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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 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.

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.

Knee 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.

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 prostrate 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 Disabilites

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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