Va Dr Will Not Fill Out Dbq Form

[jet187]

Hello all,

Can anyone tell me what's the deal with VA doctors that refuses fill out DBQ forms?

My dad primarily uses the VA for his treatment.

He had a follow up appt. yesterday and his VA Pulmonary doc told him he doesn't fill out the DBQ form for Respiratory conditions, he said the VSO does. Really?
The DBQ form has to be filled out by a physician and signed by one. It contains medical questions related to his medical condition that only a doctor can fill out.

Its very obvious a VSO is not a doctor or could fill out the DBQ form!!

I am trying to help my dad with his asbestosis claim and he has all the tests/scans/evidence done and ready to submit a claim, but I live in another state and can't be with him at his visits and he is 75 and doesn't know what to say or ask, he just tells me what the doc says.

The VA Pulmonary doc is his only treating physician for his asbestosis.

The doc says yes he has asbestosis, my dad asked him if he could make a note in his record if he would state in his medical opinion if it was more than likely a result of his military service in the Navy, he said no he wouldn't do that because the raters at the Regional would make that determination. Really?

Its obvious the doctor punted him or kicked the can down the road.

What can I do? Is there a directive for VA docs on filling it out?

Are VA doctors permitted to fill out DBQs if they are the only treating physician the patient has?

Or is the DBQs only for civilian doctors to fill out?

What's the point of these DBQs if the docs refuse to fill them out or give their patients bad info?

What should I do?

Any feedback is appreciated.

[Navy04]

VA Docs do not have to fill them out, unless the RO requires them too. Usually a DBQ is filled out during the C&P exam by that Doc. I have had over 30 C&Ps in the last 2 years, and only 1 of my regular Docs has filled out 1 DBQ for Migraines/TBI. Just like VA Docs don't like to fill out SSDI forms either. Sorry for your issues bud. Good luck and God Bless!!!

[jet187]

Thanks Navy04!

Would the VA accept a DBQ form filled out by a civilian doc?

My dad would have to get a Civilian Pulmonary doc on the outside first.

[Fat]

Hang in there Jet187.

I would think a DBQ might be a veterans best tool when trying to get service connection.

The physician doesn't have to lie, just state the truth regarding the veterans current physical condition.

No doctor is gonna risk his license by falsifying information.

The DBQ probably could be done in a day with accompanying treatment/doctor notes.

[Navy04]

I don't think you should go that route. Just submit the claim and if you have the evidence, then you will be able to show the C&P examiner the evidence, and should be able to fill out DBQ or Examine your father accurately. Most of my exams the Docs have filled out the DBQs accurately at the C&P exam. I don't believe in appeals, I just keep opening the Denied Conditions and all but 2 thus far have been granted down the road. Evidence is Evidence is Evidence, if presently well. The VA and the C&P Docs can not deny what is in front of them. Only you can decide what is best. Wish your father the best. My wife and I lost our parents as Teenagers, so you are both very lucky to Love each other

[georgiapapa]

jet187,

DBQs can be completed by VA or civilian doctors. Some VA and civilian doctors will complete them and some are just lazy and don't want to bother with them. Since the doctor is not cooperating or trying to help your Dad, he has nothing to lose by complaining and requesting another VA pulmonary doctor. You could send an email on his behalf to VA Undersecretary Hickey or VA Secretary McDonald at the following:

Allison.Hckey@va.gov

or

Robert.A.McDonald@va.gov

Explain your Dad's situation and request another pulmonary doctor for your Dad. Also, tell them why you want another doctor. They may want to contact your Dad directly so make sure he is aware of what you are doing and prepared to respond to phone calls.

Undersecretary Hickey has been good about responding to requests for help so hopefully she will help your Dad.

If your Dad does not get the help he needs from the VA, he may need to go to a civilian pulmonary doctor and get an IMO (Independent Medical Opinion) to support his claim. IMOs should be given more consideration than a DBQ since the IMOs are more detailed, provide a specific diagnosis, offer a nexus between the medical condition claimed and military service and are supported by reasonable medical rationale. There us an IMO section on this website.

I hope things work out for your Dad. He is lucky to have you working on his behalf.

Good luck to you and your Dad.

GP

[jet187]

Thanks for the quick replies, much appreciated.

Somebody at the VAMC gave my dad the DBQ and he asked me about it, but I know nothing about them.

So I looked the form up and I read all 7 pages and the sections that are relevant to his claim and guessed he had to take it with him

to his follow up appt. yesterday and have the Pulmonary doc fill it out then submit it with his claim.

I guess that is not how DBQs work from what I am reading.

Just so I am clear, DBQs are used for C&P exams only? Not for your treating VA physicians to fill out?

[georgiapapa]

I had a typo on Undersecretary Hickey's email address. The correct address is:

Allison.Hickey@va.gov

Sorry for the error.

[jet187]

georgiapapa just saw your reply, thanks for the help.

[jet187]

I feel that the doc looked at my dad at 75 yrs old and rolled the dice that my dad would go away if he blew smoke up his butt, knowing my dad would probably just go with what he said.

[georgiapapa]

Navy has a good point. If you feel like your Dad has strong evidence in his VA medical records supporting his claim, he should go ahead and submit his claim. However, he may have strong evidence of a diagnosis but his claim will not succeed unless he also has strong evidence showing a nexus or connection between his medical condition(s) and his military service.

