DBQ Scheme Shifts Cost Burden To Veterans

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DBQ Scheme

Benjamin KrauseSlides from a 2014 presentation about Veterans Affairs new DBQ scheme show flaws within the system including a shifting of the cost burden from VA to veterans. DBQ is short for disability benefits questionnaire, and the scheme has caused a blow out between veterans and their doctors.

Yesterday, I discussed a secret policy that instructs VHA providers to -NOT- fill out the DBQ in Part 1 of my assessment.  Well buried in that same presentation the story takes a deeper turn.  Perhaps you missed the discussion on slide #2 of part two of the presentation.  But I didn’t.

SEE: Presentation 2 Download

– Part 1 – Your mental health exam and the dubious DBQ

Bullet point #2 states the following:

– DBQs require training to use properly (ex. ROM)

– DBQs take time – more than a busy doctor can allow if other

patients are waiting

– Government gives no financial reimbursement. Veteran may be

charged

– Role of Office of Management and Budget (OMB)

– Potential for fraud

– May be seen as shifting program cost to the Veteran

There is a lot to unwrap here but I’d like to focus on the last bullet.

VA is shifting the cost to veterans and is aware of the perception of the problem regarding its coveted DBQ system.

Veterans are immediately at a disadvantage because they cannot get their VA doctors to conduct the examination. Outside VA, most non-VA doctors will also not be able to conduct the examinations because DBQs are too complex.

Now, how can a disabled veteran with limited income afford a doctor’s examination to establish evidence of disability?  They cannot. However, I recall Under Secretary Allison Hickey and friends preaching the benefits of DBQs as allowing a non-VA doctor to conduct such an exam.

However, the complexity and high cost creates a catch-22 that VA not only knows about but appears to be intended by creating such convoluted formalities. If a veteran can find a doctor willing to help, he or she will likely get charged through the nose because of the increased complexity.

Taken as a whole, apparently VA believes the best way to eliminate the backlog is to eliminate support to document claims.

This purported ‘fix’ to the backlog has actually increased the burden onto overstretched C&P examiner requirements by effectively impeding medical evidence support from primary care providers, both within VA and outside VA.

What will it take for VA to reverse course and create a system that really works for veterans rather than forcing veterans into a DBQ scheme that clearly only works for Veterans Affairs raters?

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32 Comments

  1. I don’t understand. Is this going to be the VA vs VETERANS? I should think that the VETERANS are confusing that the VA is a helping, supporting enity commissioned to work for and serve us. If the VA doesn’t know this, they have got to go and go quickly. The light is turned on in the VA and now everyone can see. Support Veteran rights and do it now. If not, I am sure we can work something out to help ourselves.

  2. One point I completely disagree with is getting private doctors to do the DBQ because they are “too complex.” Apparently, the private practioners you know, or are hearing about, must be complete morons or got their medical degrees from a box of Cracker Jacks. I send many of my clients to private clinicians for PTSD and TBI evaluations, before I ever file a claim. I have a network of well qualified psychologists and psychiatrists across the country and not one of them has been unable to understand and properly complete the DBQ for PTSD, or TBI. I have also had private doctors complete the DBQs for various orthopedic problems, ischemic heart disease and prostate cancer. I think it’s really unfair for you, or anyone, to paint all doctors with so broad a brush. In fact, I have had no problems, here in the Portland, Oregon, region, getting doctors from our CBOC in Bend to complete the DBQs for their clients whose claims I am handling. If doctors in other regions are too gutless to do the DBQ, that’s a problem that needs to be resolved in those regions.

    • @stu, the article is a quick analysis of what VA execs state within their own documents. It is vital to know what they think even if the logic is flawed.

