Follow the steps to complete the form with ease.

1. Press the ‘Get Form’ button to access the document and open it for editing.
2. Begin by entering your name at the top of the form in the designated field. Ensure that your name is spelled correctly to avoid any confusion.
3. Fill in your street address or PO box in the address field provided. Make sure to include any relevant details such as apartment numbers.
4. Provide your city and state along with the zip code. Additionally, include your cell phone number for contact purposes.
5. Enter your date of birth and VA claim number. Ensure that these details are accurate as they are essential for processing your request.
6. List your social security number to help identify your records efficiently.
7. Indicate your military branch and the dates you served. This information is critical for the clinic’s records.
8. If applicable, include the name and firm of your VA representative or attorney, along with their contact number and mailing address.
9. In the section for requesting a VA disability expert medical opinion report, specify the body parts or diseases you are claiming for review.
10. For each condition listed, indicate whether you wish to 'Accept' or 'Raise' your current VA evaluation percentage. Fill in the corresponding VA diagnosis code and current VA percent for each condition.
11. If you have more conditions to include, you may attach a separate page to the form.
12. Complete the section regarding previous injuries or diseases that are not service-connected. This information helps clarify your medical history.
13. Ensure to attach all necessary medical records, decorated by colored tabs, and list them as instructed to facilitate the VA's review process.
14. Enclose the required payment, specifying whether it is via check or credit card, and ensure your detailed payment information is clear.
15. Review the entire form for accuracy and completeness before saving, downloading, printing, or sharing the document as needed.

Complete your Ellis Clinic VA Disability Reviews form online today for a smoother application process.