Medical evidence
A completed DBQ can support the record, but the form itself does not establish service connection or guarantee a percentage.
Official VA questionnaires
Find the DBQ that matches the condition.
Understand what each Disability Benefits Questionnaire records, then open or download the current PDF directly from the Department of Veterans Affairs.
69 public questionnaires with official VA downloads
What a DBQ does
A DBQ organizes medical findings for a disability claim.
Most public DBQs are completed and signed by a qualified healthcare provider. They prompt the clinician to record the diagnosis, medical history, examination findings, treatment, testing, and functional effects relevant to the condition.
Clinician findings
Except for the Part A self-assessment, the examining clinician should complete the medical findings and certification.
Use the current form
VA may revise questionnaires. These buttons point to VA's live PDF location so the current published version opens.
Separation health assessment
For service members approaching separation or retirement.
Separation Health Assessment DBQ — Part A
A self-assessment for service members in BDD or IDES that records medical history, current concerns, occupational exposures, and conditions that may need further examination.
Cardiovascular
Heart, blood pressure, arteries, veins, and vascular impairment.
Artery and Vein Conditions
Documents vascular diagnoses such as varicose veins, post-phlebitic syndrome, peripheral arterial disease, aneurysm, and related symptoms, treatment, testing, and functional limits.
Heart Conditions
Covers ischemic and non-ischemic heart disease, arrhythmias, valve disease, cardiomyopathy, surgery, cardiac testing, workload capacity, and occupational effects.
Hypertension
Records a hypertension diagnosis, treatment history, serial blood-pressure readings, and whether elevated pressure affects work or is associated with another condition.
Dental and oral
Mouth, jaw, teeth, tongue, and oral structures.
Oral and Dental Conditions
Used for diseases or injuries of the mouth, lips, tongue, teeth, mandible, and maxilla, excluding temporomandibular disorders covered by their own DBQ.
Dermatological
Scars, disfigurement, and diseases of the skin.
Scars and Disfigurement
Measures painful, unstable, deep, or disfiguring scars and records their location, size, tissue damage, functional effects, and relevant treatment.
Skin Diseases
Covers dermatitis, eczema, psoriasis, infections, acne, alopecia, urticaria, vitiligo, and other skin disorders, including treatment duration and exposed body area.
Endocrinological
Diabetes, thyroid conditions, and other endocrine disorders.
Diabetes Mellitus
Documents diabetes type, required treatment, regulation of activities, episodes of ketoacidosis or hypoglycemia, complications, and functional impact.
Other Endocrine Diseases
Covers endocrine disorders other than diabetes and thyroid or parathyroid disease, with diagnosis-specific symptoms, treatment, residuals, and limitations.
Thyroid and Parathyroid Conditions
Records hyperthyroidism, hypothyroidism, thyroid enlargement, thyroiditis, parathyroid disease, treatment, residual symptoms, and related complications.
Ear, nose, and throat
Vestibular disorders, smell or taste loss, and upper-airway conditions.
Ear Conditions
Covers Meniere's disease, vertigo, chronic ear infections, vestibular disorders, tumors, surgery, balance testing, and ear-related functional impairment.
Loss of Sense of Smell or Taste
Documents partial or complete loss of smell or taste, the medical cause, testing, anatomical findings, and effects on daily activities.
Sinusitis, Rhinitis, and Other Nose or Throat Conditions
Covers sinusitis, allergic or vasomotor rhinitis, nasal obstruction, larynx and pharynx disorders, treatment, episodes, surgery, and breathing or speech effects.
Gastrointestinal
Esophagus, stomach, intestines, liver, pancreas, and related organs.
Esophageal Disorders
Documents GERD, esophageal stricture, motility disorders, swallowing difficulty, treatment, diagnostic testing, nutrition effects, and functional impact.
Gallbladder Conditions
Covers gallbladder disease, gallstones, removal surgery, bile-duct conditions, attacks, digestive symptoms, treatment, and residual impairment.
Hernias
Records abdominal, inguinal, and femoral hernias, size, recurrence, support, surgery, pain, reducibility, and limitations caused by the condition.
Intestinal Conditions
Covers irritable bowel syndrome, inflammatory bowel disease, bowel resection, diverticular disease, symptoms, flare patterns, nutrition effects, and treatment.
Liver Conditions
Documents hepatitis, cirrhosis, liver injury and other hepatic disease, including treatment, incapacitating episodes, complications, testing, and functional effects.
Pancreas Conditions
Covers pancreatitis and pancreatic disease, documenting attacks, pain, treatment, nutrition or weight effects, surgery, and related complications.
Peritoneal Adhesions
Records abdominal adhesions, prior surgery or injury, obstruction episodes, pain, nausea, treatment, imaging, and resulting work limitations.