      • This is another terrible situation where the VA seems to be in the business of denigrating the very systems they create and then, apparently, have no thought of using as intended. The “check-the-box” system of the DBQ is absurd and can never replace the reality of a full-blown evaluation. The Clinician’s Guide for conducting a PTSD exam says that a good exam should take 2-3 hours and when I send my people to a private practitioner, that’s what occurs. Here’s something else about the C&P process that is an issue we should be looking into. In the typical case where I have my people privately evaluated, who then have a C&P that may include a DBQ, the rating people always–in every single case–go with the C&P opinion, which, somehow, always come out making the client look better than the private exam. The issue that is the most disturbing is the Axis V GAF score. In every case, say, for instance, where the private GAF is in the 40s, the C&P examiner manages to put it in the 50-60 range. Instead of giving the client the benefit of the better possible rating, the rater always goes with the exam that rates the vet at the lowest possible level. I fully believe there is a VA policy to ignore private evaluations. In fact, in one recent case in Boise, the decision actually said they were ignoring my private doctor because “only a VA psychologist or psychiatrist can do an evaluation.” This is, as you know, a flat-out lie, and I have obsviously appealed. While it’s true that only a VA psychologist or psychiatrist, or contractor, can do a C&P exam, this rule does not apply to an initial evaluation. I have filed a FOIA request seeking the regulation, rule, or memorandum, that says that they can ignore a private doctor’s opinion because they are not a VA employee or contractor. In this case, my private doc is, in fact, also a VA contractor, although she was not contracted to do this exam. In fact, when there arew two opposing opinons, the regulation requires a third opinion, done from someone outside of the VA, to determine which of the two opinions is the better summary of the veteran’s situation. This has never happened in any case I have handled. Not once. I have two of these cases at the BVA on this very issue. By the way, what is the name of the case where the judge got on the DBQ business in his footnote?

  3. Our wounded vets will never heal with dignity and honor if they are denied the very liberty and justice they were defending for all.

    • I never knew that the oath I took expired. I believe that I am still suppose to defend the Constitution, even and forever.
      Has anyone read it lately? I just did. It puts all that is going on into perspective.

    • The “Oath” we took HAD NO TIME LIMIT! Therefore, ol bob, and MANY others in Government, will have a lot of explaining to do “when the time comes!”

  4. VA Drs. refuse to fill out Social Security questions to assist me in getting benefits. Even have a letter from one that says I must get an outside Dr. to assist me. I guess the 30 years of documented medical record of proof won’t help this Dr. fill out the form I need. Yet this is a documented policy these forms must be filled out for the Veteran ( These policies are an absolute joke. The VA is above the law and can ignore anything they please.
    If they fill out these forms or DBQ’s it is extra weight in making it harder for VA to deny us our benefits we were promised.
    Time for change!

    • What about various complicated medical/mental issues in which any given Veteran just does not FIT into ANY GIVEN “DBQ Check-Box Form”? What if other medical issues arose after one filled out these forms? Does the Veteran then have to start all over with yet another abbreviated check box form?
      Seems the VA has designed a new form of chaos and with little to none VA Suicide Prevention Program, I can only see this causing even MORE Veteran Homelessness and/or Veteran Suicides due to the adversarial nature of it all.

  5. I will say right now that MY BRAIN cannot for the life of me remember the anagram of ‘DBQ’…it sounds like a new damn sandwich at Dairy Queen that nobody wants to call it by it’s name.
    This ‘DBQ’ is supposedly vague check-mark box-type questions, which concerns me because I can only imagine how purposefully vague they will be IF designed by the VA.

    According to one of your articles earlier this week, the very BVA/Veteran’s Appeal Court **does not use these forms**, so it sure sounds to me that these new ‘forms’ have not even been fully adopted by the very folks that may ultimately be forced to rely on them and them alone.

    In the Private Medical Sector, they are being really hardnosed about “billable hours”…I am being switched yet again to another prescribing Psych Dr. for just medication management (I go to a civilian Psychologist for Cognitive Therapy monthly), and was told by my Faculty Psych Dr. at last visit that MANY Faculty were LEAVING and a good % of them are HOPING to work for the VA for the “banker hours” and “better pay” and get this: he specifically stated, “NO MALPRACTICE LIABILITY”…and the University Medical Center I go to (a really large and respected) had a boardroom full of attorneys and administrators that determined the Psych Dept. was NOT providing enough billable hours AND my Dr. even said it’s a good thing I already have gone through and won my own VA Disability Claim with the help of a previous Psych Dr.’s statements **because**…wait for it…and I quote/paraphrase him, “…we are not being allowed to bill for time of filling out forms for Soc Sec and VA Disability as Independent Medical Opinions (IMO) because the VA either takes FOREVER to pay or not at all and Social Security will not pay for these needed IMO’s either…so consider yourself fortunate but that I should advocate for change now because he could do nothing…”!

