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Vertebral fracture vertebrae of the back Other specify Other diagnosis 1 VA FORM MAY 2013 21-0960M-14 SUPERSEDES VA FORM 21-0960M-14 OCT 2012 WHICH WILL NOT BE USED. OMB Approved No. 2900-0808 Respondent Burden 45 minutes Expiration Date 04-30-2017 BACK THORACOLUMBAR SPINE CONDITIONS DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS VA WILL NOT PAY OR REIMBURSE ANY EXPENSES OR COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. SPECIFY NERVE RO ...

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