The Gist: Disability Benefits Questionnaires (DBQs) are standardized medical forms that help the VA evaluate the severity of a claimed condition. Filing them with a Fully Developed Claim (FDC) can strengthen your evidence and may speed up decisions. Below is the official VA list of public DBQs by body system.

Separation Health Assessment DBQ

If filing through a Benefits Delivery at Discharge or Integrated Disability Evaluation System, you must complete the Separation Health Assessment DBQ - Part A.

• Separation Health Assessment DBQ - Part A
• Guidance for Separation Health Assessment DBQ - Part A

All clinician information blocks at the bottom of the forms must be completed. Also, the clinician filling out the form must sign and date it. We reserve the right to confirm the authenticity of ALL DBQs. Information is subject to verification through computer matching programs with other agencies or any other means deemed appropriate.

Cardiovascular

• Artery and Vein Conditions
• Heart Conditions
• Hypertension

Dental & Oral

• Oral and Dental

Dermatological

• Scars
• Skin Diseases

Endocrinological

• Diabetes Mellitus
• Endocrine (Other than Thyroid, Parathyroid or Diabetes Mellitus)
• Thyroid and Parathyroid

Ear, Nose, Throat

• Ear (including Vestibular and Infectious)
• Loss of Sense of Smell and or Taste
• Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx

Gastrointestinal

• Esophageal Disorders
• Gallbladder
• Hernias (Including Abdominal, Inguinal and Femoral Hernias)
• Intestinal Conditions
• Liver Conditions
• Pancreas
• Peritoneal Adhesions
• Rectum & Anus
• Stomach and Duodenum

Genitourinary

• Kidney Conditions
• Male Reproductive Organ Conditions (Including Prostate Cancer)
• Urinary Tract Conditions

Gynecological

• Breast
• Gynecological Conditions

Hematologic & Lymphatic

• Hematologic and Lymphatic Conditions, Including Leukemia

Infectious Diseases

• HIV-Related Illnesses
• Infectious Diseases (other than HIV-related illness chronic fatigue syndrome and tuberculosis)
• Persian Gulf/Afghanistan Infectious Diseases
• Tuberculosis

Musculoskeletal

• Amputations
• Ankle
• Back (Thoracolumbar Spine)
• Bones and Other Skeletal Conditions
• Elbow & Forearm
• Foot Conditions Including Flatfoot (Pes Planus)
• Hand and Finger
• Hip and Thigh
• Knee and Lower Leg
• Muscle Injuries
• Neck (Cervical Spine)
• Osteomyelitis
• Shoulder and/or Arm
• Temporomandibular Disorders
• Wrist

Neurological

• ALS (Lou Gehrig's Disease)
• Central Nervous System and Neuromuscular Diseases
• Cranial Nerve Conditions
• Diabetic Peripheral Neuropathy
• Fibromyalgia
• Headaches (including Migraines)
• Multiple Sclerosis (MS)
• Narcolepsy
• Parkinson's Disease
• Peripheral Nerves
• Seizure Disorders (Epilepsy)

Nutrition

• Nutritional Deficiencies

Ophthalmological

• Eye Conditions

Psychological

• Eating Disorders
• Mental Disorders
• PTSD Review

Respiratory

• Respiratory Conditions (other than tuberculosis and sleep apnea)
• Sleep Apnea

Rheumatological

• Arthritis
• Chronic Fatigue Syndrome
• Systemic Lupus Erythematosus (SLE) and other Autoimmune Diseases

Spina Bifida (natural child of a Veteran exposed to herbicides)

• Spina Bifida

Aid and Attendance or Housebound

• Please search the Find a VA Form webpage for VA Form 21-2680.

The following DBQs are not available for public use. There are limitations outlined in federal regulations and/or specialized training needed to complete them.

• Cold Injury Residuals
• Former POW Protocol
• General Medical – Compensation
• General Medical – Pension
• Gulf War General Medical Examination
• Medical Opinion
• Separation Health Assessment – Part B
• Initial Post Traumatic Stress Disorder (PTSD)
• Hearing Loss and Tinnitus
• Initial Evaluation of Residuals of Traumatic Brain Injury
• Review Evaluation of Residuals of Traumatic Brain Injury