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VA Form 21-0960A-1

Description: VA Form 21-0960A-1 is a medical questionnaire form to be filled out by a physician treating a veteran who is applying for disability benefits. Ischemic heart disease (IHD) has been recognized by the VA as being connected with exposure to Agent Orange. Vietnam veterans with IHD may be eligible for fast-track benefits due to their exposure to Agent Orange.
Form Type: Other Document Templates, Questionnaires
Practice Area: Health Care, Litigation, Pro Bono

Date: Nov 2013
PLI Item #: 60324
Official ID: VA Form 21-0960A-1 JAN 2014
Keywords: "ischemic heart disease disability benefits questionnaire"; "health benefits"; "department of veterans affairs"; military; "armed forces"; VA; IHD; "agent orange"
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