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VA Form 21-10210: Lay/Witness Statement Guide

What VA Form 21-10210 is, how to complete and submit a Lay/Witness Statement, and where to find the official VA form and buddy letter examples.

Fact checked

VA Form 21-10210, officially titled Lay/Witness Statement, is used to submit a written statement supporting your own VA claim or the claim of another veteran or eligible family member. VA also calls these statements buddy statements. A witness may be a spouse, family member, coworker, friend or fellow service member who has personal knowledge of relevant events or observations.

Use the official VA form: VA Form 21-10210 - download and online submission. VA offers a downloadable PDF and an online submission option. VA Pay Calc is an independent educational resource, not a VA submission portal.

When might Form 21-10210 help?

A witness statement may describe a service event, a personally observed injury, symptoms over time, or limitations in daily life and work. It can be submitted with a claim where such observations are relevant. VA evaluates lay evidence alongside other evidence. A statement does not automatically establish a diagnosis, medical causation, service connection or disability rating.

See VA's evidence requirements for examples of claims where lay evidence may be relevant.

How to prepare a useful statement

  1. Identify the person making the statement. State how they know the veteran and, where relevant, the period of their acquaintance or service together.
  2. Describe facts actually witnessed. Explain what happened or what was seen, heard or otherwise directly experienced.
  3. Add specific time and context. Include approximate dates, locations, frequency and relevant examples when remembered honestly.
  4. Separate observation from opinion. A spouse may describe sleep disruption or observed symptoms but should not present a medical diagnosis or nexus opinion as established fact.
  5. Review and submit through VA. The actual witness must confirm the statement accurately reflects their own knowledge and follow VA's signature and submission instructions.

Example of a factual observation

Fictional example for explanation only: "I worked with the veteran from March 2022 to July 2024. On several shifts each month, I observed them stop working and move to a dark, quiet room because of a severe headache. I did not examine or diagnose them; these are my workplace observations."

Use this as an illustration of specificity, not text to copy as a real event. For several different fictional examples and a practical structure, see our VA Buddy Letter Examples guide.

Submit online or use the PDF

  • Online: Open VA's official Form 21-10210 page and follow the current online submission pathway.
  • PDF: Download the current PDF from the same VA page, follow the form's own instructions, and submit it through an accepted VA submission channel.
  • Multiple witnesses: VA's online instructions specify a separate statement for each witness; do not combine several people's accounts into one witness's form.
  • Privacy: Send protected personal identifiers only through the official VA process. Do not enter Social Security numbers or sensitive medical details into VA Pay Calc to obtain a copy of this form.

For the official submission instructions, see Submit a Lay or Witness Statement.

VA Form 21-10210 vs. VA Form 21-4138

Both forms may be used to provide written evidence, but 21-10210 is specifically the Lay/Witness Statement. VA also accepts other forms of lay evidence, including statements written on a blank page and VA Form 21-4138. Use the option that fits the statement and the current VA instructions; don't assume every witness must use 21-4138.

Frequently asked questions

Is VA Form 21-10210 the same as a buddy letter?

Form 21-10210 is VA's official Lay/Witness Statement form. "Buddy letter" is an informal name for a statement containing relevant firsthand observations.

Can my spouse or coworker complete it?

Yes. A witness need not be a fellow veteran; they should describe facts they actually know or have observed.

Does a buddy statement replace medical evidence?

Not necessarily. It can provide factual observations, while claims requiring a medical diagnosis or nexus may need additional medical evidence.

Where can I download the latest form?

Use the official VA Form 21-10210 page, not a third-party PDF mirror.

How do I see sample statements?

Read our VA Buddy Letter Examples article. All sample text is fictional and must be personalized only with truthful firsthand facts.

Primary official sources