A Disability Benefits Questionnaire (DBQ) is a standardized VA form that your private doctor or VA examiner completes to document your condition for a disability rating. Submitting a DBQ with your claim can help ensure the rater has all the information needed to assign an accurate rating.
Each DBQ below links directly to the official PDF on VA.gov. Ask your doctor to complete the form that matches your condition before or during your claim.
Musculoskeletal
AmputationsPDF ↗AnklePDF ↗Back (Thoracolumbar Spine)PDF ↗Bones and Other Skeletal ConditionsPDF ↗Elbow & ForearmPDF ↗Foot Conditions (Including Flatfoot/Pes Planus)PDF ↗Hand and FingerPDF ↗Hip and ThighPDF ↗Knee and Lower LegPDF ↗Muscle InjuriesPDF ↗Neck (Cervical Spine)PDF ↗OsteomyelitisPDF ↗Shoulder and/or ArmPDF ↗Temporomandibular Disorders (TMJ)PDF ↗WristPDF ↗
Neurological
ALS (Lou Gehrig's Disease)PDF ↗Central Nervous System and Neuromuscular DiseasesPDF ↗Cranial Nerve ConditionsPDF ↗Diabetic Peripheral NeuropathyPDF ↗FibromyalgiaPDF ↗Headaches (Including Migraines)PDF ↗Multiple Sclerosis (MS)PDF ↗NarcolepsyPDF ↗Parkinson's DiseasePDF ↗Peripheral NervesPDF ↗Seizure Disorders (Epilepsy)PDF ↗
Mental Disorders
Cardiovascular
Respiratory
Gastrointestinal
Genitourinary
Gynecological & Breast
Ear, Nose & Throat
Eye
Skin
Endocrine
Hemic & Lymphatic
Infectious Diseases
Rheumatological
Nutritional Deficiencies
Dental & Oral
Other
Source: VA Benefits — Public DBQs. Some DBQs are restricted to VA examiners only and are not listed here. For aid and attendance or housebound claims, use VA Form 21-2680.