Va form 21 0960m 14 2025

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The document is a Disability Benefits Questionnaire (DBQ) for evaluating back (thoracolumbar spine) conditions for veterans applying for disability benefits from the U.S. Department of Veterans Affairs (VA). It includes sections for medical history, diagnosis, range of motion measurements, pain assessment, muscle strength testing, and functional impact. The form requires detailed information from physicians regarding the veteran's condition and its effects on their daily functioning and ability to work.

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What is an example of a functional impairment?

Functional Loss - Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal exertion, strength, speed, coordination, and endurance.

What does functional loss or functional impairment mean?

To obtain a 100% VA disability rating for back pain on its own, there must be a total immobilization of the spine, where both the thoracolumbar (lower/middle back) and cervical (neck) areas show no mobility.

What is VA form 21 10210 used for?

When to use this form. Use VA Form 21-10210 to submit a formal statement to support your VA claimor the claim of another Veteran or eligible family member. People also sometimes call this statement a buddy statement.

What is the VA CP exam for degenerative disc disease?

A CP Exam is conducted by a VA medical examiner who performs a physical examination for the specific medical condition for which you are seeking compensation. The examiner will ask you a series of questions related to your medical history, current symptoms, and how your condition has impacted your life.

What is an example of functional loss or functional impairment of the back?

Functional Loss For example, a veteran might be able to bend forward 85 degrees but start to experience pain at 55 degrees. In this case, the veteran should receive a disability rating that is consistent with both the range of motion measurements and the functional limitations caused by their back pain.