Questionnaire Text

Aug 2022
Aug 2021
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Aug 2022
Questionnaire form view entire document:  text  image
D1
[Have/Has] [you/NAME] filed a claim for or received a rating from the Department of Veterans Affairs or the Department of Defense confirming that [you/he/she] [have/has] a service-connected disability; that is, a health condition or impairment caused or made worse by military service?
(1) Yes (Skip to D2)
(2) No (If S9 > 2010 goto E1; else go to END)
Blind: (D) Don't know
(R) Refused (If S9 > 2010 goto E1; else go to END)

top
Aug 2021
Questionnaire form view entire document:  text  image
D1
[Have/Has] [you/NAME] filed a claim for or received a rating from the Department of Veterans Affairs or the Department of Defense confirming that [you/he/she] [have/has] a service-connected disability; that is, a health condition or impairment caused or made worse by military service?
(1) Yes (Skip to D2)
(2) No (If S9 > 2010 goto E1; else go to END)
Blind: (D) Don't know
(R) Refused (If S9 > 2010 goto E1; else go to END)