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  • Va Form 21 0960c 5

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OSIS, HEADACHES, TMJ CONDITIONS, EPILEPSY, NARCOLEPSY, PERIPHERAL NEUROPATHY, SLEEP APNEA, CRANIAL NERVE DISORDERS, FIBROMYALGIA, CHRONIC FATIGUE SYNDROME) DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES OR COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. PLEASE READ THE PRIVACY ACT AND RESPONDENT BURDEN INFORMATION BEFORE COMPLETING FORM. NAME OF PATIENT/VETERAN PATIENT/VETERAN'S SOCIAL SECURITY.

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Beginning Jan. 1, 2023, Veterans and beneficiaries who receive VA compensation benefits will see an 8.7% increase in their monthly payments—the largest increase in over 30 years. The annual COLA increase is tied to the Social Security rate change and is based on the consumer price index (CPI).

2023 VA disability pay rates, which are effective December 1, 2022, have a year over year increase of 8.7% based on the latest cost-of-living adjustment (COLA).

Effective December 1st, 2023, the monthly veterans disability payment amounts for veterans with no dependents are as follows: $165.92 per month for 10% disability. $327.99 per month for 20% disability. $508.05 per month for 30% disability.

To file a claim for VA disability benefits for restless leg syndrome, Veterans can use VA Form 21-526EZ. Under the VA Disability codes, restless leg syndrome is rated under Diagnostic Code 8620. This is used to rate injuries and disabilities similar to neuritis.

Use VA Form 21-686c to submit a claim for additional benefits for a dependent, or to request to remove a dependent from your benefits.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232