VA 21-0960M-13 2018-2025 free printable template

OMB Approved No. 2900-0807 Respondent Burden: 45 Minutes Expiration Date: 03/31/2021 NECK (CERVICAL SPINE) CONDITIONS DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS

How to fill out 210960m 13 2018-2025 form

How to fill out 21-0960m-13

1. Begin by downloading the 21-0960M-13 form from the official VA website.
2. Read the instructions carefully to understand the purpose of the form.
3. Fill in your personal information at the top of the form, including your name, Social Security number, and contact information.
4. Indicate the type of benefit you are applying for by checking the appropriate box.
5. Provide detailed information regarding your service-connected disabilities, including dates and descriptions of your conditions.
6. Include any relevant medical evidence or documentation to support your claims.
7. Review all the information for accuracy and completeness.
8. Sign and date the form at the bottom before submitting it.

Who needs 21-0960m-13?

1. The 21-0960M-13 form is needed by veterans who are seeking to apply for increased compensation based on new or worsening service-connected disabilities.

People Also Ask about

What is the VA rating criteria for radiculopathy?

VA disability ratings are expressed as percentages and range from 10% to 100%. The disability rating for radiculopathy can range from 10% for minor radiculopathy affecting the hand to 90% for major paralysis affecting all three radicular groups (cervical, thoracic, and lumbar).

Can you get VA disability for a pinched nerve?

Arm and leg VA disability claims are frequently made to the VA. Common nerve damage issues for veterans are radiculopathy (pinched nerves in the spine), sciatica (pain along the sciatic nerve from the lower back through hips, buttocks, and down each leg), and neuropathy (frequently prickling, burning, or numbness).

How do you prove radiculopathy to VA?

Veterans seeking service connection for their radiculopathy will need multiple kinds of evidence in order to prove to the VA that their condition is a result of their military service. The two most important kinds of evidence veterans need to provide are medical records and service personnel records.

What is peripheral nerve Dbq?

The second reason is the DBQ itself. The Peripheral Nerves Condition Disability Benefits Questionnaire guides the physician to provide an assessment of the extent of either incomplete or complete paralysis of the upper and lower extremities in boxes 10 and 11 in the form.

What is evidence of radiculopathy?

Symptoms of Radiculopathy Sharp pain in the back, arms, legs or shoulders that may worsen with certain activities, even something as simple as coughing or sneezing. Weakness or loss of reflexes in the arms or legs. Numbness of the skin, “pins and needles,” or other abnormal sensations (paresthesia) in the arms or legs.

What is the VA rating code for radiculopathy?

However, none of the other diagnostic codes relevant to the Veteran's bilateral lower extremity radiculopathy (DCs 8621 through 8630) provide for a disability rating in excess of 40 percent, and all of them use the same criteria of mild, moderate, and severe incomplete paralysis.

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What is 21-0960m-13?

21-0960m-13 is the VA Form used to apply for Veterans Affairs benefits related to disability compensation, specifically for mental health conditions.

Who is required to file 21-0960m-13?

Veterans seeking benefits for mental health conditions or those who have a diagnosis of a mental disorder must file 21-0960m-13.

How to fill out 21-0960m-13?

To fill out 21-0960m-13, individuals must provide personal information, details about their mental health diagnosis, treatment history, and how the condition impacts their daily life.

What is the purpose of 21-0960m-13?

The purpose of 21-0960m-13 is to gather the necessary information for the Department of Veterans Affairs to evaluate a veteran's claim for mental health-related benefits.

What information must be reported on 21-0960m-13?

Information required on 21-0960m-13 includes personal identification details, specific mental health diagnoses, medical treatment history, and assessment of impairment caused by the condition.