VA 21-0960M-9 2013 free printable template
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3A. INITIAL ROM MEASUREMENTS Knee RIGHT KNEE All Normal LEFT Joint Movement ROM Measurement Flexion normal endpoint 140 degrees Not indicated Extension If ROM testing is not indicated for the veteran s condition or not able to be performed please explain why and then proceed to Section 5 Not able to perform VA FORM 21-0960M-9 MAY 2013 Page 2 3B. Explain your findings and reasons in comments section. Knee strain Side affected Right Left Both ICD Code Date of diagnosis Knee...
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How to fill out VA 21-0960M-9
01
Download the VA Form 21-0960M-9 from the VA website.
02
Review the instructions on the first page of the form.
03
Fill out the veteran's personal information including name, social security number, and contact details.
04
Indicate the type of condition being claimed for benefits.
05
Provide information about the treatment received, including dates and healthcare providers.
06
Answer all sections accurately, making sure to check 'Yes' or 'No' where applicable.
07
If necessary, include any additional comments or explanations in the designated area.
08
Sign and date the form at the end.
09
Make a copy of the completed form for your records.
10
Submit the form through the appropriate channels, either online or by mail.
Who needs VA 21-0960M-9?
01
Veterans who are seeking disability compensation for a qualifying medical condition.
02
Individuals who have been referred by a healthcare provider to apply for increased benefits.
03
Those undergoing a claim review process for pre-existing health conditions related to military service.
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What is VA 21-0960M-9?
VA 21-0960M-9 is a form used by veterans to provide medical information regarding their mental disorders for the purpose of applying for disability benefits.
Who is required to file VA 21-0960M-9?
Veterans who are seeking disability benefits related to a mental disorder are required to file VA 21-0960M-9.
How to fill out VA 21-0960M-9?
To fill out VA 21-0960M-9, veterans must provide personal information, details about their mental health condition, relevant treatment history, and symptoms affecting their daily life.
What is the purpose of VA 21-0960M-9?
The purpose of VA 21-0960M-9 is to assess the severity of a veteran's mental disorder and to determine their eligibility for disability compensation from the VA.
What information must be reported on VA 21-0960M-9?
VA 21-0960M-9 requires reporting personal details, diagnosis of the mental disorder, symptoms, medical history, treatment received, and the impact of the condition on daily activities.
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