Non-Veteran Total and Permanent Disability Physicians / Optometrist Certification/Statement of Gross Income  - Forms Download
    
	Physician’s Certification of Total and Permanent Disability - 
        DR 416 Form
    
    Optometrist’s Certification of Total and Permanent Disability -
        DR 416B Form
    
    Statement of Gross Income - 
        DR 501A Form
    
    Applicants who are Hemiplegic, Paraplegic, or require wheelchair use for mobility (except Quadriplegic) must file Form DR 501A along with their Physician/Optometrist Certification.