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To help our agents serve you better please give us a little more information. This is optional but will provide us with a better understanding of your case.

  • Overall Disability Rating

    Please select your current overall service-connected disability rating. This is a rating that the VA gave you.
  • Please select your current overall service-connected disability rating. This is a rating that the VA gave you.

  • Service-Connected Disbilities

    What is a Service-Connected Disability? - An injury or illness that the VA awarded a rating, which incurred or aggravated during active military service.

    Skip any questions that do not apply to you.

  • Ankle Disabilities

    Do you have a service-connected disability for your ankle(s)? If so, please tell us your rating and which side of the body it relates to.

  • Back Disabilities

    Do you have a service-connected disability for your back? If so, please tell us your rating and which side of the body it relates to.
  • Yes - I have numbness and tingling. No- I do not have numbness and tingling.

  • Chronic Fatigue Syndrome

    Do you have a service-connected disability for Chronic Fatigue Syndrome? If so, please tell us your rating..

  • Diabetes Disability

    Do you have a service-connected disability for diabetes? If so, please tell us your rating..

  • Epilepsy Disability

    Do you have a service-connected disability for Epilepsy? If so, please tell us your rating..

  • Elbow Disabilities

    Do you have a service-connected disability for your elbow(s)? If so, please tell us your rating and which side of the body it relates to.

  • Fibromyalgia Disability

    Do you have a service-connected disability for Fibromyalgia? If so, please tell us your rating..

  • Foot Disabilities

    Do you have a service-connected disability for your feet? If so, please tell us your rating and which side of the body it relates to.

  • GERD Disability

    Do you have a service-connected disability for GERD? If so, please tell us your rating.

  • Headache Disabilities

    Do you have a service-connected disability for your headaches? If so, please tell us your rating and which side of the body it relates to.

  • Heart Disabilities

    Do you have a service-connected disability for your heart? If so, please tell us your rating and which side of the body it relates to.

  • Hip Disabilities

    Do you have a service-connected disability for your hip(s)? If so, please tell us your rating and which side of the body it relates to.

  • Irratatable Bowel Disease

    Do you have a service-connected disability for IBS? If so, please tell us your rating.

  • Hip Disabilities

    Do you have a service-connected disability for your knee(s)? If so, please tell us your rating and which side of the body it relates to.

  • Kidney Disability

    Do you have a service-connected disability for Kidney? If so, please tell us your rating.

  • Neck Disabilities

    Do you have a service-connected disability for your neck? If so, please tell us your rating and if your upper or lower extremities are affected by your disability.
  • Yes - I have numbness and tingling. No- I do not have numbness and tingling.

  • Mental Disabilities

    Do you have a service-connected disability for any mental conditions? This includes anxiety, PTSD, and depression. If so, please tell us your rating.

  • Neuropathy Disability

    Do you have service-connected Neuropathy disabilities? If so, please tell us your rating.

  • Prostrate Disability

    Do you have service-connected prostate disabilities? If so, please tell us your rating.

  • Respiratory Disabilities

    Do you have service-connected respiratory disabilities? If so, please tell us your rating.

  • Scar Disabilities

    Do you have service-connected scar disabilities? If so, please tell us your rating.

  • Sinusitis Disabilities

    Do you have service-connected sinusitis disabilities? If so, please tell us your rating.

  • Shoulder Disabilities

    Do you have a service-connected disability for your shoulder(s)? If so, please tell us your rating and which side of the body it relates to.

  • Sleep Apnea Disabilities

    Do you have a service-connected disability for sleep apnea? If so, please tell us your rating.

  • Wrist Disabilities

    Do you have a service-connected disability for your wrist(s)? If so, please tell us your rating and which side of the body it relates to.

  • Non-Listed Disabilities

    Please list any additional disabilities that are not listed above. Only list disabilities that you are service-connected for and your current rating.
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