Disability Benefits Questionnaire Instructions for Veterans
You are using this Disability Benefits Questionnaire (DBQ) as part of your application to the U.S. Department of Veterans Affairs (VA) for disability benefits. For VA to use a DBQ to process your claim, your doctor must provide all requested medical information.
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.1 | Find the appropriate DBQ based on your claimed disability.
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2 | Take the DBQ to your doctor and have your doctor complete the form.
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3 | Obtain a copy of the completed DBQ for your records. |
4 | If your DBQ was complete by a VA provider, skip to step 5. If your DBQ was completed by a non-VA provider, complete a VA Form 21-4142 for "DBQ Purposes".
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5 | Submit the completed DBQ to VA. If a VA Form 21-4142 was also completed in Step 4, please submit it along with the DBQ to VA.
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