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How to use or fill out VA Form 21-0960A-4 Non-Ischemic Heart Disease (Including Arrhythmias and Surgery) Disability Benefits with Our Platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient's name and Social Security number at the top of the form. This information is crucial for identification.
- In Section I, indicate whether the veteran has a non-ischemic heart disease, arrhythmia, or has undergone cardiac surgery by selecting 'Yes' or 'No'. If 'Yes', provide relevant diagnoses and their details.
- Proceed to Section II to document the veteran's medical history. Answer questions regarding heart disease and any related conditions, checking all applicable boxes.
- Continue through Sections III to VII, providing detailed information about treatment plans, functional impacts, and any additional remarks as necessary.
- Finally, ensure that a physician completes Section VIII by signing and providing their contact information before submitting the form.
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