    When I started my process, I was literally near death’s door and I had started the SSDI (Social Security Disability Income) Claim process because I had more than enough “Work Credits” from my solid work history, including a solid decade of working as a Document Clerk at a huge syndicated law firm…if it were not for a “VA Stand-Down” I my area, and a few people talking about the benefits I did not even know I potentially had, so I then started my VA Disability Claim because I definitely had evidence and documented “Nexus for Service Connection”.

    Mind you, this was 2007. Even then, in the short time I even used the VAMC, the VA outright REFUSED to fill out ANYTHING for Social Security nor would they share ANY docs! Luckily, I had/have the physical evidence and records to make copies and submit to Soc. Sec. BUT it also worked the other way in that Social Security outright told me that Social Security would NOT share info with the VA nor would the VA even bother asking…and was told this by several different Soc. Sec. personnel.

    So, I had to do all the freaking work filing two different claims; one for Social Security and one for VA, while knocking at death’s door. I had also already been in Cognitive Therapy and Psych Med. Management for 11 years for some of the very issues in both claims. I definitely felt the “Burden of Proof” was placed entirely on ME and the VA did little to help, even though they supposedly are to do just that, but it was not so.

    I wound-up going through several Appeals with Soc. Sec. then to an Admn. Judge, whereas at least for me, the VA was the easier entity to deal with because of the blatant supporting evidence I had that clearly depicted several “Nexus for Svc. Connection”, but I can tell you from MY experience, even the Private Dr.’s for the most part are not exactly pleased to have to fill-out cryptic and convoluted forms that they CANNOT BILL FOR…

    It seems to me it’s quite obvious the VA is creating an even MORE adversarial environment by making things more difficult than they should be. If the VA Dr.’s refused to fill out forms for Social Security Disability 8 years ago, I cannot see the VA Dr.’s taking the time to fill out check-box forms that do not require ANY medical supporting evidence…this will come back to chagrin of Veteran when eventually at the Appeal Stage and then the BVA will NEED those IMO’s and paper trail for the Nexus for Svc. Connection…the VA is doing as I stated on here a few days ago when topic was about the VA laughing/mocking the Judge and Court…the VA is setting-up veterans for certain failure and I think they are doing this to curtail Veterans from ever filing a claim in first place.

    These new “DBQ’s” (Disability Benefits Questionnaires) are not even incorporated in the very REGULATIONS the VA is to FOLLOW!!
    How can this be legal?
    Is it true these “DBQ’s” came about from a “VA Contest Winner”? Are these part of Sec. McDonald’s “Disney-fi-cation of the VA”? I thought the VA had to go through Congress to make such huge changes, esp. given that we are officially still in a State of War?
    Seems the VA is trying to blame their “deficit” on too many Veteran’s making Disability Claims…so they are doing all this to make it incredibly hard and burden on the Veteran. Does not sound like the VA is doing this for the benefit of Veterans but to solely cut their liability and responsibilities.

    Again, the “veteran” part of the VA is being pissed on. “Veteran’s First”…seems like a huge sick joke. Seems the VA now should be called, “The Administration that has to DEAL WITH Veterans”…even though if not for we Vets, the VA would not exist. Now, where’s my anti-anxiety medication because this has really made this cat’s hair ruffle and all hair standing on end!

    Ben, how are you/we going to contest the very legality of changing to these “DBQ’s”?

    • Namnibor, not only is VA doing what you’re saying. Have you read the Stars and Stripes (I believe it was this news magazine) article about the Veteran in Georgia who was turned away, from two VA’s, because “[they] were not taking any new patients!” There’s even a video. Is this one more way VA keeps veterans from filing any claims? Or, so VA can ‘fudge the numbers’ again? Or, claim they “are the best of the best”, AGAIN!?

      • The news article I’m referring to is; Iraq War Vet, Chris Dorsey is turned away from to VA’s in Georgia.” He recorded the second ‘incident’!
        When you google it, it has gotten out to MANY news organizations.

