DBQ Question

[Fat]

I know DBQ's were taken off the VA website and many have expired.

However is it still feasible to submit a DBQ for information and rating purposes?

In lieu of the VA discontinuing the DBQ's online. They still provide a basic legal insight into the disability as stated by your physician.

Furthermore, if the physician adds rating criteria in the context of the DBQ, wouldn't that make the DBQ sufficient?

My thought process is that medical information is noteworthy and the key. The DBQ can be discontinued; however if the medical information is substantive and meets the rating criteria, then the information is good regardless of the forms status. 

The VA wont discard any substantive information related to the claimed issue and if that DBQ has all information needed to properly rate the issue then it should be good.

Any thoughts?

Alternatives to DBQ?

All comments are welcomed.............

 

[Mark D Worthen PsyD]

Information from a non-VA clinician (physician, psychologist, audiologist, etc.) supporting a veteran's disability claim can be divided into two types:

(1) A report of diagnosis, treatment, prognosis, progress notes, etc. from a treating clinician, without an opinion regarding causation (nexus). For PTSD and other mental disorder claims, which is what I know best, medical records from treating clinicians are very important. VBA—and a VA examiner—should have access to your VHA (Veterans Health Administration) medical records.

They should also have access to your STRs (service treatment records, also known as SMRs or service medical records), but it's worth making sure that they have all relevant records from your military service.

Neither VBA nor the C&P examiner will have access to Vet Center treatment records unless you have asked your Vet Center to send records to VBA.

You must also request that VBA obtain medical records from private clinicians that you saw while in service or afterward. You can also obtain the records yourself and send them to VBA. 

In most instances, your treating clinicians do not need to complete a DBQ, unless they wish to do so, and provided they understand all the laws regarding service connected disability compensation. Providing an expert witness opinion (which is what a "nexus letter" or IPE/IME is) constitutes a "dual-role conflict" (an ethical concern) for most mental health clinicians, which is why most treating psychologists and psychiatrists won't complete a DBQ to support a veteran's claim. (A few treating MH clinicians will complete a DBQ or write a letter with an opinion, so there's nothing wrong with asking, but be prepared for a "no" because it can be ethically risky for treating clinicians to submit expert witness opinions.)

(2) If you pay for an IPE (independent psychological exam) or IME (independent medical exam) to support your original claim or for an appeal, then completing a DBQ is a good thing to do for most examiners, to make sure they address all the relevant issues. If the examiner possesses extensive experience, he or she might write a report without using a DBQ but they will still include all the relevant information in that report. 

There are several subsections of the M21-1 Adjudication Procedures Manual that are helpful to review, although for appeals I highly recommend retaining the services of a veterans law attorney or VA-accredited claims agent since understanding the law is very important for appeals to the Board of Veterans Appeals and beyond.

Some of the subsections you might want to review are: 

• III.iv.3.A.3.b.  Use and Acceptance of DBQs for VA Examination and Opinion Purposes
• III.iv.3.D.2.e.  Discontinuance of Publicly Available DBQs
• III.iv.3.D.2.f.  Authenticity of DBQs
• III.iv.3.D.2.q.  Accepting a Fee-Based Examiner’s Report

You can access the M21-1 Adjudication Procedures Manual at https://www.knowva.ebenefits.va.gov/ under "Compensation".

All the best,

Mark

[brokensoldier244th]

Yes. They are still admissible. They aren't discontinued, they just don't count as a C&P if done by a private doctor. They are still medical evidence. Many private doctors do the DBQ for service connection but they don't do the 2nd part, which is required for an SC evaluation- the opinion with rationale. The DBQ is the exam with remarks, the Opinion is WHY the doctor thinks its SC. Your doctor may do the DBQ and then write up an opinion but you'll still probably end up getting a C&P. 

[AllTheWay]

Well said Brokensoldier. 

[Fat]

So the doctor can do the DBQ (medical diagnosis with residuals of claimed condition) and provide a nexus statement (causation of current diagnosis to military injury/sickness).

[brokensoldier244th]

of course they can. The flip side is that they often don't have access to your medical records to correlate cause to current effect. This makes their evidence carry less weight, unless they can refer directly to your medical (whatever you give them).

If they can say "in an LOD dated XX/YY/ZZZZ veteran was injured in such a way. Subsequent reports of residual "whatever" from that injury persist throughout (whatever supplied records) dated XX to YY. Based on this and current measurements/findings veterans injury/contention is at least as likely (or likely) caused by military service."  means a lot more than "Veterans injury in service is connected to current condition because I think so....".

 

Ive seen opinion statements that vague. Just because it may have the required "likely" or "less likely" or "at least as likely as not" in the opinion doesn't make it a good opinion. 

[AllTheWay]

As long as that Dr. uses the magic statement "as likely as not" and have a good rationale.