the critical first step to unlocking Aid and Attendance (A&A) benefits — either as Special Monthly Compensation (SMC) for service-connected veterans or as an added pension supplement for veterans and surviving spouses receiving non-service-connected VA pension. In 2026, the A&A pension supplement brings a veteran's maximum pension to roughly $2,296 per month.
What Is Aid and Attendance?
Aid and Attendance (A&A) is a VA benefit available to veterans and surviving spouses who need the regular help of another person to perform everyday activities — things like bathing, dressing, eating, or going to the bathroom. It is also available to people who are bedridden or who have severe visual impairment.
A&A is not the same as housebound status, though both are documented on the same form. Here is the difference:
| Status | Definition | Benefit Level |
|---|---|---|
| Aid and Attendance | Needs daily personal assistance or is bedfast or blind | Higher benefit amount (SMC-L or A&A pension supplement) |
| Housebound | Substantially confined to the home due to permanent disability | Lower benefit amount than A&A, still above basic pension rate |
Who Fills Out Form 21-2680?
The form has three sections. Here is who is responsible for each:
- Section I — Physician Certification: A licensed physician (MD or DO) examines the veteran and documents functional limitations. This is the most important section — the VA uses it to decide whether A&A or housebound status is warranted.
- Section II — Physician Examination Findings: The examining physician records specific physical and cognitive findings, including vision, mobility, and ability to perform activities of daily living (ADLs).
- Section III — Claimant's Statement: The veteran, surviving spouse, or their representative fills out this section to describe care needs in their own words.
The VA does not schedule the examination — you bring the blank form to your own doctor, who completes it and signs it. You then submit the completed form to the VA along with your benefits application.
What Conditions Qualify for Aid and Attendance?
According to VA regulations, a person qualifies for A&A if they meet at least one of the following:
- Requires the aid of another person to dress or undress, feed themselves, or attend to sanitary needs
- Is bedridden because of disability
- Is a patient in a nursing home because of mental or physical incapacity
- Has visual acuity of 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less
Two Paths to A&A Benefits
Form 21-2680 can support two very different types of VA benefits depending on the veteran's situation:
Path 1: Special Monthly Compensation (SMC) — Service-Connected Veterans
Veterans who have a service-connected disability and also need regular A&A can qualify for SMC-L (or a higher SMC tier). SMC is paid on top of regular disability compensation. A veteran rated 100% who also qualifies for SMC-L receives substantially more than the standard 100% rate. See our full breakdown at Special Monthly Compensation explained.
To claim SMC for A&A, submit Form 21-2680 along with VA Form 21-526EZ.
Path 2: VA Pension A&A Supplement — Low-Income Veterans and Surviving Spouses
Veterans and surviving spouses who receive VA pension (non-service-connected) can receive a higher pension rate if they need A&A. In 2026, the A&A pension supplement brings the maximum annual pension rates to approximately:
| Claimant Type | 2026 Maximum Monthly Pension (A&A) |
|---|---|
| Veteran with no dependents | ~$2,296/month |
| Veteran with one dependent | ~$2,727/month |
| Surviving spouse (no dependents) | ~$1,556/month |
| Surviving spouse with one dependent child | ~$1,859/month |
Note: The VA pension is needs-based. The VA pays the difference between the maximum annual pension rate (MAPR) and your countable income. The figures above are the MAPRs, not guaranteed payment amounts. The 2026 net worth limit for pension eligibility is $163,699.
Housebound Pension Rates (2026)
If a veteran is housebound but does not need personal daily assistance, the housebound pension supplement applies — at a rate lower than A&A but higher than basic pension. Check the current VA pension rates page at VA.gov for the precise housebound MAPR.
How to Submit VA Form 21-2680
- Download the blank form from VA.gov.
- Bring it to your treating physician. Explain that you are applying for VA Aid and Attendance or housebound benefits and need them to complete Sections I and II. Bring any relevant medical records to help them document your condition accurately.
- Complete Section III yourself (or have a family member or VSO assist you).
- Determine which VA benefit you are claiming — SMC or pension — and attach the correct application form (VA Form 21-526EZ for disability/SMC, or VA Form 21-527EZ for pension).
- Submit the complete package to your VA regional office by mail, fax, or in person. You can also submit through an accredited Veterans Service Organization (VSO) representative.
Tips for a Stronger A&A Application
- Be specific in Section III. Describe exactly what help you need every day — not just "I need help" but "I cannot bathe without my spouse's help because I lose my balance."
- Ask your doctor to be thorough. Vague entries like "patient needs assistance" are weaker than specific functional descriptions with clinical findings.
- Include medical records that support the need for assistance, especially notes from home health visits, physical therapy evaluations, or hospital discharge summaries.
- Work with a VSO. An accredited Veterans Service Organization representative can review your application before submission at no cost. Find one at VA.gov/vso.
A&A and Your Disability Rating
If you are a service-connected veteran but your current disability rating does not reflect how much your condition has worsened, you may also benefit from filing for an increased rating. Use our free VA disability rating calculator to see what your combined rating might be, and visit our guide on TDIU if your disabilities prevent you from working.
Next Steps
If you or a loved one needs daily assistance and may qualify for VA A&A benefits, here is what to do:
- Download VA Form 21-2680 and schedule an appointment with a treating physician.
- Contact a free VSO representative to help you package and submit the claim.
- If the veteran has a service-connected disability, review our SMC explainer to understand how A&A stacks with disability compensation.
- If the veteran has not yet filed a disability claim, start with VA Form 21-526EZ.