Disability Benefits Questionnaires (DBQs)

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 www.benefits.va.gov/compensation/evidence.asp

 

With Disability Benefits Questionnaires (DBQs) Veterans now have more control over the disability claims process. Veterans have the option of visiting a private health care provider instead of a VA facility to complete their disability evaluation form.

Veterans can have their providers fill out any of the more than 70 DBQs that are appropriate for their co nditions and submit them to us. It’s that easy!

See our instruction pages to help you with the process. I am a Veteran – VSO –Health Care Provider.

 

Where can I see a listing of the Questionnaires?

 

Visit our pages to see the available forms

DBQ List by Form Name 

http://www.benefits.va.gov/COMPENSATION/dbq_ListByDBQFormName.asp

or  DBQ List by Symptom .

http://www.benefits.va.gov/COMPENSATION/dbq_ListBySymptom.asp

 

Who fills them out?

 

For VA exams, a VA clinician will fill out the DBQ. If being seen by a private provider, have them complete the DBQ and submit it to us either by Regional Office Fax Numbers or mail.

 

Where can I get more information?

 

See our DBQ Frequently Asked Questions  for more information. You can also call us at 1-800-827-1000 or Ask us a Question.

DBQs also help support VA’s Fully Developed Claims (FDC) Program. DBQs are valuable for claims processing because they provide medical information that is directly relevant to determining a disability rating. When submitted with afully developed claim, DBQs ensure VA’s rating specialists have precisely the information they need to st art processing the claim.

http://www.benefits.va.gov/compensation/dbq_providerinstruct.asp

 

DBQ Provider Instructions

 

Your patient is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will use the information you provide o n this Disability Benefits Questionnaire (DBQ) to process the Veteran’s claim.

Important: VA will not pay or reimburse any expenses or costs incurred in the process of completing and/or submitting a DBQ. VA reserves the right to confirm the authenticity of all DBQs completed by private health care providers.  The following steps do not apply to VA compensation and pension examination clinics.

Steps

 

1If your patient brings the DBQ, go to step 2.

If your patient requests you download the appropriate DBQ based on his or her claimed disability,

· Go to http://benefits.va.gov/compensation/disabilityexams

· Select the appropriate DBQ by using the List by DBQ form name or List by Symptoms web pages.

· To complete the DBQ electronically, download it. To complete the DBQ by hand, print it.

2Complete the DBQ.

· Follow all instructions carefully.

· Legibility is important! Therefore, VA prefers you complete the DBQ electronically. If you complete a DBQ by hand, VA must be able to read the information.

· You must complete the last section of the DBQ by providing your name, signature, and contact information. VA will only accept a DBQ signed by a licensed healthcare professiona l.

· If you completed an electronic DBQ, you must print it to sign it.

3Provide your patient with a copy of the completed DBQ for his or her records.
4If your patient requests, submit the completed DBQ to VA.

· Ask your patient to identify the VA Regional Office (RO) responsible for handling the claim.

· You can submit the DBQ to that VA RO by fax or mail. You can find the RO’s mailing address and fax number on the DBQ website.

Here’s a comprehensive video on DBQ Provider Instructions

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