- DBQs measure severity, not service-connection — they help determine your rating percentage
- DBQs are optional — the VA provides free C&P exams that serve the same purpose
- Best completed by your treating physician — credibility increases with established patient relationships
- Still attend VA-ordered exams — even if you submit a DBQ, go to any scheduled C&P exams
The primary purpose of a DBQ is to determine the SEVERITY of the Veteran's disability, not whether the disability is service-connected. The DBQ can be a key piece of evidence the rater uses in assigning a Veteran's rating, whether in a Supplemental appeal or when the Veteran initially files their claim.
DBQs are NOT required! The VA provides free C&P exams to determine disability severity. Don't feel obligated to pay for one.
Always attend VA-ordered exams! Even if you submit a DBQ, you must attend any C&P exam the VA schedules. Skipping can derail your claim.
Obtaining DBQ Forms
Veterans may obtain the latest DBQs HERE. The forms can be filled in electronically and then printed/signed, or may simply be printed and filled in by hand by the physician.
Who Can Complete a DBQ?
DBQs should be completed by the Veteran's primary care provider or specialist that has treated the disability the Veteran is claiming.
Your VA Health Care Professional (Doctor, Psychologist, Nurse Practitioner, etc.)
For Veterans receiving health care from the VA, they may ask their primary care or specialty care provider to complete a DBQ for conditions which are already diagnosed and documented and for which the provider is treating the Veteran.
Your VA physician may not be sure about their authority to do this. You may need to provide them a copy of VHA Directive 1134(2) (direct pdf download from the VA website). The relevant section is on page 7 (numbered as page 4 in the document), "(c) Completion of DBQs to Support VA Benefits Claims."
IMPORTANT NOTES:
While VHA Directive 1134(2) is now itself expired, currently active VHA Directive 1046 (direct pdf download from the VA website) states in section 1 to "Follow VHA Directive 1134(2), disability exam requests that are not associated with a formal request from VBA and are external to the VA C&P disability examination process.".
While the VA permits all DBQs to be completed, they do NOT recommend that VA employees complete mental health DBQs, in order to maintain the integrity of the patient-provider relationship.
Your provider is NOT required to complete a DBQ!
Your Private Health Care Professional
If you see a private practice doctor, TriCare, health insurance through a job or spouse, etc., you may want to get them to fill out the DBQ for you.
Be aware that the VA will NOT reimburse third party providers for filling out DBQs, you will have to pay this out of pocket if not covered by other insurance.
A Provider You Have NEVER Seen Before
The VA is required to consider medical evidence from ALL sources, including a telehealth exam from a physician you have never met and who has not treated you. However, the VA has clearly stated that it is intended that DBQs be completed by the Veteran's provider, and they may not accept a DBQ from a physician who you are not under treatment from.
IMPORTANT NOTE:
It is the position of r/VeteransBenefits that Veterans avoid going this route. But we do recognize that for some Veterans this may be their only option.
Again remember, your claim does NOT require a DBQ to be successful or to get the proper evaluation you deserve.
Yourself
If the Veteran themselves is a physician or other health care provider with relevant expertise, they CAN complete their own DBQ!
Factors that Add to the Credibility/Weight of Your DBQ
There are several factors that will increase or decrease the value of your DBQ. Here are just a few things that will help:
Physician has a history of treating the Veteran.
Completed during an in-person examination.
Physician has reviewed the Veteran's relevant pre/post military and non-military medical records.
Amount of experience, education, and specialization.
Conditions that REQUIRE a Specialist
The following conditions MUST be done by a specialist:
Hearing Loss and Tinnitus
Hearing loss examinations must be completed by a state-licensed audiologist.
Tinnitus examinations may be conducted by either an audiologist or non-audiologist clinician, IF a hearing loss examination is of record!
Mental Health
If you do not have service-connection yet for mental health, the VA requires the examiner have much greater qualifications.
Initial Mental Health (NOT Currently Service-Connected)
Board-certified or board-eligible psychiatrists;
Licensed doctorate-level psychologists; OR
One of the following other mental health professionals, under the CLOSE supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist:
Doctorate-level mental health providers
Psychiatry residents; and
Clinical/Counseling psychologists completing a one-year internship or residency.
NOTE:
“Close supervision” means that the supervising psychiatrist or psychologist met with the Veteran and conferred with the examining mental health professional in providing the diagnosis and the final assessment. The supervising psychiatrist or psychologist must co-sign the examination report.
Increase Mental Health
The above initial qualified docs or any of the following who are under the close supervision of them.
Clinical nurse specialists;
Licensed clinical social workers;
Nurse practitioners; or
Physician assistants.
Traumatic Brain Injury
The initial examination must be done by one of the following:
Psychiatrists;
Physiatrists;
Neurologists; or
Neurosurgeons.
Conditions that REQUIRE a C-file Review
There are several conditions the VA has identified as needing the examiner to review the Veteran's C-file BEFORE they can complete a DBQ. If an examiner fails to indicate they have reviewed the Veteran's c-file the DBQ is considered inadequate!
IMPORTANT NOTE:
This requirement ONLY applies to VA examiners and VA contract examiners!
These conditions are as follows:
Final Words
Remember, the Veteran does NOT need complete and submit a DBQ when making a claim. Ultimately, a DBQ is only a declaration as to the severity of a Veteran's disability. It might be said, it makes the most sense to submit a DBQ if the Veteran disagrees with their rating. In this case submitting one in a Supplemental claim might make the most sense.
A DBQ will not of any help to a Veteran whose claim was denied due to lack of service-connection. In this case, an IMO which can opine as to the likelihood of the Veteran's condition being service-related might be the best route.