Get the free VA Form 21-0960C-9 - Veterans Benefits Administration - VA.gov

OMB Control No. 2900-0778 Respondent Burden: 45 minutes MULTIPLE SCLEROSIS (MS) DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES

How to fill out va form 21-0960c-9

How to fill out VA Form 21-0960C-9:

1. Retrieve a copy of VA Form 21-0960C-9. This form is used for requesting increased disability compensation based on individual unemployability (IU).
2. Begin by providing your personal information. Write your name, social security number, address, phone number, and email address in the designated sections.
3. Indicate the VA regional office where you want the form to be processed. This is typically the regional office responsible for your current residence.
4. Proceed to Section I - Claimant's Statement. Here, you will need to answer a series of questions regarding your current employment status, education, and any limitations you may have that impact your ability to work.
5. In Section II - Employment History, provide detailed information about your past jobs, including job titles, employers, dates of employment, and the type of work you performed.
6. If you are currently employed, complete Section III - Current Employment. This section requires you to list your current job details, such as employer name, job title, earnings, and the number of hours you work per week.
7. Section IV - Education History should be completed if you have any educational background or vocational training. Include details such as school names, dates attended, degrees or certifications earned, and any honors received.
8. Section V - Dependency Information requires you to provide details about any dependents you have, including their names, dates of birth, and relationship to you.
9. In Section VI - Service Connection, you will need to provide information related to your service-connected disabilities, if applicable. Include the percentages of disability assigned to each condition and any information regarding IU claims previously submitted.
10. The last section, Section VII - Medical Providers, should be completed by listing the names and contact information of all medical providers who have treated you for your claimed disabilities. Ensure you include the dates of treatment.
11. Once you have completed the form, review it carefully to ensure all sections are properly filled out and all relevant information has been provided.
12. Sign and date the form to certify the accuracy of the information you have provided.

Who needs VA Form 21-0960C-9?

1. Veterans who are seeking increased disability compensation based on individual unemployability (IU) should fill out VA Form 21-0960C-9.
2. It is also necessary for veterans who have service-connected disabilities and are unable to maintain substantial gainful employment to complete this form.
3. Additionally, veterans who have received prior IU claims decisions and wish to request a reevaluation or provide updated information should utilize VA Form 21-0960C-9.

For pdfFiller’s FAQs

What is va form 21-0960c-9?

Va form 21-0960c-9 is a form used by the Department of Veterans Affairs for filing a claim for disability compensation.

Who is required to file va form 21-0960c-9?

Veterans who are seeking disability compensation benefits from the Department of Veterans Affairs are required to file va form 21-0960c-9.

How to fill out va form 21-0960c-9?

Va form 21-0960c-9 needs to be completed with accurate information regarding the veteran's medical history, disabilities, and any supporting documentation.

What is the purpose of va form 21-0960c-9?

The purpose of va form 21-0960c-9 is to gather important medical and disability information from veterans seeking disability compensation benefits.

What information must be reported on va form 21-0960c-9?

Information such as medical history, current disabilities, treatment received, and supporting medical documentation must be reported on va form 21-0960c-9.

When is the deadline to file va form 21-0960c-9 in 2023?

The deadline to file va form 21-0960c-9 in 2023 is typically within one year of the veteran's last medical examination or treatment for the claimed disability.

What is the penalty for the late filing of va form 21-0960c-9?

The penalty for late filing of va form 21-0960c-9 can result in delays in receiving disability compensation benefits from the Department of Veterans Affairs.

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