Get the free VA Form 21-0960M-2 - formuPack

OMB Approved No. 2900-0776 Respondent Burden: 30 minutes ANKLE CONDITIONS DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES

How to fill out va form 21-0960m-2

How to fill out VA Form 21-0960M-2?

1. Retrieve the form: Start by obtaining VA Form 21-0960M-2, which is the Mental Disorders (Other Than PTSD) Disability Benefits Questionnaire. You can download it from the official website of the U.S. Department of Veterans Affairs or request a physical copy from your nearest VA office.
2. Provide personal information: Begin by entering your personal details at the top of the form. This includes your full name, social security number, date of birth, and contact information. Ensure that all the information is accurate and up to date.
3. Specify your mental disorder: In Section I of the form, you will need to indicate the specific mental disorder for which you are seeking disability benefits. This could include conditions such as depression, anxiety, bipolar disorder, schizophrenia, or any other non-PTSD mental illness. Write the diagnosis given by your healthcare provider, along with any additional details or descriptions as requested.
4. Medical history: Section II of the form requires you to provide your medical treatment history related to the mental disorder. You will need to list all the facilities and healthcare providers you have seen for this particular condition, including dates and details of each visit or treatment received. Make sure to provide accurate and complete information.
5. Medications and side effects: In Section III, you should list all the medications you are currently taking or have taken in the past for your mental disorder. Include the names of the medications, dosages, and any side effects experienced as a result. If you are not taking any medications, indicate so on the form.
6. Impact on daily life: Section IV focuses on how your mental disorder affects your daily life. Describe any difficulties or limitations you experience in various areas, such as work, social interactions, family relationships, concentration, sleep, or any other relevant aspects. Be thorough in explaining the extent to which your mental disorder impairs your ability to function normally.
7. Additional information: If there is any additional information or supporting evidence related to your mental disorder that you believe is important for the VA to consider, you can provide it in Section V. This may include medical records, letters from healthcare providers, or any other relevant documents.

Who needs VA Form 21-0960M-2?

1. Veterans seeking disability benefits for mental disorders: VA Form 21-0960M-2 is specifically designed for veterans who are applying for disability benefits related to mental disorders that are not post-traumatic stress disorder (PTSD). If you have been diagnosed with a mental illness and believe it is connected to your military service, you may need to fill out this form as part of your disability benefits claim.
2. Veterans diagnosed with non-PTSD mental disorders: This form is intended for veterans with mental disorders such as depression, anxiety, bipolar disorder, schizophrenia, or other non-PTSD conditions. If you are a veteran who has been diagnosed with such a mental disorder, you may be required to complete VA Form 21-0960M-2 when applying for disability benefits.

It is important to note that the information provided here is a general guideline. It is recommended to consult with a VA representative or a healthcare professional familiar with the disability benefits application process for personalized guidance and specific instructions.

For pdfFiller’s FAQs

What is va form 21-0960m-2?

VA Form 21-0960M-2 is a form used by veterans to apply for VA disability benefits for mental disorders.

Who is required to file va form 21-0960m-2?

Veterans who are seeking disability benefits for mental disorders are required to file VA Form 21-0960M-2.

How to fill out va form 21-0960m-2?

VA Form 21-0960M-2 must be filled out with accurate and detailed information about the veteran's mental health history and current condition.

What is the purpose of va form 21-0960m-2?

The purpose of VA Form 21-0960M-2 is to help veterans apply for disability benefits for mental disorders and receive appropriate medical care.

What information must be reported on va form 21-0960m-2?

VA Form 21-0960M-2 requires information about the veteran's mental health symptoms, medical history, and any treatment received.

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