The VBA VA 28-1902w form is a critical document for veterans seeking educational benefits through the U.S. Department of Veterans Affairs. It serves as an application for education benefits, enabling veterans to access programs designed to aid in their post-service educational pursuits. To streamline the process of securing these benefits, interested individuals are encouraged to fill out the form by clicking the button below.
Embarking on the journey of understanding and utilizing the VBA VA 28-1902w form is a significant step for veterans seeking to avail themselves of educational benefits. This pivotal document serves as a gateway for those who have served their country to access a range of opportunities designed to aid in their transition to civilian life through higher education or vocational training. It plays a crucial role in the Veterans Affairs' mission to support service members by simplifying the process of claiming benefits they are rightfully entitled to. The form itself is meticulously designed to gather essential information from applicants, ensuring that the benefits they receive are tailored to their unique circumstances and aspirations. By providing details about their service, educational history, and desired educational or training programs, veterans set the groundwork for a future that acknowledges their service and sacrifices. Thus, the importance of this form cannot be overstated—it acts not only as a procedural step but as a bridge to new beginnings, facilitating a smoother transition for veterans aspiring to further their education or career paths post-service.
OMB Control No. 2900-0092
Respondent Burden: 45 Minutes
Expiration Date: 08-31-2018
REHABILITATION NEEDS INVENTORY (RNI)
Privacy Act Notice: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., to determine entitlement to vocational rehabilitation benefits and to plan a program of rehabilitation services) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your obligation to respond is voluntary. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect. Information submitted is subject to verification through computer matching programs with other agencies.
Respondent Burden: We need this information for educational and vocational planning to help you make the best use of your vocational rehabilitation benefits. Title 38, United States Code chapter 31, allows us to ask for this information. We estimate that you will need an average of 45 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at http://www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.
1. NAME (First, middle, last)
2. TELEPHONE NUMBER(S)
HOME PHONE NUMBER
CELL PHONE NUMBER
WORK PHONE NUMBER
3. CURRENT ADDRESS
4a. E-MAIL ADDRESS 1
4b. E-MAIL ADDRESS 2
5. GENDER
6. MARITAL STATUS
7. CLAIM NUMBER
8. SOCIAL SECURITY NUMBER
MALE
FEMALE
9. CLAIMING DEPENDENTS?
10. NICKNAME/AKA
11. EMERGENCY CONTACT INFORMATION
YES
NO #
CONTACT NAME
CONTACT PHONE NUMBER
CONTACT RELATIONSHIP
12.HOW DO YOU EXPECT THIS PROGRAM TO HELP YOU?
13.WHAT ARE THE JOBS OR CAREER FIELDS YOU ARE MOST INTERESTED IN?
14.HAVE YOU EVER PARTICIPATED IN OR ARE CURRENTLY PARTICIPATING IN A VA EDUCATION BENEFIT PROGRAM?
NO
14A. HAVE YOU EVER PARTICIPATED IN A PROGRAM OF VOCATIONAL REHABILITATION BEFORE?
YES NO
(If "Yes," complete Items 14B and 14C)
14B. CHECK ALL THAT APPLY IN WHICH YOU HAVE PARTICIPATED
WORKER'S COMP
PRIVATE
STATE VOCATIONAL REHABILITATION
OTHER (Please explain)
VA VOCATIONAL REHABILITATION
14C. LIST ANY TYPE OF SERVICES YOU WERE PROVIDED (i.e., training, medical, vocational testing, functional capacities, job search activities):
EMPLOYMENT
Please fill out each area as completely as possible. If you have a resume, please attach it.
15.CIVILIAN EMPLOYMENT HISTORY: Please start with your most current position.
JOB TITLE
DATES
AVERAGE GROSS
FROM
TO
MONTHLY SALARY
COMPANY NAME
STATUS
A
TEMPORARY ASSIGNMENT OR CONTRACT
PART TIME
PERMANENT POSITION
FULL TIME
DESCRIBE JOB DUTIES IN DETAIL
REASON FOR LEAVING
B
VA FORM
28-1902w
SUPERSEDES VA FORM 28-1902w, FEB 2012,
SEP 2015
WHICH WILL NOT BE USED
15. CIVILIAN EMPLOYMENT HISTORY (CONTINUED)
C
D
16. MILITARY WORK HISTORY: What did you do in the military? Please fill out the following area as completely as possible.