  6. I read that article, thanks. I am having some serious problems posting here, and even Norton 360 is saying something “fishy” is going on with this and only this website?
    Would this be the VA IT Dept. attacking again? Anyone else having problems?

    • I have also been having problems with some sort of virus…mine is from the failed VA screwing me (US)! Some of the doctors in my 47 year’s experience with this failed system have been great, however those wise doctor’s moved on out of the failed VA…the one’s I have been exposed to since then are nothing than bonus seeking, last in their medical class bigot’s, bullies and some are racist! “VETERAN’S LIVES MATTER!” The Bob Mc Donald’s and other’s profess to make a change…there has been some change and it blow’s my mind that that change just keeps on getting worst than before…FTVA!

  7. Ben , I have a very substantiated IDEA! (from my experience on attending the various meetings , talking to other veterans, and following the comments of our brothers and sisters of your blog, and of course MY PERSONAL EXPERIENCE OF THIS MATTER)

    Why the Government does not Create a “Joint team” WITH THE SAME RULES with the Social Security Disability system or have the SOCIAL SECURITY DISABILITY TEAM EXAMINE THE VETERAN’s CASES ? They are doing MUCH BETTER AND FASTER JOB THEN THE VA (C&P).
    ARE WE “SECOND CLASS CITIZENS”?
    Just a thought!
    Thanks
    Vassilis Margaris
    MSG RETIRED (Chapter 61) US Army

    • I can tell you from my experience with Social Security is that they outsource their exams to REALLY incompetent Dr.’s and it’s actually worse, in my humble opinion and other’s I have assisted with SSDI process, to be as much adversarial at Soc. Sec. as the VA is. I had to even get my State Senator to Admonish a Soc. Sec. Appeals for telling me it would be 4 years before an Appeals Judge would see my file, and so a soc. Sec. Admn. Judge was assigned and within 3 months I not only was approved, but that Judge formally Admonished Social Security outsourced Evaluators that are contracted like “ambulance chasers”, and my case was so evident with tons of medical but yet denied 3 times while at death’s door…no, it was not easier than the VA Claim…and I did BOTH by myself. Soc. Sec. took 3 years and VA was 1.5 years. Those are actually more on the rare side quick, as mine were, but again, nothing was convoluted…convoluted was trying to understand what all the very foreign Dr.’s Soc. Sec sent you to said, and all they would do is half-ass eval…it’s designed to deny, no different than the VA.
      So in my opinion, as crazy as it may sound, the VA is a bit more efficient. My State currently has almost a 5 year backlog with Soc Sec. claims just in Appeal stages, so I think it really all depends on strength of case, evidence, and credulity of Independent Medical Opinions, and unfortunately, those outside of Soc. Sec. or VA are expensive when at a state of making these kinds of Claims to where if you are not homeless, you are damn near it, going to food pantries, et al. I think I used the Public Library computer lab for much of my research and doing claim even…it’s no slam dunk either way and the VA simply needs an enema. A BIG ENEMA! Word of day is…E N E M A.

      Happy 4th

      • Dear Namnibor

        Happy 4rth to you
        I don’t know your case, but in my case, I have No complains at all, from the SSA Disability system and (Statistically speaking) very few veterans, That I met in the various meetings, had problems.
        I can tell for sure :The SSA Disability system is an ANGEL in comparison with the C&P of the VA.
        I filled for my Disability at the SSD office at Walter Reed Army Medical Center (WRAMC) and they awarded me, my Disability Benefits 5 months after my Disability Event (MEDICAL MALPRACTICE AT WRAMC during an Open heart surgery while on OEF orders) happened. And they pay me since then (middle 2008) without any questions or problems!
        Hope that Helps
        MSG, US Army, VAM (retired, Chapter 61)