Your Dad is 75 years old and has been out of the Navy for a long time. He will need his service medical records showing he had his current medical conditions while in service or some post discharge medical records showing a continuity of treatment for his current medical conditions from shortly after his discharge until the present. Absent either of those, he will need a strong IMO from a pulmonary doctor stating it is "as likely as not" his current medical condition was caused by his military service. The only exception would be if your Dad's medical condition has been identified by the VA as a "presumptive disease" and recognized as service connected due to exposure to certain substances and at certain locations during specified war eras. JMO

[georgiapapa]

DBQs are not just used for C & P exams only. They are often completed and submitted with a claim. C & P examiners also often use them as a checklist when questioning an examinee during their C & P exam. Basically, the C & P examiner's role is to try to determine if the examinee has the condition being claimed, severity of the condition and they may also be asked by the regional office to give an opinion as to whether or not the claimed condition is service connected. However, the rating official at the regional office will make the decision as to whether a condition is service connected and the severity of the condition based on all of the evidence available.

[georgiapapa]

jet187,

You may already have some of this info. If you do, just disregard.

For VA reference info, Google the following:

38 CFR part 4.97 (In the Schedule of Ratings, look at Diagnostic Code 6833 "Asbestosis")

VA DVB Circular 21-88-8 "Asbestos Related Diseases in 1988"

GP

[jet187]

Georgiapapa,

Thanks so much for the info.

I do have the Schedule of Ratings for Asbestosis and he meets 1 criteria, the pulmonary hypertension rated at 100%.

I have to look up the VA Circular "Asbestos related diseases in 1988"

And I agree with your assessment, he needs a strong nexus between his medical condition and service.

The VSO my dad is working with wants to submit his claim as Fully Developed Claim(FDC) because it would be quicker, I guess due to his age. My dad's SMR don't reflect any diagnosis of Asbestosis in service, he was diagnosed last year. The VA doc said exposure to asbestos could take a long time to show up, 25-50 yrs later. He's had CT & PET scans done with nodules in both lower lungs that confirm prior asbestos exposure & noted in his VA records. He was on 2 Heavy Cruisers in 58-61 with his job as Boatswain Mate, which I read is one of the primary MOS exposed to asbestos in the Navy.

His jobs after the Navy did not expose him to Asbestos, so his likely exposure was on the ships. Some of his shipmates were diagnosed also.

He has no post discharge continuity of treatment for his medical condition until the past 2 years when he started having symptoms.

Since the VA Pulmonary doc was the only doc treating him for asbestosis I was hoping he would at least make a strong IMO argument that it was "as likely as not" related to his military service. He said late last year that he thinks its most likely from the Navy but had to wait for all the tests(PFT/CT/PET) to be done to make a decision. But he flipped and now appears to not want to do anything to help or assist my dad, and give my dad bad info like taking the DBQ to the VSO to fill out.

I believe he doesn't fall under any "Presumptive Disease" because he was in 57-61, not a war time period. He was in Beirut in 58 for Op. Blue Bat during the Lebanon crisis.

I am seeing this might be an uphill battle but I have to try. I just need a doc to connect the dots.

My dad said he was going to call the Pulmonary doc on Monday and ask him why he told him to take the DBQ to the VSO when a Dr. needs to fill it out, and then ask him again to please fill it out as its his duty to assist.

If he refuses again, I guess my next step is to file a complaint with the Patient Advocate, contact the VAMC Director and like you said send an email to Hickey or McDonald.

Then get a new Pulmonary doc, probably outside the VA.

And the VA saga continues, Delay Delay Delay & hope you go away!

Does anybody think I have a good plan to address this correctly?

[georgiapapa]

You are welcome.

In preparation for a possible appointment with a private pulmonary specialist, your Dad needs to make sure he has copies of all of his relevant VA medical records, lab tests, radiology reports, etc. He should also be able to get his actual CT & Pet scan images on a CD disc. These can all be requested through the Release of Information Office at his VAMC.

When you or your Dad go to find a Pulmonary Specialist, try to find a doctor that specializes in the treatment of Asbestosis, preferably a doctor who has treated veterans with asbestos exposure and has previously prepared IMOs for veterans. Your Dad should also make available to the new doctor his military records showing his military occupational specialty "Boatsman Mate" as well as any treatise info available showing that "Boatsman Mate" was one of the primary MOS exposed to asbestos in the Navy. Before making an appointment with a new doctor, make sure the doctor is willing to provide an IMO, otherwise your Dad will be back at square one.

Sounds like you have a reasonable plan of action. If you do not get assistance in a timely manner from the patient advocate or VAMC Director, I would go ahead and send off an email to Allison Hickey. Do not give up. With a good solid IMO, I believe your Dad will win his claim. He has sacrificed his health for his country and deserves disability compensation.

Good luck.

[diver]

I asked my doctor at the Bellevue Washington clinic for an imo and they told me that they were not allowed to fill out any paperwork for claims. I do not know if that is a VA policy or a seattle policy or just the clinic. That definitely would explain why so many can't get help from their doctors.

[kate7772]

Check your dad's medical notes on healthy vet. If this doctor originally said he saw a connection, it may be stated in the notes. My husband's VA kidney doctor did not do a DBQ but he did state in the notes "as likely as not" which was a critical factor in the award.

Kate

[georgiapapa]

diver,

Unless it has recently changed, it is not a VA policy. My VA psychologist kept blank DBQs in her desk and did not hesitate to complete them upon request.

GP

[saxman]

I truly believe that it's a conflict of interest because my VA doctor will not do a nexus letter for me for my Hypertension claim after I gave him copies of my elevated high blood pressure reading while in the AF, and the continuation of the reading after I got out. i was then later diagnosed with Hypertension, unfortunately more than one year after I got out.

[CBaker84]

There used to be a policy for them to fill out the forms. Was there a follow on letter rescinding that policy?

Shit. I used to have that va letter saved. Will have to find it.

[Chuck75]

The policy before the letter was not to fill out forms related to a VA claim. Many of the VA doctors still follow the old rules.

Beyond that, do you really want a VA doctor to fill out a form that he or she does not want to fill out?

Edited March 4, 2015 by Chuck75 (see edit history)