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Va form 21 0960m 14 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the veteran's name and Social Security number at the top of the form. This information is crucial for identification purposes.
- In Section I, diagnose any thoracolumbar spine conditions. If applicable, provide detailed diagnoses along with ICD codes and dates of diagnosis.
- Proceed to Section II to summarize the medical history related to the thoracolumbar spine condition, including any flare-ups that impact functionality.
- For Section III, measure and record initial range of motion (ROM) using a goniometer. Ensure you document each measurement accurately.
- Continue through Sections IV to XII, filling out details regarding functional loss, pain assessment, radiculopathy history, and any diagnostic testing results as required.
- Finally, ensure that a physician certifies and signs the form in Section XIV before submission.
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by SR Simcox 2016 Cited by 10 VA offers is disability compensation.14 Over four million veterans draw a 21-0960M- 1 3-ARE.pdf;. Catherine. Trombley, Getting Your Claim ProcessedRead more
This document is the publicly released Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire.