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How to fill out the VA 10-9009 online
The VA 10-9009 form, known as the Agent Orange Registry code sheet, is essential for veterans seeking to report exposure to Agent Orange and related health concerns. This guide provides clear, step-by-step instructions to help users complete this form conveniently online.
Follow the steps to successfully complete the VA 10-9009 form online.
- Click ‘Get Form’ button to access the VA 10-9009 form and open it in your preferred online editor.
- In Part 1, collect the required information from the patient's chart. Enter the last name in Block 8, the first name in Block 3, and the middle name in Block 4.
- Fill in the social security number in Block 6, beginning with Block 61. If using a pseudo number, enter 'P' in Block 60.
- Record the date of birth in Block 8, ensuring to specify the day, month, and year accurately.
- Complete the address section, including street name, apartment number, city, state, county, and ZIP code.
- Indicate race or ethnicity in Block 10 by entering the corresponding code.
- Fill out marital status in Block 11 and current status in Block 13, choosing from the provided options.
- Document the branch of service in Block 14 and specify if the veteran had military service in Vietnam or Korea in Block 15.
- For questions regarding exposure to Agent Orange, answer each item in Blocks 214-219 with the appropriate code.
- Complete the physician and coordinator sections as necessary in Part II, including symptoms and diagnostic information.
- Once all sections are filled out, users can save changes, download, print, or share the VA 10-9009 form as needed.
Start filling out your VA 10-9009 form online now to ensure accurate submission.
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The VA generally recognizes certain conditions as presumptive for veterans exposed to Agent Orange, which can lead to automatic approval of disability claims. This means that if you have one of the recognized conditions, the VA may expedite your claim process. However, it’s essential to provide adequate evidence to support your claim. To ensure you address all requirements effectively, consider using resources like uslegalforms.
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