VHA DBQ Assistance

In accordance with VHA Directive 1134(2) dated November 28, 2016 VHA healthcare providers are required to assist patients in completing Department of Veterans Affairs (VA) and non-VA medical forms and to provide patients with medical statements with respect to their medical condition(s) and functionality.

This means that they may assist veterans with the following:

VHA Doctors May Provide Medical Statement to Support VA Benefits Claims:
If not presented with a conflict of interest or ambiguity VHA doctors may provide medical statements to veterans. Also, VHA providers, if requested by the Veteran, may place a descriptive statement in the Veteran’s medical record regarding the current status of the Veteran’s existing medical condition, disease, or injury, including prognosis and degree of function, unless the provider is uncomfortable doing so or if it would be a conflict of interest.

VHA Doctors are Required to Complete VA Medical Forms such as:
1. Application for clothing allowance form,
2. Aid and Attendance (A&A) pension forms,
3. Housebound pension forms,
4. Survivors pension forms,
5. Vocational rehabilitation forms,
6. Disability Benefits Questionnaires (DBQ). Veterans may ask their primary care or specialty care provider to complete a DBQ for conditions which are already diagnosed and documented and for which the provider is treating the Veteran.
7. Veterans Benefits Administration (VBA) life insurance forms.

VHA Doctors are Required to Complete non-VA Medical Forms such as:
1. Family Medical Leave Act forms;
2. Life insurance application forms;
3. Non-VA disability retirement forms;
4. Return to work/work status forms,
5. Medical clearance forms (e.g., for activities, oral surgery/dental work, school/college, therapeutic work programs, etc.);
6. State and federal workers’ compensation forms.

Note:
DBQs can be completed by the treating provider during a routine office visit when there is sufficient time and the medical information is available. DBQs can also be completed outside of an office visit, or an appointment can be scheduled for completion.

Problem with PCP:
If you’re having problems getting your Primary Care Physician (PCP) to complete the DBQ contact the Medical Statements and Forms Point of Contact. The MS&F POC, or designee(s), at that location.

See the VHA Directive 1134(2) below.