VA Form 10-9009. Agent Orange Registry Code Sheet
The VA Form 10-9009, also known as the Agent Orange Registry Code Sheet, is used by the Department of Veterans Affairs (VA) to document and track the exposure of veterans to Agent Orange during their military service. The purpose of the form is to collect information from veterans who believe they were exposed to Agent Orange and to provide them with information about the potential health effects of exposure.
The form consists of several parts, including personal information of the veteran, their military service history, and any known exposure to Agent Orange. Important fields include the veteran's name, address, and VA file number, the dates and locations of their military service, and any information about exposure to Agent Orange.
It is important to consider providing accurate and complete information in all fields, as incomplete or inaccurate information may affect the veteran's eligibility for benefits related to Agent Orange exposure. When filling out the form, veterans may attach any relevant medical records or test results that support their claim of exposure.
An example of when this form may be used is if a veteran served in Vietnam and believes they were exposed to Agent Orange during their military service. By submitting this form, the veteran is providing information about their exposure to Agent Orange and may be eligible for healthcare and benefits related to the health effects of exposure.
Strengths of this form include providing a formal process for veterans to document and track their exposure to Agent Orange and to receive information about potential health effects. Weaknesses may include the potential for incomplete or inaccurate information on the form and the potential for delays in processing the form.
Related form is the VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits).
Submitting the form can be done online through the VA's eBenefits portal or by mail to the VA regional office. Once submitted, the form is stored in the VA's electronic records system and may be used to determine the veteran's eligibility for benefits related to Agent Orange exposure.