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NOTE:

VA Fast Letter 10-34.pdf

DEPARTMENT OF VETERANS AFFAIRS

Veterans Benefits Administration

Washington, D.C. 20420

September 2, 2010

Director (00/21)

All VA Regional Offices and Centers

In Reply Refer To: 211

Fast Letter 10-34

SUBJ: Disability Benefits Questionnaires

As part of the Pittsburgh Regional Office's Innovation Initiative, a working group composed of representatives from VBA, VHA, Office of the General Counsel, the Board of Veterans' Appeals and the Pittsburgh Regional Office, was formed to develop streamlined Disability Benefits Questionnaires.

Formerly known as Worksheets, the streamlined Questionnaires are designed for use by both private and VA physicians in connection with applications for VA disability benefits. Each Questionnaire is derived directly from the disability rating criteria contained in the VA Schedule for Rating Disabilities.

The first three Questionnaires that the working group developed are attached. They pertain to the disabilities related to herbicide exposure that are part of the proposed Agent Orange regulation: Ischemic Heart Disease, Hairy Cell Leukemia and other B-cell Leukemias, and Parkinson's Disease.

The three attached Questionnaires have been approved by OMB and can be filled out by the Veteran's treating or examining physician (VA or private).

The Questionnaires have been sent for programming in VISTA. Notification will be provided once the questionnaire is available in VISTA.

For any questions e-mail VAVBAWAS/CO/21Q&A.

/S/

Thomas J. Murphy

Director

Compensation and Pension Service

Enclosures:

Ischemic Heart Disease Disability Benefits Questionnaire

Hairy Cell and Other B-cell Leukemias Disability Benefits Questionnaire

Parkinson's Disease Disability Benefits Questionnaire

NOTE TO USER: These forms are available online at VA.gov. Their numbers are:

21-0960A Ischemic Heart Disease Disability Benefits Questionnaire

21-0960B Hairy Cell and Other B-cell Leukemias Disability Benefits Questionnaire

21-0960C Parkinson's Disease Disability Benefits Questionnaire

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  • question-001.jpegLooking for Answers? Here are tips for finding the answers you seek.

     

    All VA Claims questions should be posted on our forums. To post, you must register. Registration is free. You can register for a free account here.

     

    You can read the forums without registering.

     

    Tips on posting on the forums.
     

    1. Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question.
    2. Knowledgeable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.
    3. Use paragraphs instead of one massive, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph, there are fewer who will investigate to dig it out.

     

    Leading to:

     

    Post straightforward questions and then post background information.

     

    Examples:
     
    • A. I was previously denied for apnea – Should I refile a claim?
      • Adding Background information in your post will help members understand what information you are looking for so they can assist you in finding it.
    • I was diagnosed with apnea in service and received a CPAP machine, but the claim was denied in 2008. Should I refile?
       
    • B. I may have PTSD- how can I be sure?
      • See how the details below give us a better understanding of what you’re claiming.
        • I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?

     

    This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

     

    Note:

     

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