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3A. INITIAL ROM MEASUREMENTS BACK All Normal Joint Movement ROM Measurement Forward Flexion normal endpoint 90 degrees Not indicated Extension Right Lateral Flexion Left Lateral Rotation VA FORM 21-0960M-14 MAY 2013 If ROM testing is not indicated for the veteran s condition or not able to be performed please explain why and then proceed to Section 5 Not able to perform Page 2 3B. Explain your findings and reasons in comments section. Mechanical back pain syndrome ICD Code Date of diagnosis Lumbosacral sprain/strain Facet joint arthropathy Degenerative disc disease Foraminal/lateral recess/ central stenosis Spondylolysis/isthmic spondylolisthesis degenerative joint disease of lumbosacral spine Intervertebral disc syndrome Radiculopathy Ankylosis of thoracolumbar spine Ankylosing spondylitis of the thoracolumbar spine back NOTE If there are systemic or other constitutional manifestations of ankylosing spondylitis ALSO complete the Non-degenerative Arthritis DBQ and the appropriate DBQ f....

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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