Rectum and Anus Conditions
Covers hemorrhoids, fissures, fistulas, prolapse, sphincter impairment, leakage, bleeding, treatment, and effects on ordinary activity.
Stomach and Duodenum Conditions
Documents ulcer disease, gastritis, post-surgical residuals, pain, vomiting, bleeding, anemia, weight changes, treatment, and functional impact.
Genitourinary
Kidney, bladder, urinary tract, and male reproductive conditions.
Kidney Conditions
Covers chronic kidney disease, nephritis, kidney stones and other renal disorders, including laboratory findings, dialysis, attacks, treatment, and occupational effects.
Male Reproductive Organ Conditions
Documents prostate and male reproductive diagnoses, voiding or erectile impairment, treatment, surgery, tumors, and related functional limitations.
Urinary Tract Conditions
Covers bladder and urethral disorders, leakage, frequency, obstruction, recurrent infections, catheter or appliance use, treatment, and work impact.
Gynecological
Breast and gynecological diagnoses, treatment, and residuals.
Breast Conditions
Documents benign or malignant breast conditions, surgery, tissue loss, treatment, scars, residual symptoms, and functional effects.
Gynecological Conditions
Covers conditions of the uterus, ovaries, cervix, vagina, vulva, and related organs, including symptoms, treatment, surgery, fertility effects, and complications.
Hematologic and lymphatic
Blood and lymphatic diseases, including leukemia.
Hematologic and Lymphatic Conditions
Covers anemia, leukemia, lymphoma, clotting and platelet disorders, treatment, infections, transfusions, laboratory evidence, and effects on daily function.
Infectious diseases
Chronic infections, tuberculosis, and deployment-associated diseases.
HIV-Related Illnesses
Documents HIV diagnosis, treatment, viral and immune findings, constitutional symptoms, opportunistic disease, complications, and functional impact.
Other Infectious Diseases
Covers infectious diseases other than HIV, chronic fatigue syndrome, and tuberculosis, including activity, residuals, treatment, and disabling episodes.
Persian Gulf and Afghanistan Infectious Diseases
Records qualifying deployment-associated infectious diseases, onset, diagnosis, treatment, recurrence, residual symptoms, and resulting limitations.
Tuberculosis
Documents active or inactive tuberculosis, affected organs, treatment dates, test results, complications, residuals, and occupational impact.
Musculoskeletal
Joints, spine, bones, muscles, limbs, and range of motion.
Amputations
Records the site and level of an amputation, prosthetic use, residual symptoms, assistive devices, scars, and the effect on occupational tasks.
Ankle Conditions
Measures ankle motion and documents pain, flare-ups, repeated use, instability, ankylosis, treatment, assistive devices, and functional loss.
Back — Thoracolumbar Spine
Documents lumbar and thoracic spine diagnoses, range of motion, flare-ups, repeated use, guarding, radiculopathy, IVDS, ankylosis, and work limitations.
Bones and Other Skeletal Conditions
Covers fractures, bone disease, tumors, limb-length differences and other skeletal conditions, including treatment, residuals, and functional impairment.
Elbow and Forearm Conditions
Measures elbow and forearm motion and records pain, flare-ups, repeated use, ankylosis, instability, surgery, and impact on lifting or other tasks.
Foot Conditions, Including Flatfoot
Covers pes planus, plantar fasciitis, hallux valgus, claw foot, metatarsalgia and other foot injuries, with pain, deformity, treatment, and functional loss.
Hand and Finger Conditions
Measures finger and thumb motion, grip, pain, flare-ups, ankylosis, amputation-related findings, repeated use, and limitations of hand function.
Hip and Thigh Conditions
Measures hip and thigh motion and records pain, flare-ups, repeated use, instability, ankylosis, surgery, assistive devices, and occupational effects.
Knee and Lower Leg Conditions
Documents knee motion, pain, flare-ups, instability, meniscus conditions, shin splints, repeated use, assistive devices, and functional limitations.
Muscle Injuries
Identifies affected muscle groups and records wounds, tissue loss, weakness, fatigue, cardinal symptoms, scars, strength, and effects on work and movement.
Neck — Cervical Spine
Documents cervical spine motion, pain, flare-ups, guarding, radiculopathy, IVDS, ankylosis, repeated use, and resulting functional impairment.
Osteomyelitis
Records active or recurrent bone infection, affected sites, drainage, constitutional symptoms, treatment, surgery, residuals, and limitations.
Shoulder and Arm Conditions
Measures shoulder motion and records pain, flare-ups, repeated use, instability, dislocation, joint replacement, ankylosis, and occupational impact.
Temporomandibular Disorders
Measures jaw opening and lateral movement and documents pain, flare-ups, diet restrictions, repeated use, treatment, and functional loss.
Wrist Conditions
Measures wrist motion and records pain, flare-ups, repeated use, ankylosis, surgery, assistive devices, and limitations of hand or wrist tasks.
