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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient/veteran's name and social security number at the top of the form. This information is crucial for identification purposes.
In Section I, indicate whether the veteran currently has or has ever had a gynecological condition by selecting 'Yes' or 'No'. If 'Yes', provide detailed diagnoses and corresponding ICD codes.
Proceed to Section II to describe the medical history related to each gynecological condition, including causes and symptoms experienced.
In Section III, check all current symptoms related to gynecological conditions, ensuring you note their frequency and severity.
Continue through Sections IV to XVIII, providing detailed responses about treatments, complications, diagnostic testing, and any functional impacts on work.
Finally, ensure that a physician certifies and signs the form in Section XX before submission.
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See more VA Form 21-0960K-2 - Veterans Benefits Administration versions
We've got more versions of the VA Form 21-0960K-2 - Veterans Benefits Administration form. Select the right VA Form 21-0960K-2 - Veterans Benefits Administration version from the list and start editing it straight away!
What is the difference between VA Form 21 4142 and VA Form 21 4142a?
Complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA) and VA Form 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA); submit completed forms with your claim and VA will attempt to obtain your records through our
Does a CP examiner fill out a DBQ?
Throughout the CP exam, the examiners will ask questions about the veterans disability and how it affects aspects of daily functioning. During this, the examiner might complete a VA Disability Benefits Questionnaire (DBQ).
Do VA doctors fill out DBQ?
Yes, VA doctors are allowed to fill out DBQs for veterans to support their VA disability claims for benefits.
How do I download VA forms?
How to download and open a VA.gov PDF form Click the Download VA form link for the form you want to fill out. The PDF will download to your Downloads folder. Open Adobe Acrobat Reader. From the File menu, choose Open. Go to your Downloads folder or the location on your device where you saved the PDF.
Who fills out DBQ for VA disability?
Use VA Form 21P-601 to apply for accrued benefits due the beneficiary but not paid prior to death. Each person claiming a share of accrued benefits must complete a separate VA Form 21P-601. Any available accrued benefits are payable to the first living person listed below.
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DBQs can be filled out by licensed medical professionals. This includes both VA and private doctors. However, having a private physician complete a DBQ can be advantageous, especially if the Veteran faces delays in getting VA appointments.
Who can complete a VA DBQ?
While VA doctors can complete DBQs, many veterans turn to private providers for quicker, more detailed documentation tailored to VA standards. A private DBQ, when thoroughly completed, can often reduce the need for additional CP exams, saving you time and moving your claim forward faster.
Page 2. VA FORM 21-0960K-2, FEB 2011. Page 2. 4C. If yes, indicate effectiveness of treatment in controlling symptoms: SECTION IV - FINDINGS, SIGNS AND
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