Get Va Form 21-0960l-2 (3-11) - Veterans Disability Attorney

This guide provides comprehensive instructions for users on how to fill out the VA Form 21-0960L-2 (3-11) online. The form is essential for veterans applying for disability benefits related to sleep apnea and requires careful attention to detail.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and access it in the editor.
2. Begin with Section I - Diagnosis. Indicate if the veteran has ever had sleep apnea by selecting 'Yes' or 'No.' If 'Yes,' provide details in Item 1B including diagnosis types and relevant ICD codes with their diagnosis dates.
3. Move to Section II - Medical History. Provide a brief summary of the veteran's sleep disorder history in Item 2A. Indicate whether continuous medication is required in Item 2B, and specify if the use of a breathing assistance device is needed in Item 2C.
4. In Section III - Findings, Signs and Symptoms, check 'Yes' or 'No' to indicate if the veteran has current findings or symptoms related to sleep apnea. If 'Yes,' check all applicable symptoms.
5. Proceed to Section IV - Other Pertinent Findings. Answer whether the veteran has any scars related to treatment in Item 4A, and provide details if applicable. Repeat for Item 4B concerning other physical findings.
6. In Section V - Diagnostic Testing, indicate if a sleep study has been performed in Item 5A, including the test date and location. If additional significant diagnostic findings exist, record them in Item 5B.
7. Section VI requires the user to assess the functional impact of the sleep apnea. Indicate if it affects the ability to work in Item 6, providing examples if 'Yes.' Use Item 7 for any remarks.
8. Finally, complete Section VII - Physician's Certification. Ensure the physician's signature, printed name, medical license number, phone and fax number, date signed, and address are filled in correctly.
9. After completing the form, users can save changes, download a copy, print the form, or share it as necessary.

Ensure your disability benefits application is accurate and complete by filling out the VA Form 21-0960L-2 online.