Get the free VA Form 21-0960A-2. ARTERY AND VEIN CONDITIONS (VASCULAR DISEASES INCLUDING VARICOSE...
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TYPE OF VASCULAR DISEASE CONDITION (Check all that apply and then ... Section IV: Peripheral vascular disease, aneurysm of any large artery (other than ...
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How to fill out va form 21-0960a-2 artery
How to fill out VA Form 21-0960A-2 Artery:
01
Start by reviewing the instructions provided on the form itself. This will give you an overview of the information and documentation required.
02
Begin by providing your personal details, including your full name, address, Social Security number, and contact information. Ensure that all the information is accurate and up to date.
03
Next, indicate the specific artery(s) being evaluated by checking the appropriate boxes. The form provides a list of different arteries, such as the carotid, renal, or femoral arteries.
04
In the following sections, provide a detailed medical history of the artery condition being claimed. Enter the date of diagnosis, the name of the medical professional who diagnosed you, and any treatments or surgeries you have undergone.
05
Provide a thorough description of your symptoms, including any pain, numbness, or limitations you experience as a result of the artery condition. Be specific and provide as much detail as possible to ensure a comprehensive evaluation of your claim.
06
If you have obtained any relevant medical records, include copies or summaries of these records with your form. This can support your claim and provide additional evidence of the severity of your condition.
07
Finally, sign and date the form and include any additional documentation or evidence that you believe is pertinent to your case. Ensure that you have completed all the necessary sections before submitting the form to the appropriate VA office.
Who needs VA Form 21-0960A-2 Artery:
01
Veterans who are seeking disability compensation or benefits for artery-related conditions may need to fill out VA Form 21-0960A-2 Artery.
02
It is specifically designed for veterans who have been diagnosed with arterial conditions, such as peripheral artery disease, carotid artery disease, or renal artery disease.
03
Additionally, this form may be required for veterans who are applying for an increase in their current rating for artery-related disabilities or for establishing eligibility for other VA programs related to arterial conditions.
Note: It is always recommended to consult with a VA representative or a healthcare professional for guidance specific to your situation when filling out VA forms.
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