How to Complete VA Form 134: Amend Your VA Record and Appeal Denials

To correct an error in your VA medical record, complete the VA patient amendment request form used by the VA medical center where you received care, identify the specific entry you want changed, write out the exact correction you want, and submit the form with supporting evidence to the facility’s Privacy Officer. There is no fee, and the VA must acknowledge your request in writing within ten business days.¹

Where To Get the Form

Each VA medical facility uses its own locally produced version of the form. You can pick one up at the Release of Information office or the Privacy Officer’s office at any VA medical center or outpatient clinic, and some facilities post a downloadable copy on the VA website. The safest approach is to contact the facility where you received the care in question and ask for their patient amendment request form. The VA’s Privacy Act Requests page confirms that amendment requests for VHA health records must be submitted in writing to the Privacy Officer at the facility that holds the record.²

What To Gather Before You Fill It Out

Pull everything together before you start writing. A half-finished request with missing evidence is the fastest way to get a denial.

Your full legal name, the last four digits of your Social Security number, and your current mailing address.
The note title, clinic visit date, or procedure date for the entry you want changed. A printed copy of the disputed record helps.
The exact language you want the record to say after the amendment.
Supporting documentation such as private physician records, lab results, or imaging reports that show the current entry is wrong.

You can pull copies of your existing VA health records through the My HealtheVet portal on VA.gov to pinpoint the exact entry before you fill out the form.

Filling Out Each Section

Formatting varies by facility, but most VA amendment request forms share the same core sections.³

Identifying Information

Enter your full name, the last four digits of your Social Security number, and your address at the top. This links your request to the correct electronic health record. A mismatch delays everything.

Description of the Entry To Be Amended

Name the type of record (a progress note, lab result, discharge summary, or procedure report) and give the date of the entry. Vague descriptions like “my records from last year” force the Privacy Officer to guess which entry you mean, and guessing usually ends in a rejection letter.

Reason for the Amendment

Most forms give you four checkboxes: inaccurate, incomplete, irrelevant, or untimely. Pick the one that fits. Under the Privacy Act, these are the only four grounds the VA can use to amend a record.⁴ A misrecorded diagnosis is inaccurate. A note that leaves out a symptom you reported is incomplete. An entry that has nothing to do with your care is irrelevant. A record kept well past its useful life is untimely.

Proposed Correction

Write out exactly how the record should read after the fix. If the note says “patient denies chest pain” when you actually reported chest pain, state: “Change ‘patient denies chest pain’ to ‘patient reports chest pain.'” If you want an entire entry deleted, say so plainly. Specificity matters most in this section, because the Privacy Officer needs to know precisely what action to take.

Prior Recipients

The form asks whether anyone else may have received or relied on the disputed information. If you know the record was shared with an outside specialist or an insurance company, list them. When the amendment is approved, the VA is required to notify those prior recipients of the correction.⁴

Signature

Sign the form with a wet (ink) signature. Electronic signatures are not accepted on the paper form. If you cannot physically sign because of a disability, you may use an “X,” a thumbprint, or a stamp, or ask someone present with you to sign on your behalf.

Filing as a Representative

A personal representative such as a legal guardian, someone holding a power of attorney, or a court-appointed conservator can submit the amendment request on the veteran’s behalf. The representative must print their name, address, and phone number on the form and attach a copy of the legal document that grants them authority.³ Acceptable documents include a guardianship order, a durable power of attorney for health care (VA Form 10-0137 or a state equivalent), or a court order. Without that paperwork attached, the VA will not process the request.

How To Submit the Completed Form

You have several options for getting the completed form and supporting documents to the right person.

In person at the Release of Information office at the VA medical center where you received care. This lets you confirm on the spot that your paperwork is complete.
By mail to the facility’s Privacy Officer. Use certified mail with return receipt so you have proof of delivery.
By fax to the facility’s Privacy Officer, followed by a phone call to confirm receipt.
Through My HealtheVet secure messaging, which the VA accepts for amendment requests. This is the most convenient option if your supporting documents can be scanned and attached.²

Finding the Privacy Officer

Every VA medical facility has a designated Privacy Officer. To find yours, use the VA’s Find Locations tool at va.gov/find-locations, enter your location, select “VA health,” and call the main number for the facility. Ask to be connected to the Privacy Officer.⁵ If you cannot reach the local officer, the VHA Privacy Office can be contacted at VACOVHAPrivIncoming@va.gov.

What Happens After You Submit

The VA must acknowledge your request in writing within ten business days of receiving it.¹ If ten business days pass with no acknowledgment, follow up. Your form may not have reached the Privacy Officer.

After acknowledging receipt, the VA reviews your request and supporting evidence against the existing health record. The VA’s own regulation says this review should normally be completed within 30 business days.¹ If the facility needs more time, it must notify you in writing explaining the delay and giving a new expected completion date.⁶

You will receive one of three outcomes in writing: the amendment is granted in full, granted in part, or denied. A full or partial grant means the VA corrects the record and notifies any person or agency that previously received the incorrect information.

If Your Amendment Is Denied

A denial letter must explain the reason the VA refused the change, describe the procedure for requesting a higher-level review, and give the name and address of the official who will conduct that review.⁴ Under 38 CFR 1.579, the reviewing official is typically the facility director or a designee of the Secretary of Veterans Affairs.¹

Requesting an Appeal Review

If you disagree with the initial denial, submit a written request for review to the official named in the denial letter. The Privacy Act gives the VA 30 business days from the date you request the review to complete it and issue a final determination. The agency head can extend that period for good cause but must notify you in writing.⁴

Filing a Statement of Disagreement

If the appeal review also results in a denial, you have the right to file a concise written statement explaining why you believe the record is wrong. That statement becomes a permanent part of your file. Any time the VA discloses the disputed record in the future, it must note which portion is disputed and include a copy of your statement.⁴ The statement does not change the record itself, but it ensures anyone reading the file sees your side.

Federal Court

After you have filed the initial amendment request, received a denial, requested the appeal review, and been denied again, you can bring a civil action in U.S. District Court under 5 U.S.C. § 552a(g)(1)(A). Those administrative steps must be exhausted first. The statute of limitations is two years from the date the VA issues its final denial.⁷

How a Corrected Record Affects Disability Claims

Correcting a medical record does not automatically reopen or change a disability claim. It does give you stronger evidence for a supplemental claim or appeal if the original rating relied on an incorrect diagnosis or a missing treatment note. Under the VA’s duty to assist, the agency is required to make reasonable efforts to gather relevant VA medical records when evaluating a claim.⁸ Once the amendment is finalized, notify the Veterans Benefits Administration that the corrected record exists so it can be pulled into any pending or future claim review.

1
eCFR. 38 CFR 1.579 – Amendment of Records
2
Department of Veterans Affairs. Privacy Act Requests
3
Department of Veterans Affairs. Patient Amendment Request Form
4
Office of the Law Revision Counsel. 5 USC 552a
5
Department of Veterans Affairs. Report a Privacy Complaint
6
Department of Veterans Affairs. Right to Request Amendment of Records
7
Department of Justice. Overview of the Privacy Act 2020 Edition – Remedies
8
Veterans Affairs. VA’s Duty to Assist