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NECK (CERVICAL SPINE) CONDITIONS DISABILITY BENEFITS ...

Updated on June 17, 2020 ~v20_2 Page 1 of 13 Neck (Cervical spine ) CONDITIONS DISABILITY BENEFITS Questionnaire Released January 2022 NECK (CERVICAL spine ) CONDITIONS DISABILITY BENEFITS QUESTIONNAIREC laimant/Veteran's Social Security NumberName of Claimant/VeteranSECTION I - DIAGNOSISNote: These are condition(s) for which an evaluation has been requested on an exam request form (Internal VA) or for which the Veteran has requested medical evidence be provided for submission to List the claimed condition(s) that pertain to this questionnaire:Note: These are the diagnoses determined during this current evaluation of the claimed condition(s) listed above.

Jun 17, 2020 · Date of Examination. Right Left. Ambidextrous Dominant hand: DOMINANT HAND. Note - The Veteran is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information you provide on this questionnaire as part ... Does the Veteran report flare-ups of the cervical spine? 2C. Does the Veteran report ...

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