This version of the form is not currently in use and is provided for reference only. Download this version of VA Form 21-0960C-11 for the current year.

VA Form 21-0960C-11 Seizure Disorders (Epilepsy) Disability Benefits Questionnaire

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What Is VA Form 21-0960C-11?

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-11?
A: VA Form 21-0960C-11 is the Seizure Disorders (Epilepsy) Disability Benefits Questionnaire.

Q: What is the purpose of VA Form 21-0960C-11?
A: The purpose of VA Form 21-0960C-11 is to assess the level of disability and determine eligibility for disability benefits for individuals with seizure disorders (epilepsy).

Q: Who is eligible to use VA Form 21-0960C-11?
A: Veterans who have been diagnosed with seizure disorders (epilepsy) and are seeking disability benefits from the Department of Veterans Affairs (VA) can use this form.

Q: What information is required on VA Form 21-0960C-11?
A: The form requires information about the veteran's medical history, current symptoms, and the impact of the seizure disorder (epilepsy) on their daily life.

Q: Is VA Form 21-0960C-11 mandatory?
A: No, the use of VA Form 21-0960C-11 is not mandatory. However, it is recommended for veterans seeking disability benefits for seizure disorders (epilepsy) to provide as much information as possible to support their claim.

Q: How should VA Form 21-0960C-11 be submitted?
A: The completed VA Form 21-0960C-11 should be submitted to the local VA office handling the disability benefits claim.

Q: Does VA Form 21-0960C-11 guarantee disability benefits?
A: No, VA Form 21-0960C-11 is just one component of the disability benefits claim process. The final decision on eligibility and the level of disability benefits is determined by the VA based on all available evidence.

Q: Can a representative assist in completing VA Form 21-0960C-11?
A: Yes, veterans can seek assistance from a representative, such as a Veterans Service Officer or an accredited attorney, to help complete VA Form 21-0960C-11.

Q: Are there any fees associated with submitting VA Form 21-0960C-11?
A: No, there are no fees associated with submitting VA Form 21-0960C-11 or applying for disability benefits from the VA.

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-11 by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.