Get Va Form 21-0960m-14 2010-2025

Filing the VA Form 21-0960M-14 online can be a straightforward process when you have the right guidance. This form is essential for veterans seeking disability benefits related to thoracolumbar spine conditions, and we are here to support you through each step.

Follow the steps to fill out the VA Form 21-0960M-14 online

1. Click ‘Get Form’ button to obtain the form and open it in your browser.
2. Begin by entering the name of the patient or veteran in the designated field at the top of the form.
3. Provide the patient or veteran's social security number in the next section accurately to ensure proper identification.
4. In Section I, indicate whether the veteran has a thoracolumbar spine condition by selecting 'Yes' or 'No'. If 'Yes', complete Item 1B with the diagnoses that pertain to the condition.
5. Continue to Section II and describe the history of the condition. Include details such as onset and course, and indicate whether flare-ups impact functionality.
6. For Section III, measure and document initial range of motion using a goniometer. Report the measurements in the provided boxes for each movement category.
7. In Section IV, confirm if the veteran is able to perform repetitive-use testing, select 'Yes' or 'No', and follow the provided format to document post-test measurements.
8. Move to Section V, indicating any additional limitations in range of motion or functional loss. Checkbox options will guide your entries.
9. Section VI focuses on pain responses – answer the questions pertaining to objective evidence of painful motion and tenderness.
10. Proceed to Section VII, where you will assess radiculopathy symptoms. Make note of any relevant signs and severity ratings.
11. Complete Sections VIII through XIII by addressing any other neurological abnormalities, intervertebral disc syndrome concerns, assistive devices in use, and functional impacts.
12. In the final section, Section XIV, have the physician certify and sign the form. Ensure all contact information is included.
13. Once you have filled out all sections, review your responses for accuracy and completeness. Save your changes, and you can then download, print, or share the form as necessary.

Start the process now by completing the VA Form 21-0960M-14 online.