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Disability Benefits Questionnaires (DBQs)

CONTROLLED UNCLASSIFIED INFORMATION. Disability Benefits Questionnaires (DBQs). Vet Law Forum 2014 02 April 2014. DBQ Topics Covered. Disability Examination Requirements History of VA Disability Examinations What are DBQs? Use of DBQs: VBA, Private Providers, and VHA Clinicians

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Disability Benefits Questionnaires (DBQs)

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  1. CONTROLLED UNCLASSIFIED INFORMATION Disability Benefits Questionnaires (DBQs) Vet Law Forum 2014 02 April 2014

  2. DBQ Topics Covered • Disability Examination Requirements • History of VA Disability Examinations • What are DBQs? • Use of DBQs: VBA, Private Providers, and VHA Clinicians • Completing a DBQ • DBQs and Advocacy: Helpful Tips

  3. Disability Examinations and VA Disability Compensation • VAhas a legal “Duty to Assist” Veterans in pursuing claims • Claim for Service Connection: Triggered when evidence of record shows: • Competent lay evidence or medical evidence of current diagnosed disability or symptoms; • Event, injury, or disease in service OR qualifying service/events to trigger a presumptive regulation; and • Indication that the claimed disability or symptoms MAY BE associated with service • McLendon v. Nicholson, 20 Vet. App. 79 (2006) • Low threshold for examination requirement • “May be associated” versus “is associated” • Nexus is not limited to medical evidence • Claim for Increase: Triggered when medical evidence of record is not current for rating purposes • Palczewski v. Nicholson, 21 Vet, App. 174 (2007) • The mere passage of time does not make medical evidence “not current” • Does evidence suggest a material change? • Lay statement can suffice

  4. VA Disability Examination History • Legacy Examinations • Narrative format • Standardized examination format • Answer format varied • August 2009: President Obama’s Innovation Initiative • Reduce time to complete a claim • Improve rating quality • Increase transparency • Result: Disability Benefits Questionnaires (DBQs) • Collaboration across multiple VA agencies and offices • Veterans Health Administration (VHA) • Veterans Benefit Administration (VBA) • Board of Veterans’ Appeals (BVA) • Office of General Counsel (OGC)

  5. What is a DBQ? • Form designed to collect relevant medical evidence for evaluation of disabilities for VA compensation • Mapped to VA Schedule of Rating Disabilities (VASRD), found at 38 CFR Part 4 • Addresses legal requirements • Streamlined, efficient submission of medical evidence • Standardized format for examination questions and answers • Forensic medical report • Condition-specific

  6. Benefits of DBQs • Rater-Centric • Transparency • Veteran Friendly

  7. VBA and DBQs • Regional Office (RO) reviews claim • Examination threshold criteria and Duty to Assist • VHA receives examination request • Examination conducted by VHA • Results recorded electronically • Transmitted to VBA for review and rating

  8. Private Physicians and DBQs • Veteran downloads paper copy of DBQ form • Private physician performs examination as necessary • Results recorded on paper DBQ form • Veteran submits DBQ to VBA with claim • VA cannot reimburse for expenses associated with private provider

  9. VHA Clinicians and DBQs • Veteran downloads paper copy of DBQ form and presents to VHA Primary Care Provider (PCP) for completion • VHA physician has several options: • Complete DBQ during scheduled appointment; • Complete DBQ after scheduled appointment; or • Direct Veteran to examination department to schedule future appointment, if needed • Veteran retains original DBQ copy • Completion of DBQ by VHA physician does NOT constitute a claim

  10. Completing a DBQ: The Process • Section I: The Diagnosis • Why is this the first section? • Forensic document to assist in evaluation under VA regulations

  11. Completing a DBQ: The Process • Section II: Medical History • Subjective report from the Veteran

  12. Completing a DBQ: The Process • Physical Examination • Condition-specific questions

  13. Functional Impact • Every DBQ asks whether the Veteran’s condition impacts his or her ability to work • Clinician should describe the effect on ability to perform occupational tasks due solely to the condition at issue • What are occupational tasks? • Lifting, walking, bending, prolonged sitting/standing, repetitive movements • Medical description of abilities, not a legal conclusion

  14. DBQs and Advocacy • DBQs for public use: • www.va.gov • Veterans Services • Disability Compensation • Evidence Requirements • DBQ • DBQ Home Page • Links to DBQ user information • List by form name • List by symptom • How to submit • Instructions for use • FAQ • Link to FDC portal

  15. Private Provider Completing DBQ? • Advise Veteran to complete VA Form 21-4142, Authorization and Consent to Release Information for this physician • Why? • VA can obtain additional information or clarification from provider, if necessary • Cannot obtain private health data without consent • Avoid separate VA examination if privately-completed DBQ is unclear and/or insufficient • Reduce time spent obtaining authorization

  16. Questions?

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