Please start with your last assignment.
HIGHEST RANK ACHIEVED:
ARMED SERVICES:
ARMY
NAVY
AIR FORCE
MARINES
COAST GUARD
LIST ANY HONORS AND COMMENDATIONS
RANK
17. WOULD IT BE POSSIBLE FOR YOU TO RETURN TO WORK IN A FORMER OCCUPATION OR FOR A FORMER EMPLOYER?
VA FORM 28-1902w, SEP 2015
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MILITARY WORK HISTORY (CONTINUED)
18.WHAT WORK SKILLS DID YOU USE IN YOUR PREVIOUS POSITIONS THAT YOU THINK YOU MAY BE ABLE TO USE IN A NEW JOB?
19.PLEASE EXPLAIN WHAT YOU DID DURING PERIODS OF UNEMPLOYMENT 3 MONTHS OR LONGER:
EDUCATION AND TRAINING
Please fill out the area below regarding your education/training background as completely as possible.
Please include vocational, college, on-the-job, and other training. NOTE: Please include civilian and military schools/training.
20. MARK HIGHEST LEVEL COMPLETED:
SOME HS - HIGHEST GRADE COMPLETED:
MASTER DOCTORAL
HS - YEAR
GED - YEAR
ASSOCIATE
BACHELOR
21A. NAME OF SCHOOL
21B. DATES (MM/YYYY)
FROM TO
21C. GPA
21D.
CREDITS/
CLOCK
HOURS
21E. MAJOR COURSE
OF STUDY
21F. DEGREE (if any),
YEAR RECEIVED
22A. WHAT SUBJECTS DID YOU LIKE?
22B. WHAT SUBJECTS DID YOU DISLIKE?
1
2
3
23A. DO YOU HAVE ANY CURRENT VOCATIONAL CERTIFICATES AND/OR LICENSES?
(If "Yes," complete Items 23B and 23C)
23B. LIST CERTIFICATES/LICENSES
23C. DATE
(Apprentices or journeyman card, truck driver/CDL, etc.)
EXPIRES
24. HAVE YOU BEEN DIAGNOSED WITH A LEARNING DISABILITY? (If "Yes," please describe below):
DISABILITIES
List and describe your service-connected disability(ies). Please list the disability(ies) in order of severity.
25A. SERVICE-CONNECTED DISABILITY
25B. RATING
(%)
25C. WHAT DIFFICULTIES ARE YOU EXPERIENCING DUE TO YOUR
DISABILITIES?
26A. NON SERVICE-CONNECTED
DISABILITY
26B. RATING
26C. WHAT DIFFICULTIES ARE YOU EXPERIENCING DUE TO YOUR
27. HAS YOUR SERVICE-CONNECTED DISABILITY(IES) AFFECTED YOU IN THE FOLLOWING AREAS OF WORK? (Check all that apply)
JOB PERFORMANCE
JOB OPPORTUNITIES
CO-WORKER RELATIONS
JOB SATISFACTION
MISSED WORK TIME
MANAGER RELATIONS
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DISABILITIES (CONTINUED)
28.ARE ANY OF YOUR DISABILITIES IMPROVING? YES NO
29.ARE YOUR DISABILITIES STABLE? YES NO
30.ARE ANY OF YOUR DISABILITIES WORSENING? YES NO
31. DO YOU RECEIVE ANY OF THE FOLLOWING? (Check all that apply)
RETIREMENT (Military/civilian)
DISABILITY PENSION (Military/civilian)
UNEMPLOYMENT
WORKERS COMPENSATION BENEFITS
SOCIAL SECURITY DISABILITY INCOME (SSDI/SSI)
ALIMONY/CHILD SUPPORT
WELFARE ASSISTANCE
MEDICARE/MEDICAID
OTHER
32. DO YOU HAVE A CLAIM PENDING FOR ANY OF THE FOLLOWING? (Check all that apply)
MEDICAL TREATMENT
Please describe medical treatment you have received or are receiving.
