VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire

VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire

What Is VA Form 21-0960g-3?

This is a legal form that was released by the U.S. Department of Veterans Affairs on October 1, 2012 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is VA Form 21-0960g-3?
A: VA Form 21-0960g-3 is a Disability Benefits Questionnaire specifically for assessing intestinal conditions other than surgical or infectious conditions.

Q: What types of intestinal conditions does Form 21-0960g-3 cover?
A: Form 21-0960g-3 covers a range of intestinal conditions, including Irritable Bowel Syndrome (IBS), Crohn's Disease, Ulcerative Colitis, and Diverticulitis.

Q: What is the purpose of Form 21-0960g-3?
A: The purpose of Form 21-0960g-3 is to evaluate the severity and impact of intestinal conditions on an individual's ability to work and perform daily activities, for the purpose of determining eligibility for disability benefits.

Q: Who should fill out Form 21-0960g-3?
A: Form 21-0960g-3 should be completed by a licensed healthcare provider, such as a physician, who has knowledge and expertise in evaluating intestinal conditions.

Q: Is Form 21-0960g-3 the only form for intestinal conditions?
A: No, there may be other forms or questionnaires specifically tailored for different intestinal conditions. It is important to check with the VA or your healthcare provider for the appropriate form to use.

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Form Details:

  • Released on October 1, 2012;
  • The latest available edition released by the U.S. Department of Veterans Affairs;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of VA Form 21-0960g-3 by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

Download VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire

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  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire

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  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 2

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  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 3

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  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 4

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  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohns Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 1
  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohns Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 2
  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohns Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 3
  • VA Form 21-0960g-3 Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohns Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire, Page 4
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