VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire

VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire

What Is VA Form 21-0960A-4?

This is a legal form that was released by the U.S. Department of Veterans Affairs on March 1, 2018 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 21-0960A-4?
A: VA Form 21-0960A-4 is a Disability Benefits Questionnaire specifically for heart conditions.

Q: What does this form cover?
A: This form covers a range of heart conditions including ischemic and non-ischemic heart disease, arrhythmias, valvular disease and cardiac surgery.

Q: Who needs to fill out this form?
A: This form needs to be filled out by veterans seeking disability benefits for heart conditions.

Q: What information is required in this form?
A: This form requires detailed information about your heart condition, medical history, and any treatments or surgeries you have undergone.

Q: What are the benefits of filling out this form?
A: Filling out this form allows veterans to apply for disability benefits specifically related to their heart conditions.

Q: Who can help me fill out this form?
A: You can seek assistance from a Veterans Service Officer or a representative from a veterans service organization to help you fill out this form.

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Form Details:

  • Released on March 1, 2018;
  • 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;

Download a fillable version of VA Form 21-0960A-4 by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

Download VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire

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  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire

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  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 1
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 2
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 3
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 4
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 5
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 6
  • VA Form 21-0960A-4 Heart Conditions (Including Ischemic and Non-ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire, Page 7
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