Veteran Instructions
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 completed 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". (This is so we can request additional information if clarification is needed.)
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5 | Submit the completed DBQ to VA.
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