OMB Control No. 29000778 Respondent Burden: 15 Minutes Expiration Date: 09/30/2019 ESOPHAGEAL CONDITIONS (Including gastroesophageal reflux disease (GERD), hiatal hernia and other esophageal disorders).
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How to fill out the VA 21-0960G-1 online
The VA 21-0960G-1 form is essential for veterans applying for disability benefits related to esophageal conditions. This guide provides clear and supportive steps to assist users in filling out the form accurately and efficiently online.
Follow the steps to successfully complete the VA 21-0960G-1 form.
- Press the ‘Get Form’ button to access the VA 21-0960G-1 form and open it for editing.
- Begin by entering the name of the patient or veteran. You will need to provide the first name, middle initial (if applicable), and last name.
- Next, fill in the veteran's social security number accurately in the designated field.
- In Section I, indicate whether the veteran currently has or has ever been diagnosed with an esophageal condition by checking ‘Yes’ or ‘No.’ If ‘Yes,’ complete the subsequent fields regarding diagnoses.
- List all applicable diagnoses in Item 1B, including gastroesophageal reflux disease (GERD), hiatal hernia, and other relevant conditions. Be sure to input the corresponding ICD codes and dates of diagnosis.
- Proceed to Section II and provide a summary of the veteran's medical history regarding their esophageal conditions, including the onset and journey of the condition.
- In Section III, indicate whether the veteran is experiencing relevant signs and symptoms due to esophageal conditions. For each checked symptom, provide any required frequency and duration details.
- Complete Section IV if applicable, describing any esophageal strictures, spasms, or diverticula. Include the severity of the condition.
- Section V requires details about any other significant physical findings, complications, signs, or symptoms related to the diagnosis.
- If diagnostic testing has occurred, fill in Section VI with details about the tests performed, their dates, and results.
- In Section VII, assess if any esophageal conditions impact the veteran's ability to work and provide examples if applicable.
- Use Section VIII for any additional remarks that may support the claim.
- Finally, Section IX requires the physician's certification. Ensure that the physician signs, includes their printed name, phone and fax number, NPI number, and the date signed.
- Review all entries for accuracy before saving changes. You have options to download, print, or share the completed form.
Complete the VA 21-0960G-1 form online today to ensure your benefits application is submitted without delay.
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How is service connected to GERD?
Getting Service Connection for GERD Direct service connection requires three elements: A current diagnosis. An in-service event, injury, or symptom. A medical nexus linking the current diagnosis to the in-service occurrence.
Is GERD considered a disability?
GERD itself rarely qualifies for disability benefits, since it can usually be treated with diet and medication. However, an individual could apply for disability benefits if GERD were to lead to a more serious complication like asthma, esophageal cancer, or stomach cancer.
Can Gerd be secondary to PTSD?
Some examples of conditions secondary to PTSD are sleep apnea, gastroesophageal reflux disease (GERD), hypertension, migraines, and erectile dysfunction. You can receive additional VA disability compensation for each of these conditions if you show they are related to your service-connected PTSD.
How is GERD rated by the VA?
VA Ratings for GERD Typically, GERD is rated analogous to a hiatal hernia under 38 C.F.R. 4.114 diagnostic code 7346. Ratings under diagnostic code 7346 range from 10 to 60% disabling, and depend on the presence and severity of a variety of symptoms.
Can PTSD cause GERD?
GERD can develop when the symptoms of PTSD, such as anxiety, stress, and depression, lead to an overproduction of stomach acid. In some people, medications taken to treat PTSD can also lead to GERD as a side effect.
Can I get VA disability for ulcerative colitis?
A 30 percent disability rating is warranted for moderately severe ulcerative colitis with frequent exacerbations. A 60 percent disability rating is warranted for severe ulcerative colitis with numerous attacks a year and malnutrition, with health being only fair during remissions.
Is GERD a presumptive condition?
The Board acknowledges that the Veteran's GERD is considered a structural gastrointestinal disease, as it has been confirmed by upper endoscopy in December 2003, and therefore does not qualify for service connection on a presumptive basis under 38 C.F.R. § 3.317.
Can you get VA disability for eosinophilic esophagitis?
After fully considering the lay and medical evidence discussed above, and resolving all reasonable doubt in the Veteran's favor, the Board finds the assignment of a 30 percent disability rating, but no higher, for eosinophilic esophagitis with stricture, dysmotility, and esophageal ring is warranted for the entire ...
What is the VA rating for GERD?
There is no specific VA rating for acid reflux or GERD. It is commonly rated under Diagnostic Code 7346, Hernia, Hiatal under § 4.114 Schedule of ratings digestive system.
What conditions are secondary to PTSD?
Some examples of conditions secondary to PTSD are sleep apnea, gastroesophageal reflux disease (GERD), hypertension, migraines, and erectile dysfunction. You can receive additional VA disability compensation for each of these conditions if you show they are related to your service-connected PTSD.
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