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OMB Approved No. 29000781 Respondent Burden: 30 Minutes Expiration Date: XX/XX/XXXXSINUSITIS/RHINITIS AND OTHER CONDITIONS OF THE NOSE, THROAT, LARYNX AND PHARYNX DISABILITY BENEFITS QUESTIONNAIRE
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How to fill out va form 21 0960n
How to fill out va form 21 0960n
01
To fill out VA Form 21-0960N, follow these steps:
1. Download the form from the VA website.
02
Start by identifying yourself in section I by providing your personal details such as name, social security number, date of birth, and contact information.
03
In section II, provide information about your military service, including branch, dates of service, and discharge type.
04
Move on to section III and specify the medical condition you are claiming benefits for. Include details about the condition, the date of diagnosis, and the names of medical facilities or physicians who treated you.
05
Attach any relevant medical documentation to support your claim in section IV. This may include medical records, test results, or other evidence.
06
In section V, provide additional remarks or comments regarding your claim if necessary.
07
Sign and date the form in section VI to certify the accuracy of the information provided.
08
Finally, submit the completed form to the appropriate VA regional office as indicated in the instructions.
Who needs va form 21 0960n?
01
VA Form 21-0960N is needed by veterans or members of the military who are applying for disability benefits related to a specific medical condition. This form is used to gather information and evidence to support the claim for benefits.
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