  8. Here is a thought: Alison Hickey’s VBMS should be scrapped; YES, get rid of it entirely! Rather than writing brand new computer programs and new code to support it and having to come up with weekly (if not daily) computer patch fixes for the VBMS get rid of the entire system….use the same system that was developed for the Social Security Administration it is proven already owned by the government (yes this is a concept already owned by the government) all you need to do is just tweak it for the VA and train the VA Personnel to use it. Oh, and speaking of training; TRAIN the VA Claims workers what the LAW really is so many of them believe that the M21-1 is the “LAW” and do not know what 38 U.S.C. or 38 C.F.R. or for that matter that a precedent decision from the Court of Appeals for Veterans Claims DOES control their decisions! Basically the entire VA claims system and the people having any input into the claims decision making process to include Alison Hickey and her subordinate’s need to have first be schooled on the claims/appeals process and know how to process a claim and an appeal before even trying to change anything. And any coach, decision team “manager’ or director of a Regional Office must first have been a Rating Official and also a Decision Review Officer otherwise they are not capable of understanding the job that their underlings are doing; it would be like putting a brain surgeon in charge of an infantry platoon and giving him the mission organize and lead an attack to take out an artillery base….it does not work.

  9. Dear Mr. Krause:

    There is no ends if or buts something has to be done immediately about that V.A.
    there abusing their position, no doubt about it.

    I will follow this message with some good Constitutional Law which I sent to another agency, I am sure it is germane to this case.

    Yours for God and Country
    Frank P. Calderon

  10. What I can quite literally foresee the VA doing is spending a few Billion $ on a new Sub-Contract, without even notifying Congress, and using Choice Card $$ for said Contract, to SHOW the VA how to check the damn boxes properly and to always color within the lines…yes, I am being a bit flip, but that’s the level of ridiculous that we have indeed now reached…new heights of screwing Vets.
    Did the VA get into a $2.6 Billion Deficit by spending huge amounts of $$ on Sub-Contracting a company to print the various “DBQ Forms”?

    Why is NOBODY ASKING…no, DEMANDING to know exactly why the VA ran out of $$ so **suddenly**? I mean, at what point does someone at the VA “notice” that they are $2 or $20 Million in RED, let alone the $2.6 Billion that the VA claims they were “not aware of”, when in fact, Sec. McDonald had been told about this….something really screwy is going on…it cannot be a mistake the VA let this bombshell out right exactly before a major USA Holiday Weekend, when everyone’s minds are all “Red, White, and Blue”…oh, and do not forget to thank a Vet for their service…never mind we are screwing them as hard as we can…thank them anyway.

    I call this week: “The Red White and Blue Vet’s Get Screwed” weekend. Make no mistake, I LOVE my USA, but find it hard to celebrate “Independence” when the very VA is blatantly devising new improved ways to screw same Vets they are supposed to serve.
    The VA has lost their way and it saddens me greatly.

  11. I spent 5 months this year trying to get two DBQ’s filled out. My three specialists and primary Care doctor REFUSED to Sign the DBQ. They said my ” texas veterans” case manager had to schedule me for an exam. He of course told me only a doctor could do it. I then went to the San Antonio Audie Murphy VA’s patient advocate who also told me they could not help me. I then called the chief medical officer of the DBQ clinic SEVERAL TIMES after a texas veterans commission senior manager received my complaint and gave me the number and name. The doctor never returned my calls. I then contacted The Houston VA and they never Gave me any assistance. I am a healthare provider and know the system very well, but have never been allowed to see a doctor and get the DBQ FILLED OUT. Finally, my ACTIVE Duty thyroid cancer surgeon filled one DBQ our because he felt Sorry for me. He was not “supposed” to but he did it to take care of a Soldier. That is what this comes down too! Not taking care of soldiers!

    John Ervin, RN

    • @John Ervin, RN-
      Sorry to read about your experience and although Benjamin Krause is on honeymoon, pretty sure he’s back in the full saddle come next week and I would now compile an email to him from the mail link in upper right corner above the handprint logo of this site, and give him your contact info, et al. This is case-in-point that the VA is using their very own created from a contest “DBQ Forms” to make it even MORE inherently adversarial in order to deny benefits. I wish I did not have to even write that because that tells me, also a Veteran, that “Freedom” has a solid glass ceiling of cost to benefit and when it comes down to keeping their end and taking care of the broken, they devise even more ways to muddy the waters.
      Write Ben.
      Thank you for your service and be well. Collectively, we Veterans can move mountains but as long as the VA continues to divide, it becomes more important to educate…no, enlighten the American Public and Taxpayers of what’s going on.
      Then there’s the recent $2.6 Billion dollar deficit that according to the VA…came out of nowhere…they were “not aware”…write Ben. Also, write and call several of your State’s Senators, esp. those strong on Veteran Issues, I had a Senator go to bat for me for both the VA and Soc Sec SSSDI, so there are some good ones out there…also, the Main Stream Media…after the fireworks and stars and stripes, our voices will not be drowned out so easily.
      Write your story to ANY candidate that has announced they are running for President, regardless of party or nuthead… good exposure can come from anywhere, incl. many Talk Radio Programs, esp. NPR. Just some direction to lead you in, and some homework, boots on the ground, but over internet…it makes the pain of being sick sometimes easier to bear when doing something for positive change, as it affects us all.
      Happy 4th, in spite of your runaround.

