Getting started

21-4192 - Request for Employment Information in Connection with Claim for Disability Benefits

Summary

Product Name

21-4192 - Request for Employment Information in Connection with Claim for Disability Benefits

Product Root URL

https://www.va.gov/disability/eligibility/special-claims/unemployability/submit-employment-information-form-21-4192/introduction

Team Name

BIO Aquia

Deployment Status

Maintained

Measurement & Monitoring
Team & Ownership

Team ID

19002

Portfolio

Benefits Portfolio

OCTO Crew

Benefits Intake Optimization (BIO)

Owned

true

Code & Repositories

Path to Code

src/applications/benefits-optimization-aquia/21-4192-employment-information

Github Product Label

benefits-optimization-aquia

Technical Details

Product ID

8451e8cf-d034-4f5a-b20a-bd1bc0139bf2

LOA

3

Testing & Quality (restricted)

Note: Use this form to update these restricted fields.

Has Unit Tests

true

Has E2E Tests

true

Package Dependencies

  • @bio-aquia/21-4192-employment-information/components/get-help

  • @bio-aquia/21-4192-employment-information/components/pre-submit-info

  • @bio-aquia/21-4192-employment-information/config

  • @bio-aquia/21-4192-employment-information/config/form

  • @bio-aquia/21-4192-employment-information/config/submit-transformer

  • @bio-aquia/21-4192-employment-information/constants

  • @bio-aquia/21-4192-employment-information/containers

  • @bio-aquia/21-4192-employment-information/containers/app

  • @bio-aquia/21-4192-employment-information/containers/confirmation-page

  • @bio-aquia/21-4192-employment-information/containers/introduction-page

  • @bio-aquia/21-4192-employment-information/manifest.json

  • @bio-aquia/21-4192-employment-information/reducers

  • @bio-aquia/21-4192-employment-information/routes

  • @bio-aquia/shared/components/pages/AddressValidationPage

  • @bio-aquia/shared/hooks

  • @bio-aquia/shared/utils

  • @department-of-veterans-affairs/component-library/contacts

  • @department-of-veterans-affairs/component-library/dist/react-bindings

  • @department-of-veterans-affairs/platform-forms-system/state/helpers

  • @department-of-veterans-affairs/platform-polyfills

  • @department-of-veterans-affairs/platform-startup/exports

  • @department-of-veterans-affairs/platform-utilities/environment

  • @testing-library/react

  • chai

  • path

  • platform/forms-system/src/js/actions

  • platform/forms-system/src/js/components/ConfirmationView

  • platform/forms-system/src/js/components/FormTitle

  • platform/forms-system/src/js/helpers

  • platform/forms-system/src/js/utilities/validations

  • platform/forms-system/src/js/validation

  • platform/forms-system/src/js/web-component-fields/VaMemorableDateField

  • platform/forms-system/src/js/web-component-patterns

  • platform/forms/components/FormFooter

  • platform/forms/constants

  • platform/forms/save-in-progress/RoutedSavableApp

  • platform/forms/save-in-progress/SaveInProgressIntro

  • platform/forms/save-in-progress/helpers

  • platform/forms/save-in-progress/reducers

  • platform/monitoring/record-event

  • platform/testing/e2e/cypress/support/form-tester

  • platform/testing/e2e/cypress/support/form-tester/utilities

  • platform/user/profile/vap-svc/constants/countries.json

  • platform/utilities/api

  • platform/utilities/date

  • platform/utilities/feature-toggles

  • platform/utilities/ui

  • prop-types

  • react

  • react-redux

  • sinon

  • vets-json-schema/dist/definitions.json

Contract

Launch Date

01/15/2026

Last updated: June 19, 2026

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