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OMB Control No. 2900-0778 Respondent Burden: 15 minutes ESOPHAGEAL CONDITIONS (Including gastroesophageal reflux disease (HERD), hiatal hernia and other esophageal disorders) Disability Benefits Questionnaire
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How to fill out va form 21-0960g-1

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01
Start by obtaining a copy of VA Form 21-0960G-1, which is used to apply for an increased evaluation for post-traumatic stress disorder (PTSD) due to personal assault.
02
Ensure that you meet the eligibility criteria for filing this form. VA Form 21-0960G-1 is specifically designed for veterans who have experienced personal assault-related PTSD and are seeking an increased evaluation for their condition.
03
Provide personal information at the top of the form, including your name, social security number, and VA file number. This information helps the VA accurately identify and process your application.
04
Section I of the form requires you to document the details of the personal assault that resulted in your PTSD. Include information such as the date, location, nature of the assault, and if it was a one-time incident or occurred repeatedly.
05
In Section II, you will need to provide a narrative description of the stressor event(s). This involves explaining the specific details of the assault, the impact it had on your mental health, and any treatment or therapy received as a result.
06
Section III focuses on documenting any stressor verification. If you have any official records or documents that support your claim related to the personal assault, provide them in this section. This can include police reports, medical records, photographs, or statements from witnesses or authorities.
07
If you have previously filed for PTSD related to personal assault and are seeking an increased evaluation, provide the VA regional office and date of the previous decision in Section IV. This information helps establish your claim history and allows the VA to review your case thoroughly.
08
Finally, sign and date the form at the bottom, certifying that the information you provided is accurate and complete to the best of your knowledge.
09
Remember to make a copy of the completed form for your records before submitting it to the appropriate VA regional office for processing.
10
VA Form 21-0960G-1 is specifically required for veterans who experienced personal assault-related PTSD and are seeking an increased evaluation of their condition. If you meet these criteria, this form is crucial for effectively communicating your claim to the VA and initiating the review process.
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VA Form 21-0960G-1 is the Application for Increased Compensation Based on Unemployability.
Veterans who are seeking increased compensation based on unemployability are required to file VA Form 21-0960G-1.
To fill out VA Form 21-0960G-1, veterans must provide detailed information about their employment history, medical conditions, and any other relevant details supporting their claim for increased compensation based on unemployability.
The purpose of VA Form 21-0960G-1 is to apply for increased compensation from the VA based on the veteran's unemployability due to service-connected disabilities.
On VA Form 21-0960G-1, veterans must report details about their employment history, medical conditions, and provide any supporting documentation for their claim for increased compensation based on unemployability.
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