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Disability Benefits Questionnaires (Group I ) 2900-0779
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 3.326 38 CFR 3.351

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 21-0960I-6 Tuberculosis Disability Benefits Questionnaire 21-0960I-6.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-14 Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire 21-0960M-14.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960I-1 Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire 21-0960I-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960J-3 Prostate Cancer Disability Benefits Questionnaire 21-0960J-3.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960P-3 Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire 21-0960P-3.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960P-2 Mental Disorders (Other than PTSD and Eating Disorders) Disability Benefits Questionnaire 21-0960P-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960J-2 Male Reproductive Organ Conditions Disability Benefits Questionnaire 21-0960J-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960C-2 Amotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits Questionnaire 21-0960C-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960C-10 Peripheral Nerves Conditions (Not including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire 21-0960C-10.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960J-1 Kidney Conditions (Nephrology) Disability Benefits Questionnaire 21-0960J-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960P-1 Eating Disorders Disability Benefits Questionnaire 21-0960P-1.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960B-2 Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire 21-0960B-2.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-0960M-13 Neck (cervical spine) Disability Benefits Questionnaire 21-0960M-13.pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

407,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 407,000 0 0 0 0 407,000
Annual IC Time Burden (Hours) 213,500 0 0 0 0 213,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.