33A. CONDITION
33B. NAME OF VA OR PRIVATE
MEDICAL FACILITY
33C. HOW OFTEN SEEN
FOR TREATMENT
33D. MEDICATION(S) PRESCRIBED
34A. DO YOU HAVE MEDICAL NEEDS
34B. WHAT DO YOU NEED?
THAT ARE NOT BEING MET?
(If "Yes," complete Item 34B)
35A. DO YOU USE ANY ADAPTIVE
35B. PLEASE DESCRIBE YOUR ADAPTIVE EQUIPMENT
EQUIPMENT SUCH AS BRACES,
ARTIFICIAL LIMBS, HEARING AIDS,
ETC?
(If "Yes," complete Item 35B)
36A. ARE THERE OTHER PROBLEMS
36B. PLEASE LIST OTHER PROBLEMS OR ISSUES WITH WHICH YOU WOULD LIKE HELP
OR ISSUES WITH WHICH YOU
WOULD LIKE HELP?
(If "Yes," complete Item 36B)
37. DO YOU HAVE ANY PENDING VA CLAIMS?
NO (If "Yes," please describe below)
38. DO YOU NEED INFORMATION ABOUT OTHER VA BENEFITS OR PROGRAMS?
MISCELLANEOUS
The following information will be used for employment planning purposes.
39A. DO YOU:
RENT
OWN
39B. DO YOU HAVE STABLE HOUSING AT PRESENT?
(If "No," complete Item 39C)
39C. DESCRIBE YOUR CURRENT LIVING SITUATION:
40A. WHAT MODE OF TRANSPORTATION DO YOU USE?
PERSONAL
PUBLIC TRANSPORTATION
40B. HOW FAR ARE YOU WILLING TO COMMUTE FOR WORK AND/OR SCHOOL?
40C. DO YOU HAVE A VALID DRIVER'S LICENSE?
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MISCELLANEOUS (CONTINUED)
41. ARE YOU WILLING TO RELOCATE FOR A JOB?
42. IF YOU HAVE HAD A HISTORY OF OR ARE CURRENTLY DEALING WITH LEGAL ISSUES, PLEASE SELECT AND DESCRIBE BELOW:
BANKRUPTCY
MISDEMEANOR
FELONY
PROBATION
PAROLE
N/A
43. IF YOU HAVE HAD AND/OR PRESENTLY HAVE SUBSTANCE ABUSE ISSUES, PLEASE SELECT AND DESCRIBE BELOW:
ALCOHOL
DRUGS (Illicit)
DRUGS (Prescription)
44. IF YOU HAVE A HISTORY OF OR ARE CURRENTLY IN ON-GOING TREATMENT(S) FOR SUBSTANCE ABUSE(S), PLEASE DESCRIBE BELOW:
45. DID ANYONE HELP YOU COMPLETE THIS FORM?
DATE COMPLETED
PROTECTION OF PRIVACY INFORMATION STATEMENT
(For use by counselees and rehabilitation program participants)
I have been informed and understand that the information requested in this and any later interviews is requested under the authorization of Title 38, United States Code, 1.576, Veterans Benefits. This information is needed to assist in vocational and educational planning, to authorize my receipt of rehabilitation services, to develop a record of my vocational progress, and to assure I obtain the best results from my rehabilitation program. I understand that the information I provide will not be used for any other purpose and that my responses may be disclosed outside the VA only if the disclosure is authorized under the Privacy Act of 1974, including the routine uses identified in VA system of records, 58VA21/22/28, Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA, published in the Federal Register. Generally, disclosures under the authority of a routine use will be made to develop my claim for vocational rehabilitation benefits under title 38, United States Code.
My giving the requested information is voluntary. I understand that the following results might occur if I do not give this information:
(1)I may not receive the maximum benefit either from counseling or from my education or rehabilitation program.
(2)If certain information is required before I may enter a VA program, my failure to give the information may result in my not receiving the education or rehabilitation benefit for which I have applied.