Neurological
Central and peripheral nerves, migraines, seizures, and progressive disease.
ALS — Lou Gehrig's Disease
Documents ALS diagnosis, progression, weakness, bulbar and respiratory effects, neurologic findings, assistive needs, and effects on daily and occupational function.
Central Nervous System and Neuromuscular Diseases
Covers neurologic and neuromuscular diseases not addressed by a more specific DBQ, recording symptoms, examination findings, treatment, and residual impairment.
Cranial Nerve Conditions
Identifies affected cranial nerves and records paralysis, sensory loss, pain, muscle weakness, testing, treatment, and functional effects.
Diabetic Peripheral Neuropathy
Documents diabetic nerve impairment, pain and numbness, strength, reflexes, sensation, affected nerves, severity, and occupational limitations.
Fibromyalgia
Records widespread pain, tender points, fatigue, sleep disturbance, treatment response, symptom frequency, and effects on routine activities.
Headaches, Including Migraines
Documents headache diagnosis, treatment, characteristic prostrating attacks, frequency, duration, associated symptoms, and impact on work.
Multiple Sclerosis
Covers the broad neurologic, visual, swallowing, bowel, bladder, mental-health, strength, and mobility effects that may result from multiple sclerosis.
Narcolepsy
Records narcolepsy diagnosis, sleep attacks, cataplexy, treatment, episode frequency, diagnostic studies, and occupational effects.
Parkinson's Disease
Documents tremor, rigidity, slowed movement, balance, speech, swallowing, cognitive and autonomic effects, treatment, and functional limitations.
Peripheral Nerve Conditions
Identifies affected peripheral nerves and records pain, numbness, weakness, reflex and sensory findings, paralysis severity, assistive devices, and work impact.
Seizure Disorders — Epilepsy
Records seizure type, confirmed diagnosis, treatment, major and minor seizure frequency, witness information, testing, and occupational restrictions.
Nutrition
Nutritional deficiencies and resulting impairment.
Nutritional Deficiencies
Documents vitamin or nutrient deficiencies, cause, symptoms, treatment, laboratory findings, residuals, and effects on ordinary and occupational activity.
Ophthalmological
Eye disease, visual impairment, and related testing.
Eye Conditions
Records eye diagnoses, visual acuity and fields, muscle function, incapacitating episodes, treatment, anatomical findings, and functional impact.
Psychological
Eating disorders, mental disorders, and review evaluations for PTSD.
Eating Disorders
Documents anorexia, bulimia, treatment, incapacitating episodes, weight and health effects, current symptoms, and occupational or social impairment.
Mental Disorders
Covers mental-health diagnoses other than PTSD and eating disorders, recording symptoms, history, functional impairment, competency, and occupational and social effects.
PTSD Review
Used to review already diagnosed PTSD, documenting current symptoms, relevant history, diagnostic criteria, and the level of occupational and social impairment.
Respiratory
Lung disease, respiratory impairment, and sleep apnea.
Other Respiratory Conditions
Covers asthma, COPD, bronchitis, emphysema, restrictive disease and other lung conditions, including pulmonary testing, treatment, and functional effects.
Sleep Apnea
Documents sleep apnea diagnosis, sleep-study findings, symptoms, CPAP or other breathing assistance, treatment, complications, and work impact.
Rheumatological
Inflammatory arthritis, chronic fatigue, lupus, and autoimmune disease.
Non-Degenerative Arthritis
Covers inflammatory, autoimmune, crystalline and infectious arthritis, documenting affected joints, episodes, constitutional effects, treatment, and functional impairment.
Chronic Fatigue Syndrome
Records onset, exclusion of other causes, debilitating fatigue, cognitive symptoms, periods of incapacitation, activity restriction, and treatment.
Systemic Lupus and Other Autoimmune Diseases
Documents lupus and systemic autoimmune disease, exacerbations, organ involvement, treatment, constitutional symptoms, and effects on health and work.
Spina bifida
For a qualifying natural child of a Veteran exposed to herbicides.
Spina Bifida
Documents diagnosis, neurologic and orthopedic effects, mobility, bowel and bladder impairment, treatment, assistive devices, and daily-function needs in the separate spina-bifida benefit context.
No public DBQ matches that search. Try a shorter condition name or choose all body systems.
Forms VA does not publish
Some examinations require VA scheduling or specialized examiners.
VA identifies the following questionnaires as unavailable for public use. There is no substitute download in this library. The public PTSD Review DBQ is different from the non-public Initial PTSD examination, and the public Ear Conditions DBQ is different from the non-public Hearing Loss and Tinnitus examination.
- 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 PTSD
- Hearing Loss and Tinnitus
- Initial TBI Evaluation
- Review TBI Evaluation
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