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 licensed healthcare professional 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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Take the DBQ to your licensed healthcare professional and have your licensed healthcare professional complete the form.
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Obtain a copy of the completed DBQ for your records. |
4 | Submit the completed DBQ to VA.
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If you are in crisis or having thoughts of suicide, visit VeteransCrisisLine.net for more resources.
U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420
Last updated January 19, 2018