(3)If I am in a program in which information on my progress is required, my failure to give this information may result in my not receiving further benefits or services.
My failure to give this information will not have a negative effect on any other benefit to which I may be entitled.
I HEREBY CERTIFY THAT the information I have given above is true and correct to the best of my knowledge and belief.
SIGNATURE OF VETERAN
DATE SIGNED
SIGNATURE OF CASE MANAGER OR VOCATIONAL REHABILITATION COUNSELOR (VRC)
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Filling out a VBA VA 28-1902w form is a crucial step in accessing benefits and services provided by the Veterans Benefits Administration. This process can be overwhelming, but breaking it down into manageable steps can simplify it. Ensuring every section is completed accurately is vital to avoid unnecessary delays. Below is a step-by-step guide to assist in filling out the form efficiently and correctly.
After submitting the VBA VA 28-1902w form, an acknowledgment of receipt should be issued by the Veterans Benefits Administration. They will review the application and may request additional information if necessary. Patience is important during this period as processing times can vary. Keep a copy of the completed form and any correspondence for personal records. This careful documentation can assist in tracking the application's progress and resolving any potential issues that might arise.
This form, issued by the Department of Veterans Affairs (VA), is designed for veterans seeking to apply for Vocational Rehabilitation and Employment (VR&E) benefits and services. It serves as the initial application that veterans must fill out to determine their eligibility for the program, which supports those who face challenges in living and working due to service-connected disabilities.
Eligibility primarily includes:
This form can be accessed through several channels:
Completing the form requires various pieces of information, including:
Once filled out, the form can be submitted through the following ways:
Filling out forms is often seen as a straightforward task, but when it comes to documents that impact one's access to benefits or services, such as the VBA VA 28-1902w form related to Veteran's benefits, accuracy and attention to detail become paramount. Unfortunately, errors are not uncommon and can lead to delays or denials in receiving the assistance needed. Let's explore five common mistakes people make when completing this form.
Not Double-Checking Personal Information: It might seem simple, but inaccuracies in personal details such as names, social security numbers, or dates of birth can lead to significant processing delays. It's crucial for individuals to review their personal information meticulously before submission.
Leaving Sections Incomplete: Every section of the VBA VA 28-1902w form serves a purpose, and omitting information can result in an incomplete application that cannot be processed. Applicants often overlook sections that they think might not apply to them or they are uncertain how to fill. If in doubt, seeking clarification is better than leaving a blank space.
Failure to Provide Required Documentation: The form often requires supplementary documents to support the application, such as medical records or proof of military service. Failure to attach these necessary documents can stall the application process. It is important for individuals to carefully review the documentation requirements and ensure all needed materials are submitted together with the form.
Misunderstanding the Questions: Some questions on the form may be phrased in a way that applicants find confusing, leading to incorrect or incomplete answers. This misunderstanding can be mitigated by reading the instructions carefully or seeking assistance if the phrasing is unclear.
Forgetting to Sign and Date the Form: An unsigned or undated form is incomplete in the eyes of the processing agency. A common oversight is rushing through the paperwork and neglecting this final, but critical, step. Ensuring the form is signed and dated verifies that the information provided is accurate to the best of the applicant's knowledge.
To sidestep these pitfalls, applicants should approach form completion patiently and attentively. Utilizing resources such as instructions, help lines, and consultation services can also provide guidance and bolster the chances of a successful application process. When in doubt, thoroughness is key.
When applying for Veterans' education benefits, the VBA VA 28-1902w form is just the beginning. Veterans commonly need to submit additional documents to complete their application process or to maintain their benefits. These documents help verify eligibility, academic progress, and personal circumstances that can affect benefits. Below is a list of six other forms and documents frequently used alongside the VBA VA 28-1902w form, each with a brief description.
Together, these documents play a vital role in the application and maintenance of Veterans' education benefits. Each form or document serves a specific purpose, from proving eligibility to changing program details, making the process smoother for veterans and their dependents. Understanding the importance and function of these additional forms can significantly impact the efficient handling of one’s education benefits.
