Va Form 21-0304 - Application For Benefits For Certain Children With Disabilities Born Of Vietnam And Certain Korea Service Veterans Page 3
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3APPLICATION INFORMATION AND INSTRUCTIONS FOR VA FORM 21-0304
IMPORTANT - Please read information and instructions before completing attached application.
Children of Women Vietnam Veterans Born with Certain Birth Defects -- 38 U.S.C. 1815
This section of the law authorizes the payment of monetary benefits to, or on behalf of, certain children of
female veterans who served in Vietnam. Benefits are payable to qualifying children, or on their behalf,
beginning December 1, 2001. There are three eligibility requirements. To be eligible, the child must:
be the biological child of a woman veteran who served in the Republic of Vietnam (RVN),
have been conceived after the date the veteran first served in the RVN during the
period 2/28/61 to 5/7/75, and
have certain birth defects identified by the Secretary of Veterans Affairs as resulting in
permanent physical or mental disability
The law does not include conditions that are:
a familial disorder
a birth-related injury, or
a fetal or neonatal infirmity with well-established causes.
Completion of VA Form 21-0304, Application For Benefits For Certain Children Of Vietnam Veterans With
Disabilities, is required.
The effective date is December 1, 2001.
Spina Bifida Benefits Eligibility -- 38 U.S.C. 1805
Monetary benefits may be paid to, or on behalf of, certain children of veterans who served in the Republic
of Vietnam or the demilitarized zone in Korea during the Vietnam era. Benefits are payable to qualifying
children regardless of age or marital status. To be eligible, the child must:
be the biological child of a veteran who served in the Republic of Vietnam (RVN), or a
veteran who served in or near the demilitarized zone (DMZ) in Korea and was exposed to
herbicides, and
have been conceived after the date the veteran first served in the RVN during the period
1/9/62 and 5/7/75, or after the date the veteran first served in or near the DMZ in Korea
during the period 9/1/67 to 8/31/71, and
have any type of spina bifida other than spina bifida occulta. The diagnosis may be
established by private physicians, or government or private institution examination reports.
Possible Entitlement:
The law does not allow payment of both benefits at the same time. If entitlement
exists under both laws, benefits will be paid under 38 U.S.C. 1815.
Health Coverage:
The law allows health care covering the defects or any disability associated with the
birth defects. This care may be provided directly or by contract.
Vocational Rehabilitation:
If achievement of a vocational goal is reasonably feasible, a program of
vocational training provided by VA's Vocational Rehabilitation and Employment Service is available to an
eligible child.
Monetary Allowance:
The law includes levels of monetary allowance, each based on the level of
disability of the eligible child.
Mail The Completed Form To:
VA Regional Office
Veterans Service Center (339/21)
Box 25126
Denver, CO 80225
VA FORM
21-0304
SEP 2006
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