VA Form 21-0960A-3 - vba va 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and Social Security number at the top of the form. This information is crucial for identifying the veteran's records.
3. In Section I, provide details regarding any diagnoses of hypertension or isolated systolic hypertension. Indicate 'Yes' or 'No' and include relevant ICD codes and dates of diagnosis.
4. Move to Section II to describe the medical history of the veteran's hypertension condition. Include treatment plans and confirm if initial diagnoses were based on multiple blood pressure readings.
5. In Section III, answer questions about any related physical findings or complications. If applicable, complete additional forms for scars or other conditions.
6. Section IV requires you to assess how hypertension impacts the veteran's ability to work. Provide specific examples if applicable.
7. Finally, ensure that a physician certifies and signs the form in Section VI, providing their contact information as required.

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