
VA 21-0960M-9 2011 free printable template
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3A. INITIAL ROM MEASUREMENTS Knee RIGHT KNEE All Normal LEFT Joint Movement ROM Measurement Flexion normal endpoint 140 degrees Not indicated Extension If ROM testing is not indicated for the veteran s condition or not able to be performed please explain why and then proceed to Section 5 Not able to perform VA FORM 21-0960M-9 MAY 2013 Page 2 3B. Explain your findings and reasons in comments section. Knee strain Side affected Right Left Both ICD Code Date of diagnosis Knee...
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How to fill out VA 21-0960M-9
01
Begin by downloading and printing VA Form 21-0960M-9 from the VA website.
02
Fill in your personal information at the top of the form, including your name, Social Security number, and date of birth.
03
Provide the details of the medical condition you are reporting, including the diagnosis and severity.
04
Indicate whether you are currently receiving treatment for the condition and provide the details of the healthcare provider.
05
Answer the questions regarding the limitations or symptoms related to your condition as prompted on the form.
06
Review your answers carefully to ensure all information is accurate and complete.
07
Sign and date the form at the bottom before submitting it.
Who needs VA 21-0960M-9?
01
Veterans who are applying for disability benefits related to conditions related to their service.
02
Individuals who are seeking an increase in their disability rating due to worsening conditions.
03
Veterans who have recently developed new conditions that may be connected to their military service.
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What is VA 21-0960M-9?
VA 21-0960M-9 is a form used by veterans to report information about their muscle and joint conditions for disability compensation claims.
Who is required to file VA 21-0960M-9?
Veterans who are applying for disability compensation for conditions related to muscles or joints are required to file VA 21-0960M-9.
How to fill out VA 21-0960M-9?
To fill out VA 21-0960M-9, veterans need to provide detailed information about their condition, including a description of the disability, the impact on daily life, and any relevant medical treatment.
What is the purpose of VA 21-0960M-9?
The purpose of VA 21-0960M-9 is to gather necessary information to evaluate a veteran's muscle and joint disabilities to determine eligibility for benefits.
What information must be reported on VA 21-0960M-9?
The information that must be reported on VA 21-0960M-9 includes the veteran's personal identification, detailed medical history, specifics about the muscle or joint condition, and how it affects their ability to function.
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