# VA Form 10-10D

URL: https://pdf.net/pdf-forms/healthcare-forms/va-form-10-10d
Category: Healthcare Forms
Attributes: Official IRS form, Trusted by accountants

VA Form 10-10D is a document used by veterans’ beneficiaries or survivors when applying for the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

Access the fillable VA Form 10-10D on our website to complete it quickly in our PDF editor. Thanks to our simple and intuitive editing tools, you’ll finish customizing the document in less than 15 minutes.

## Versions

- 2025 — [download PDF](https://cdn.sanity.io/files/i16te7yp/production/3998c46b3ad5e11b85ed68c3d85f936ff9f3bca5.pdf)

## How to Fill Out a VA Form 10-10D

Step 1: Check your eligibility for CHAMPVA benefits.

Step 2: Open VA Form 10-10D in our PDF editor.

Step 3: Fill out the section about the veteran’s personal details (name, SSN, address, whether they are deceased, etc.).

Step 4: Complete Section II with applicant information according to the VA Form 10-10D instructions.

Step 5: Sign the form or have another person sign it for you.

Step 6: Submit the document to the VA.

## Facts

### What Is VA Form 10-10D Used For?

VA Form 10-10D is used to apply for the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). This is a comprehensive health insurance program in which the VA shares the cost of covered healthcare services and supplies.

### Who Should Use VA Form 10-10D?

VA Form 10-10D is used by the spouses and dependents of veterans with disabilities caused or related to their service. Furthermore, if a veteran dies due to a service-related condition or during active duty, their surviving beneficiaries have the right to apply for CHAMPVA benefits.

### When Is the VA Form 10-10D Due?

VA Form 10-10D has no strict deadline; it should be submitted whenever the applicant becomes eligible for the benefits, which is after a veteran’s death or when the VA rates them as disabled.

### What Happens If VA Form 10-10D Is Not Submitted?

If VA Form 10-10D isn’t submitted, the veteran’s spouses, children, and other beneficiaries won’t have access to CHAMPVA benefits. This form is optional and voluntary, so there are no penalties for not filing it even when you are eligible.

### How and Where Do I File VA Form 10-10D?

You should file VA Form 10-10D with the Veterans Affairs, either by mail or online. If you opt for the former, send your completed document to the Office of Integrated Veteran Care, whose address can be found on the official VA website. Otherwise, use the online portal for faster filing.

## Related forms

- [VA Form 21-526EZ](https://pdf.net/pdf-forms/military-forms/va-form-21-526ez)
- [VA Form 21-674](https://pdf.net/pdf-forms/education-forms/va-form-21-674)
- [Form DD 2656](https://pdf.net/pdf-forms/healthcare-forms/form-dd-2656)
- [VA Form 10-5345a](https://pdf.net/pdf-forms/healthcare-forms/va-form-10-5345a)
- [VA Form 10-2850c](https://pdf.net/pdf-forms/healthcare-forms/va-form-10-2850c)