The VA discontinued public facing DBQ (Disability Benefit Questionnaire) forms online. We believe this to be a great disservice to all Veterans.
Why rely on an inadequate C&P exam for your disability claim? Download your own DBQ form(s) now for your private doctor to complete.
If you are not satisfied with the decision on your claim(s), contact us immediately to appeal and protect your rights!
21-0960A-4 Heart Conditions (including IHD, Non-IHD, Arrhythmias, Valvular Disease and Cardiac Surgery)
Dental and Oral
21-0960D-1 Oral and Dental Conditions, including Mouth, Lips, and Tongue (other than Temporomandibular Joint Conditions)
Ear, Nose, and Throat
21-0960G-3 Intestinal Conditions (other than Surgical or Infectious) Including Irritable Bowel Syndrome, Crohn’s Disease, Ulcerative Colitis and Diverticulitis
21-0960J-4 Urinary Tract (including Bladder and Urethra Conditions (excluding Male Reproductive System)
Hematologic and Lymphatic
21-0960I-3 Infectious Diseases (other than HIV-Related Illness, Chronic Fatigue Syndrome, or Tuberculosis)
21-0960M-3 Non-Degenerative Arthritis (including Inflammatory, Autoimmune, Crystalline and Infectious Arthritis) and Dysbaric Osteonecrosis
21-0960C-5 Central Nervous System and Neuromuscular Diseases (except TBI, ALS, PD, MS, Headaches, TMJ, Epilepsy, Narcolepsy, Peripheral Nerves, Sleep Apnea, Cranial Nerves, Fibromyalgia, and CFS)
21-0960C-10 Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy)
You fought for your country, it’s time someone fought for you!