VA Form 22-1990 - Application for Education Benefits: The VBA VA 28-1902w form is designed for individuals seeking vocational rehabilitation and employment (VR&E) services from the Department of Veterans Affairs. Similarly, the VA Form 22-1990 is used by veterans, service members, and select reservists to apply for education benefits under the various GI Bill programs. Both forms serve as gateways for beneficiaries to access programs aimed at enhancing their educational opportunities and employability, and require detailed personal, military, and educational background information.
VA Form 21-526EZ - Application for Disability Compensation and Related Compensation Benefits: Like the VBA VA 28-1902w, the VA Form 21-526EZ is a critical document for veterans seeking benefits from the VA. While the 28-1902w focuses on vocational rehabilitation and employment services, the 21-526EZ is specific to those applying for disability compensation. Both forms necessitate a thorough declaration of personal information, military service, and the specifics of either disabilities or vocational needs, aimed at obtaining VA support.
VA Form 22-1995 - Request for Change of Program or Place of Training: Veterans or service members who wish to adjust their educational trajectory utilize the VA Form 22-1995. This form mirrors the VBA VA 28-1902w in its purpose to realign benefits to better suit current needs or circumstances. Whether changing institutions, programs, or seeking VR&E services over education benefits, applicants are required to provide detailed updates about their needs and objectives, maintaining alignment with VA's goals to support their transition and success.
VA Form 10-10EZ - Application for Health Benefits: While the VA Form 10-10EZ is primarily used for enrolling in the VA healthcare system, it shares similarities with the VBA VA 28-1902w by facilitating access to essential VA benefits. Both forms collect comprehensive personal and military service data to determine eligibility and offer services tailored to the applicant's needs. The 10-10EZ specifically caters to health service requirements, showing the VA's broad commitment to veteran welfare across different areas of support, including health and employment.
When filling out the VBA VA 28-1902w form, an essential document for veterans seeking vocational rehabilitation and employment benefits, clarity and accuracy are paramount. The following are six dos and don'ts to ensure your application is processed smoothly and effectively.
When dealing with the Veterans Benefits Administration (VBA) and specifically the VA 28-1902w form, which is designed for individuals seeking vocational rehabilitation services, there are several misconceptions that can lead to confusion. Here, we'll address some of the most common misunderstandings to clarify the process and requirements.
Misconception 1: The VA 28-1902w form is only for service-connected disabilities. Many believe that the VA 28-1902w form and the vocational rehabilitation program it's associated with are exclusively for veterans with service-connected disabilities. Although individuals with service-connected disabilities may qualify for certain benefits, the program also extends to active duty service members awaiting medical separation for conditions that are expected to lead to a discharge.
Misconception 2: You must be unemployed to apply. It's a common belief that in order to be eligible for vocational rehabilitation programs through the VA, one must be unemployed. However, this is not the case. The program is designed to assist veterans and service members in finding employment that accommodates their disabilities, which includes those who are currently employed but unable to effectively perform their job duties due to their disabilities.
Misconception 3: The form is too complicated to fill out without professional help. Many individuals feel intimidated by the VA 28-1902w form due to its importance in the application process for vocational rehabilitation services and believe they need professional assistance to complete it. While seeking help from a VA counselor or a legal advisor can be beneficial, especially for complicated situations, the form is designed to be straightforward. Following the instructions provided and completing each section as accurately as possible is often sufficient for most people.
Misconception 4: Submission of the VA 28-1902w form guarantees immediate benefits. Submitting the VA 28-1902w form is an important step in applying for vocational rehabilitation services, but it does not guarantee immediate approval or benefits. After submission, the application undergoes a review process, which includes evaluation of the individual's eligibility, need for services, and potential to benefit from the program. The complexity of each case can affect how quickly a decision is made.
Here are key takeaways about completing and utilizing the VBA VA 28-1902w form, essential for veterans seeking educational benefits. Understanding these points can aid in a smooth application process.
By following these guidelines, veterans can navigate the application process for VR&E benefits more effectively, moving closer to achieving their vocational and educational goals.
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