Get the free VA Form 21-0960a-212-10 - vba va

OMB Approved No. 29000776 Respondent Burden: 30 Minutes Expiration Date: 11/30/2017 ARTERY AND VEIN CONDITIONS (VASCULAR DISEASES INCLUDING VARICOSE VEINS) DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT

How to fill out va form 21-0960a-212-10

How to fill out VA Form 21-0960A-212-10:

1. Obtain the form: The first step is to obtain a copy of the VA Form 21-0960A-212-10 from the Department of Veterans Affairs website or by visiting a local VA office. You can also request a form by mail if needed.
2. Fill out personal information: Start by filling out your personal information, including your full name, social security number, contact information, and any other relevant details as requested on the form.
3. Provide medical history: The next section of the form requires you to provide detailed information about your medical history. This may include any previous diagnoses, treatments, surgeries, hospitalizations, and medications. Be as thorough as possible to ensure accurate assessment.
4. Describe your symptoms: The form will ask you to describe the specific symptoms you are experiencing. This could include physical, mental, or emotional symptoms related to your service-connected disability. Provide detailed descriptions and examples to help the reviewing authority understand your situation better.
5. Provide supporting documentation: If you have any supporting documentation, such as medical records, test results, or letters from healthcare professionals, make sure to attach them to your completed form. These documents can help strengthen your claim and provide a more comprehensive understanding of your condition.
6. Review and submit the form: Before submitting the form, carefully review all the information provided to ensure accuracy and completeness. This will help avoid any potential delays or misunderstandings. Sign and date the form, and submit it according to the instructions provided.

Who needs VA Form 21-0960A-212-10?

1. Any veteran who is applying for disability benefits or seeking an increase in their existing disability rating may need to fill out VA Form 21-0960A-212-10. This form is specifically used for the evaluation of sleep apnea during the disability claims process.
2. Veterans who have been diagnosed with sleep apnea, a potentially debilitating sleep disorder, and believe it is related to their military service can complete this form to provide detailed information about their condition. This information helps the VA evaluate the severity and impact of sleep apnea on the individual's ability to perform daily activities.
3. It is important for veterans who suspect they have sleep apnea or have been previously diagnosed with it to consult with their healthcare provider before filling out the form. A proper diagnosis and ongoing medical treatment can significantly strengthen their case when applying for disability benefits related to sleep apnea.

For pdfFiller’s FAQs

What is va form 21-0960a-212-10?

It is the VA Disability Compensation Examination for Post-Traumatic Stress Disorder (PTSD) form.

Who is required to file va form 21-0960a-212-10?

Veterans who are seeking disability compensation for PTSD are required to file this form.

How to fill out va form 21-0960a-212-10?

The form must be completed by a qualified medical professional conducting an examination of a veteran for PTSD.

What is the purpose of va form 21-0960a-212-10?

The purpose of the form is to gather information to help determine if a veteran qualifies for disability compensation for PTSD.

What information must be reported on va form 21-0960a-212-10?

The form should include the results of the PTSD examination, including the medical professional's assessment and diagnosis.

When is the deadline to file va form 21-0960a-212-10 in 2023?

The deadline to file in 2023 will depend on the individual case and when the examination takes place.

What is the penalty for the late filing of va form 21-0960a-212-10?

There may be delays in processing the claim and the veteran may not receive compensation until the form is submitted.

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