Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

VA Form 21-2680 is used to determine eligibility for the aid and attendance and/or housebound benefit. The purpose of this examination is to record manifestations and findings pertinent to the question of whether the claimant is housebound (confined to the home or immediate premises) or in need of the regular aid and attendance of another person. The report should be in sufficient detail for the VA decision makers to determine the extent that disease or injury produces physical or mental impairment, that loss of coordination or enfeeblement affects the ability: to dress and undress; to feed themselves; to attend to the wants of nature; or keep themselves ordinarily clean and presentable. Findings should be recorded to show whether the claimant is blind or bedridden. Whether the claimant seeks housebound or aid and attendance benefits, the report should reflect how well they ambulate, where they go, and what they are able to do during a typical day.

The latest form for Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680) expires 2026-04-30 and can be found here.