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Get VA 21-0960E-1 2014-2024

UNCTION CAUSED BY DIABETES MELLITUS DIABETIC RETINOPATHY NOTE - For all checked boxes, also complete appropriate Questionnaire(s). VA Form 21-0960N-2, Eye Disability Benefits Questionnaire must be completed by an ophthalmologist or optometrist. 3B. DOES THE VETERAN HAVE ANY OF THE FOLLOWING CONDITIONS THAT ARE AT LEAST AS LIKELY AS NOT (at least a 50% probability) DUE TO DIABETES MELLITUS? YES NO (If "Yes," indicate the conditions below) (Check all that apply) ERECTILE DYSFUNCTION (If checked .

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