DBQ's from the VA's Website before they chose to remove them. These were current at that time. It is unclear of the VA would accept these however, they are a good tool to use with a Veteran to explain the questions that will be asked of them. In many cases the DBQ will have a number of sections, but only a few questions will apply to the condition they are seeking to have rated. A frequent question is how does this affect their daily life. If they can attend the C&P with a list of activities they have difficulty performing they can better answer that question.
DBQ Index - This is a list of DBQ's by Form Number and Title to assist you in finding the correct DBQ for the conditions to be rated.
21-0960A-1 Ischemic Heart Disease (IHD)
21-0960A-2 Artery and Vein Conditions (Vascular Diseases Including Varicose Veins)
21-0960A-3 Hypertension
21-0960A-4 Heart Conditions (Including Ischemic and Non-Ischemic Heart Disease, Arrhythmia's, Valvular Disease and Cardiac Surgery)
21-0960B-1 Hairy Cell and Other B-Cell Leukemias
21-0960B-2 Hematologic and Lymphatic Conditions, Including Leukemia
21-0960C-1 Parkinson's Disease
21-0960C-2 Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease)
21-0960C-3 Cranial Nerves Diseases
21-0960C-4 Diabetic Sensory-Motor Peripheral Neuropathy
21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Trau. Brain Injury, etc.)
21-0960C-6 Narcolepsy
21-0960C-7 Fibromyalgia
21-0960C-8 Headaches (Including Migraine Headaches)
21-0960C-9 Multiple Sclerosis (MS)
21-0960C-10 Peripheral Nerves Conditions (Not Including Diabetic Sensory - Motor Peripheral Neuropathy)
21-0960C-11 Seizure Disorders (Epilepsy)
21-0960D-1 Oral and Dental Conditions Including Mouth, Lips and Tongue (Other Than Temporomandibular Joint Conditions)
21-0960E-1 Diabetes Mellitus
21-0960E-3 Thyroid and Parathyroid Conditions
21-0960F-1 Scars/Disfigurement
21-0960F-2 Skin Diseases
21-0960G-1 Esophageal Conditions (Including gastroesophageal reflux disease (GERD), hiatal hernia and other esophageal disorders)
21-0960G-2 Gallbladder and Pancreas Conditions
21-0960G-3 Intestinal Conditions (Other than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis)
21-0960G-4 Intestinal Surgery (Bowel Resection, Colostomy, Ileostomy)
21-0960G-5 Hepatitis, Cirrhosis and Other Liver Conditions
21-0960G-6 Peritoneal Adhesions This Form may be obsolete since it was not on the VA website at the time the rest of the forms were downloaded
21-0960G-7 Stomach and Duodenal Conditions (Not Including Gerd or Esophageal Disorders)
21-0960G-8 Infectious Intestinal Disorders, Including Bacterial and Parasitic Infections
21-0960H-1 Hernias (Including Abdominal, Inguinal and Femoral Hernias)
21-0960H-2 Rectum and Anus Conditions (Including Hemorrhoids)
21-0960I-1 Persian Gulf and Afghanistan Infectious Diseases
21-0960I-2 HIV - Related Illnesses
21-0960I-3 Infectious Diseases (Other than HIV-Related Illness, Chronic Fatigue Syndrome, or Tuberculosis)
21-0960I-4 Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases
21-0960I-5 Nutritional Deficiencies
21-0960I-6 Tuberculosis
21-0960J-1 Kidney Conditions (Nephrology)
21-0960J-2 Male Reproductive Organ Conditions
21-0960J-3 Prostate Cancer
21-0960J-4 Urinary Tract (Including Bladder and Urethra) Conditions (Excluding Male Reproductive System)
21-0960K-1 Breast Conditions and Disorders
21-0960K-2 Gynecological Conditions
21-0960L-1 Respiratory Conditions (Other than Tuberculosis and Sleep Apnea)
21-0960L-2 Sleep Apnea
21-0960M-1 Amputations
21-0960M-2 Ankle Conditions
21-0960M-3 Non-Degenerative Arthritis (Including Inflammatory, Autoimmune, Crystalline and Infectious Arthritis) and Dysbaric Osteonecrosis
21-0960M-4 Elbow and Forearm Conditions
21-0960M-6 Foot Miscellaneous (Other Than Flatfoot/PES Planus)
21-0960M-7 Hand and Finger Conditions
21-0960M-8 Hip and Thigh Conditions
21-0960M-9 Knee and Lower Leg Conditions
21-0960M-10 Muscle Injuries
21-0960M-11 Osteomyelitis
21-0960M-12 Shoulder and Arm Conditions
21-0960M-13 Neck (Cervical Spine)
21-0960M-14 Back (Thoracolumbar Spine) Conditions
21-0960M-15 Temporomandibular Joint (TMJ) Conditions
21-0960M-16 Wrist Conditions
21-0960N-1 Ear Conditions (Including Vestibular and Infectious Conditions)
21-0960N-2 Eye Conditions
21-0960N-3 Loss of Sense of Smell and/or Taste
21-0960N-4 Nose, Throat, Larynx and Pharynx
21-0960P-1 Eating Disorders Disability Benefits Questionnaire
21-0960P-2 Mental Disorders (Other Than PTSD and Eating Disorders)
21-0960P-3 Review Post Traumatic Stress Disorder (PTSD)
21-0960Q-1 Chronic Fatigue Syndrome