Approved Exception To SF 171 OMB No. 2900-0205 Estimated burden: 30 minutes Expiration Date: 3/31/2006 Use TAB key or Mouse to move between data fields APPLICATION FOR NURSES AND NURSE ANESTHETISTS
va form 1028a

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Who needs a VA 10-2850a form?

The Department of Veterans Affairs (VA) gives VA disability benefits to all disabled militaries with service-connected medical conditions. A veteran must go through the VA Disability Process for getting a disability status. After applying for VA Disability, military needs to go through the process of Compensation and Pension examination to determine the adequacy of the stated limits for the status of disability. The VA 21-8940 form is used by the veteran to claim unemployability for VA Disability, and it is one of the online forms of BNI (Beneficiary Notices Initiative).

What is the VA 10-2850a form for?

In fact, the VA 10-2850a is a form of an extended summary of applicant’s qualifications. Summary provides information about nursing experience, education, anesthetist certification (if any). The form is accompanied by information about previous employers confirming applicant’s qualification. According to this information, the Department of Veteran Affairs will verify applicant's educational background, professional qualifications, and suitability for employment.

Is the VA 10-2850a form accompanied by other forms?

The VA 10-2850a form is not accompanied by any other forms. However, you must provide copies of diplomas and certificates of education along with your personal information, such as SSN.  

When is VA 10-2850a form due?

There’s no particular term of validity. The form is valid for the entire period of the employment process.

How do I fill out VA 10-2850a form?

You should provide accurate information about yourself, active military duty, registration and clinical privileges, professional liability insurance, qualifications, nursing experience and references to the previous employers. Also, you must answer the questionnaire, specifying detailed history of your work (dismissal, violations, etc.). The IV part of the VA 10-2850a form is to be completed by facility director or designee, verifying checked information.

Where do I send VA 10-2850a form?

Once you've completed and signed the BNI on-line form, mail it to the VA Regional Office.

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