Get Va 21-0960c-9 2012

Filling out the VA 21-0960C-9 form is an essential step in applying for disability benefits related to multiple sclerosis. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and effectively online.

Follow the steps to complete the form successfully.

1. Use the ‘Get Form’ button to obtain the VA 21-0960C-9 form and open it in your chosen online platform.
2. Begin with the patient/veteran's information section. Enter the name and social security number of the patient or veteran applying for benefits.
3. Move to Section I, Diagnosis. Answer whether the veteran has multiple sclerosis (MS) by selecting 'Yes' or 'No,' and if applicable, provide the relevant diagnosis details, including ICD codes and dates.
4. Proceed to Section II, Medical History. Describe the history of the veteran's MS, including onset and course, and indicate the dominant hand.
5. In Section III, Conditions, Signs and Symptoms Due to MS, respond to each question regarding muscle weakness, swallowing conditions, respiratory issues, sleep disturbances, bowel function, and voiding dysfunction, checking all that apply.
6. Complete Section IV, Neurologic Exam, by assessing gait, strength, deep tendon reflexes, and sensation testing results. Indicate any muscle atrophy present.
7. In Section V, provide details on any additional pertinent physical findings or complications related to the diagnosed conditions.
8. Section VI deals with mental health manifestations. Indicate if the veteran has symptoms of depression or cognitive impairment and provide necessary details.
9. Complete Sections VII, VIII, IX, and X addressing housebound status, aid and attendance needs, need for higher levels of care, and assistive devices used.
10. In Section XI, assess remaining effective function of extremities, indicating if functionalities are so diminished that amputation with prosthesis would be equally effective.
11. Fill Section XII regarding the veteran’s financial responsibility and ability to manage benefit payments.
12. Provide details for diagnostic testing in Section XIII, including any imaging studies or pulmonary function tests completed.
13. Discuss the functional impact of MS on the veteran's ability to work in Section XIV.
14. Add any remarks or additional information in Section XV.
15. Finalize the form with the physician's certification in Section XVI, ensuring all required signatures and contact information are included.
16. Once the form is completed, save any changes made online, and you may choose to download, print, or share the form as needed.

Begin filling out your VA 21-0960C-9 form online today!