  12. I wanted to express my thoughts to all on here about what’s happening today. That is Happy 4th of July, 2015 to y’all.
    Just a few minutes ago, I was ‘searching the web’ concerning what, if anything, was happening in Tomah, Wisconsin. What I found was a story that, in my opinion, not only concerned Wisconsin, but the whole U. S. of A.
    The title, and story, is frightening, to say the least. I would strongly recommend looking it up!
    Because, what has happened there, IS what’s occuring nationwide!
    The title;

    “Time for citizens to defend open, honest government in Wisconsin”
    Written by, George Stanley. Editors Note on July 4, 2015.

    I hope it makes sence this “piece of journalism” is not just for Wisconsinites, but for ALL CITIZENS OF THESE GREAT STATES OF AMERICA!!!!!! There are quotes from Washington, Jefferson and many other ‘distinguished gentlemen’.
    I hope y’all find it interesting.

    Again, Happy 4th of July. And please be safe.

  13. Looking at the various claim types, I decided the fully developed claim (FDC) was the best option for me. I contacted every medical provider, pharmacy and insurance company I could remember dating back to my discharge. I twice requested my C-file from the government (and got very different results each time). My military records were in shambles with a lot of information missing. I was in rapid deployment units and no data deployment data existed including immunization records. No information was available for combat deployments to Panama or the First Gulf War.

    I cobbled together what information was there and attached it to relevant post-discharge medical evidence. I made a pile for each medical condition that I was claiming. I then requested buddy statements to try and fill in the gaps where military medical evidence was missing. I then found and printed out the relevant DBQs for each condition claimed. At this point, I made an appointment with a number of my physicians and explained to them what was going on. I got a lot of blank stares and a few sighs, but my doctors all said they would help.

    Over the next few months, I spend nearly 20 hours with private physicians completing the DBQs. Even though these documents are supposed to help the VA process claims, the VA will not reimburse any physicians for their time and efforts. Fortunately, these doctors have all been treating me for up to 11 years and were willing to help a veteran in need. I then spent 5 1/2 hours with a VSO as we processed each part of an 11 inch claim. I had nexus statements for 3 conditions, had completed every VA form imaginable including TDIU and A&A with appropriate signatures and evidence. Along the way, I was told the VA wanted me to complete the Gulf War Registry examination so I complied.

    Two years later, the VA ordered a three C&P examinations for hearing, psychological, and general medical. I had medical evidence from the military stating I experienced hearing loss while in the military. Even with active duty audiometric exams documenting hearing loss the VA denied the claim. The psychological examination was difficult due to the subject matter, but the C&P examiner was polite. It is true that PTSD must be assessed by VA providers, but I had two civilian providers fill out the PTSD DBQs that helped the VA examiner navigate the appointment. The general medical C&P examination lasted 90 minutes with a provider that had no specialized medical experience in any areas I was claiming. Weeks later, I was notified that EVERY area of my general medical examination was denied because the VA examiner gave a negative opinion and the VA sided with their examiner over my private physicians.

    – The VA denied medical conditions complete with DBQ and nexus letter from a nationally-recognized neurologist. My neurologist has been on the Super Doctors list every year for the past decade and ONLY treats patients with the claimed condition. There were approximately 3 dozen incidents documenting symptoms starting while on active duty, during the presumptive window to present day. The VA denied the claim because their doctor with zero clinical experience with my condition disagreed with my neurologist.
    – On another denial, the VA denied a presumptive Gulf War conditions misquoting the law by 23 years. The VA claimed the condition had to manifest within one-year of discharge, but the law states 10% disabling by December 31, 2016.
    – On another denial the VA examiner opined that another condition was being caused by medication and how I should stop taking the medication. The condition has been diagnosed 11 years prior and I had only started the medication in question for 13 months.

