Get Va 21-0960c-1 2017-2025
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How to fill out the VA 21-0960C-1 online
Filling out the VA 21-0960C-1 form can seem daunting, but this guide will provide you with clear, step-by-step instructions on how to complete it online. With the right guidance, you can ensure that your application for disability benefits is accurate and complete.
Follow the steps to accurately complete the form online.
- Click 'Get Form' button to access the VA 21-0960C-1 form and open it in your preferred online editor or viewing software.
- Begin by entering the name of the patient or veteran in the designated field, followed by their social security number. This information is essential for identifying the individual associated with the claim.
- In Section I, answer whether the veteran has been diagnosed with Parkinson's disease. Select 'Yes' or 'No', and if applicable, provide the ICD code and date of diagnosis.
- Indicate the dominant hand of the veteran by selecting right, left, or ambidextrous.
- Proceed to Section II, where you will check the applicable motor manifestations due to Parkinson's disease or its treatment. Mark each manifestation as none, mild, moderate, or severe.
- Continue filling out Section III by assessing mental manifestations. Again, check all that apply and indicate severity.
- In Section IV, identify any additional manifestations or complications and their severity. Be thorough and honest in your assessments.
- In Section V, evaluate the functional impact of Parkinson's disease on the veteran's ability to work, providing examples if 'Yes' is selected.
- In Section VI, include the physician's certification by entering the necessary details such as signature, printed name, phone number, NPI number, and date signed.
- After completing all sections, review the information for accuracy. Finally, you can save changes, download, print, or share the completed form as needed.
Start filling out your VA 21-0960C-1 form online today for a smooth application process.
To accurately fill out VA Form 21 10210, ensure you read each section thoroughly. Provide detailed information about your employment history, limitations caused by your disability, and any vocational rehabilitation efforts. Take your time to complete the form fully, as accuracy enhances the evaluation of your VA 21-0960C-1 claim. US Legal Forms offers resources to assist you in completing this form correctly.
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