VA Statement in Support of Claim
VA Statement in Support of Claim (21-4138 equivalent)
Fields
- veteran_name
- claim_number
- conditions
- evidence_summary
Template
STATEMENT IN SUPPORT OF CLAIM
Veteran: {veteran_name}
Claim Number: {claim_number}
Date: {date}
I, {veteran_name}, submit this statement in support of my claim for service connection for the following condition(s):
{conditions}
STATEMENT OF FACTS:
{statement_of_facts}
EVIDENCE IN SUPPORT:
{evidence_summary}
LEGAL STANDARD:
Under 38 U.S.C. § 5107(b), when there is an approximate balance of positive and negative evidence, the benefit of the doubt shall be given to the claimant (Gilbert v. Derwinski, 1 Vet. App. 49 (1990)).
{legal_arguments}
I certify that the statements made herein are true and correct to the best of my knowledge and belief.
___________________
{veteran_name}
Date: {date}