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How to fill out the VA 21-0960E-1 online
Completing the VA 21-0960E-1 form online can streamline your application process for diabetes mellitus disability benefits. This guide will help you navigate through each section of the form with clear, step-by-step instructions tailored to your needs.
Follow the steps to successfully complete the VA 21-0960E-1 form.
- Press the ‘Get Form’ button to retrieve the online version of the VA 21-0960E-1 form.
- Begin by entering the name of the patient or veteran in the designated field.
- Input the patient or veteran's social security number where required.
- In Section I, 'Diagnosis', select the veteran's diabetes condition from the options provided, including type I, type II, and other categories.
- Complete any additional diagnoses related to diabetes mellitus by specifying them, along with the ICD codes and the dates of diagnosis.
- Move to Section II, 'Medical History'. Check all treatments that apply and provide examples of activity regulation if applicable.
- Indicate the frequency of visits to the diabetic care provider for episodes of ketoacidosis or hypoglycemia.
- Address any episodes of hospitalization due to ketoacidosis or hypoglycemia in the provided fields.
- In Section III, 'Complications of Diabetes Mellitus', check if there are any recognized complications and specify them as required.
- Continue to indicate whether the veteran's diabetes has permanently aggravated any other conditions.
- In Section IV, provide details about any related physical findings or conditions, including scars if applicable.
- Complete Section V by marking the results of diagnostic tests used in the diagnosis of diabetes mellitus.
- In Section VI, evaluate the impact of the diabetes condition on the veteran's ability to work, providing examples if necessary.
- Fill in Section VII with any remarks relevant to the claim.
- Finally, in Section VIII, the physician must certify the form by signing and providing their contact details. Ensure all necessary fields are completed.
- After reviewing the form for accuracy, save changes, and utilize the options to download, print, or share the completed form.
Take the next step towards securing benefits by completing your VA 21-0960E-1 form online today.
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