What is a DBQ Medical Opinion?

A DBQ medical opinion is a formal VA request for a C&P examiner to provide his/her medical opinion for service connection on the electronic version of the condition specific Disability Benefit Questionnaire (DBQ).

For example, if you filed a VA claim for Headaches secondary to Tinnitus and PTSD, the VA should order a C&P exam for Headaches as a secondary condition using the electronic version of the DBQ for Headaches.

On the electronic DBQ for Headaches, the C&P examiner will be asked to provide a medical opinion for secondary service connection as follows:

Medical opinion for secondary service connection (Headaches secondary to Tinnitus and PTSD)

• The claimed condition is at least as likely as not (50% or greater probability) proximately due to or the result of the veteran’s service connected condition. This is a favorable VA medical opinion.

• The claimed condition is less likely than not (less than 50% probability) proximately due to or the result of the veteran’s service connected condition. This is an unfavorable VA medical opinion.

What is a DBQ Medical Opinion Request?

A DBQ medical opinion request is a formal request from the VA for a C&P examiner to provide his/her medical opinion for service connection on the electronic version of the condition specific Disability Benefit Questionnaire (DBQ).

For example, if you are a first-time filer for PTSD, the VA will order a C&P exam from a Psychologist or Psychiatrist using the PTSD Initial DBQ form.

At your C&P exam for PTSD, the examiner will either make or confirm a diagnosis of PTSD (or other mental health condition), give their medical opinion for service connection (“at least as likely as not” or “less likely than not”), decide your current level of occupational and social impairment, and determine your current severity of symptoms for VA rating purposes.

5 Types of VA DBQ Medical Opinions

Generally, there are 5 types of VA DBQ medical opinion requests:

#1. DBQ medical opinion for direct service connection

C&P examiner: Choose the statement that most closely approximates the etiology of the claimed condition.

a. The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in[1]service injury, event, or illness. Provide additional rationale below.

b. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide additional rationale below.

#2. DBQ Medical opinion for secondary service connection

a. The claimed condition is at least as likely as not (50% or greater probability) proximately due to or the result of the veteran’s service connected condition. Provide additional rationale below.

b. The claimed condition is less likely than not (less than 50% probability) proximately due to or the result of the veteran’s service connected condition. Provide additional rationale below.

#3. DBQ medical opinion for aggravation of a condition that existed prior to service

a. The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by an in-service injury, event, or illness. Provide further rationale below.

b. The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakable not aggravated beyond its natural progression by an in-service injury, event, or illness. Provide further rationale below.

#4. DBQ medical opinion for aggravation of a nonservice connected condition by a service connected condition

Can you determine a baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition)?

Yes or No

If yes, answer the following:

Describe the baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition):

Is the current severity of the (claimed condition/diagnosis) greater than the baseline?

Yes or No

If yes, was the veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by the service connected condition.

#5. DBQ medical opinion regarding conflicting medical evidence

I have reviewed the conflicting medical evidence and am providing the following opinion.

For example, the C&P examiner may write something like “I am unable to give a medical opinion without resorting to mere speculation.”

Can I Use a Privately Prepared DBQ for My VA Claim?

Yes, a private healthcare provider can complete a DBQ for a veteran pursuing VA disability benefits using one of the public use DBQ forms.

• If you submit a privately prepared DBQ that’s deemed adequate for rating purposes, the VA should not order a separate C&P exam—doing so is called “overdevelopment” and the VA Rater (RVSR) can be penalized.

• If you do not submit a privately prepared DBQ, the VA should order a C&P exam for that condition, whereby a C&P examiner will complete the electronic version of the condition specific DBQ for you on behalf of the VA.

Important: A C&P examiner will give his/her medical opinion. A veteran may also submit medical evidence from a private provider, which is called an independent medical opinion. Both are generally acceptable for rating purposes.

Conclusion and Wrap-Up

A DBQ medical opinion request is an official inquiry made by the VA for a Compensation and Pension (C&P) examiner to give his/her medical opinion regarding service connection for the specific condition you filed for.

The examiner will provide his/her medical opinion through the electronic version of the Disability Benefit Questionnaire (DBQ) that corresponds to the relevant condition.

For instance, if you are a first-time applicant seeking benefits for Anxiety and Depression, the VA will schedule a C&P examination with a Psychologist or Psychiatrist.

During this examination, the examiner will assess and diagnose Anxiety and Depression or any other related mental health conditions.

Additionally, they will provide their medical opinion on the likelihood of the condition being connected to your military service (“at least as likely as not” or “less likely than not”).

They will also evaluate the current level of impairment in your occupational and social functioning and determine the severity of your symptoms for the purpose of assigning a VA rating.

About the Author

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Brian Reese

Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.

A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.