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VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire

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VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire

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What Is VA Form 21-0960C-5?

This is a legal form that was released by the U.S. Department of Veterans Affairs on September 1, 2016 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 21-0960C-5?A: VA Form 21-0960C-5 is a Disability Benefits Questionnaire for Central Nervous System and Neuromuscular Diseases.

Q: What conditions does the form cover?A: The form covers Central Nervous System and Neuromuscular Diseases, except for Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, TMJ Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, and Chronic Fatigue Syndrome.

Q: What is the purpose of VA Form 21-0960C-5?A: The purpose of the form is to gather information about the veteran's disability for the evaluation of disability benefits.

Q: Who should fill out the form?A: The form should be filled out by the veteran or their representative.

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Form Details:

  • Released on September 1, 2016;
  • 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 21-0960C-5 by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

Download VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 2

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 3

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 4

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 5

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 6

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 7

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 8

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinson's Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 9

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  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 1
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 2
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 3
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 4
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 5
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 6
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 7
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 8
  • VA Form 21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Parkinsons Disease, Multiple Sclerosis, Headaches, Tmj Conditions, Epilepsy, Narcolepsy, Peripheral Neuropathy, Sleep Apnea, Cranial Nerve Disorders, Fibromyalgia, Chronic Fatigue Syndrome) Disability Benefits Questionnaire, Page 9
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