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DBQs: VA’s New Approach

Reprinted from PN December 2010

Innovative questionnaires specifically intended to help VA rating specialists properly evaluate and rate disabilities.

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On October 1, 2010, the Department of Veterans Affairs (VA) issued implementation instructions for a new program, using unique forms called Disability Benefit Questionnaires (DBQs). These will be used to streamline the method for veterans to submit medical evidence relevant to the rating of disabilities using VA’s Schedule for Rating Disabilities.

DBQs resulted from an idea submitted by VA’s Regional Office in Pittsburgh. It called for the creation of questionnaires, to be answered by VA physicians or veterans’ private physicians, specifically intended to help VA rating specialists properly evaluate and rate disabilities.

Three disease-specific DBQs have been issued as of this writing, and VA is in the process of creating more than 60 others. Each one will be specific for a particular disease or disability and will be designed to be easy for clinicians to use, compared to existing disability evaluation templates. When completed properly, a DBQ will provide the precise medical evidence required by VA rating specialists to make accurate decisions on veterans’ disability benefits claims.

Note: While DBQs will be a vital part of future disability evaluations, VA must still consider all medical evidence related to a particular claim, not just the DBQ.

The three DBQs released so far are for the three new presumptive conditions linked to Agent Orange exposure:

- Ischemic Heart Disease (VA Form 21-0960A)

- Hairy Cell and Other B-Cell Leukemias (VA Form 21-0960B)

- Parkinson’s disease (VA Form 21-0960C)

Eventually, all DBQs will be available to public and private providers for online completion and/or printing in PDF format through VA’s website (www.va.org).

It is now VA policy that DBQs (as each new one is released) will be used to provide medical evidence for veterans claiming physical or mental conditions stemming from their military service.

DBQs are designed to ensure adequate reports by addressing each rating criterium for a given condition. They are intended for use by compensation and pension (C&P) examiners (including C&P contract clinicians), VA providers, and private-sector physicians to provide a standardized format for communication of medical evidence for rating purposes.

VA will still require appropriate professional qualifications for examiners—whether public or private—to assess certain conditions (such as posttraumatic stress disorder [PTSD] and audiology) when using a DBQ. When applicable, restrictions as to who can complete a certain DBQ will likely be on the form itself or defined in VA policy. 

Typically, VA medical center staff assigned to help with disability evaluation will have primary responsibility for completion of DBQs. However, primary and specialty care clinical staff (in accordance with their credentials, privileges, or scope of practice) may complete DBQs for their patients, within a normal clinic visit.

DBQs are not intended to be completed by veterans, only clinical providers. Paper DBQs will be available for veterans to obtain and take to VA clinical staff, just as they will be for veterans to take to their own private clinicians. If a paper version of the DBQ form is completed, VA medical center staff are required to scan the form into VA’s computerized patient records. The original will be returned to the veteran so he or she can submit it to the local VA Regional Office.

To maintain the integrity of DBQs, VA has developed review procedures submitted by private physicians to look for irregularities in functional assessment for similar conditions, evidence of falsification, and any evidence of disproportionate use by any clinic or entity. The forms are designed to be useable without specific training. However, VA will not reimburse veterans for costs they may incur when their private physician completes the DBQ.

While DBQs will change the process VA uses to document the extent of a claimed disability, they will not change the examination process needed to determine a diagnosis or provide required information for C&P examinations. For mental-health-related DBQs, VA will develop rules designed to help maintain the integrity of the patient-provider relationship for a veteran’s treating mental-health provider. As such, VA policy will discourage that provider from completing mental-health-related DBQs.

Some VA clinicians will not agree to complete a DBQ or will find it requires diagnostic testing beyond what is indicated by the veteran’s history or current symptoms, or would otherwise be contraindicated or inappropriate. In these cases, the clinician must forward the veteran’s request to the appropriate VA Regional Office so the rating specialists can determine whether the veteran meets the requirements for providing a C&P examination.

 Important: A DBQ is not a claim form! If a veteran has not previously claimed VA disability benefits, he/she must still submit an application for compensation and/or pension to his or her local VA Regional Office. The Regional Office is responsible for the adjudication of claims, including assessment of the medical evidence submitted with a claim.

PVA’s national service officers (NSO) are ready to assist you in ensuring your claim is developed properly and will review all available evidence to guide you through the claims process. Contact your NSO before filing a claim so your questions are answered and you are fully informed of the process that will occur throughout the course of the claims process.

Contact: PVA Veterans Benefits Department, 800-424-8200.

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DBQs: VA’s New Approach

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