    There were other problems, but you get the point. Even if you get medical providers to spend their free time completing the DBQs, the VA still does not give them any credibility. I cannot express the pain and suffering involved with first your condition, but second having to deal with the VA. Without my wife doing the majority of the paperwork and physicians willing to volunteer their services this claim never would have happened. Then the VA essentially treated the DBQs, nexus letters and opinions of my board certified doctors like rubbish. After my appeal, every decision against me was overturned and every claimed condition was granted. The VA created the DBQ process to ‘help veterans,’ but the VA dismissed their own program at the detriment of veterans using it. This is quite similar to the ‘Buddy Statements’ that are often completely ignored by the VA.

    • VA will always deny a claim at the initial stages. The initial examiners are probably direct by a code of silence from the government to deny all claims. The VA is hoping that most if not all military personnel filing claims will give up at the first initial filing. If you file a NOD and complete the appeals form you will more than likely win the appeal with the documentation. But they are hoping you do not fight pass the initial filing. All veterans need to fight and appeal to get service connected.

  14. Two quick points.
    First, the VA has not wanted treating physicians to become involved in evaluating veteran’s disabilities. Veterans do then ask to change providers to one willing to advocate for them. I saw it over and over. It created problems including threats by vets and assaults. Desperate people resort to desperate measures. Mostly this happened regarding psychiatric conditions. The Rating authorities began giving less credence to favorable reports from treating mhc providers because they seemed so disparate from reports from C&P reports. A climate of open hostility developed within the mhc. Ultimately, the doctors involved retired, but the situation never completely resolved.

    Second, many doctors do not want to get involved in evaluating disabilities, even if it involves a cut and dried measurement of range of motion. If a pcp doesn’t write what the veteran feels he/she should it can fracture the dr patient relationship. Doctors have left the VA or transferred to a different facility after being threatened or assaulted by vets, being blamed by the vet for not getting a favorable rating decision.

    I don’t have an answer. I do think filling out a dbq is unnecessary most of the time as long as the doctor makes detailed notes during each visit. Of course if the veteran is seeking a medical opinion requiring records review and opinion writing by a specialist, that is unlikely without consent of the chief of that specialty clinic. Some doctors were willing to spend the extra time but most were not, and I don’t think it is fair to hold it against the doctor who won’t.

    • Why is it not fair to hold it against the doctor… They are the ones refusing to do their job… If a dr works at the va and doesn’t want to or know how to assist the veteran with filling out a dbq or nexus statement, then eht are they working for the va… THAT’S THEIR JOB!!! . they ar dirctly invoved in your decisions weather they want to admitt it or not… If they aren’t going to help the veterans they should never have neen hired to work at the va from the beginning. It can hel your vase extremely by having a sbq and nexus statement filled out and sent to regional.. But the doctors have been hired to stop you from receiving your benefits… They Will just say they dnt want to fill it out. Dnt waste years…. Get a attorney that has drs that work for them, your lawyers dr will fill out the dbq and nexus statements. Your attorney will take the cost out of your back pay… Get a attorney….. The veterans affairs departments are denieing veterans theirmuch deserved benefits and watching veterans die waiting everyday.. DO NOT WAIT ON THE VA TO DOCUMENT WHAT U NEED.

  15. Primary Care physicians are not going to spend time filling out pages of an exam toward a C+P claim. It is complex and time consuming, when time is money.
    If a personal physician does this for a veteran, then they are doing it as a real favor, or they are being pressured by their patients. VA clinicians will not complete DBQ’s during routine visits, because, it would then be a C+P exam. And the C+P exams are to a higher standard as to sort out frivolous claims, deny various conditions, and make the patient prove that a condition is really service related. If documentation is missing from the service record, then the condition is not service related. Presumptive conditions for Gulf War conditions related to Sarin gas and chronic Q-Fever exposure are impossible to prove, unless a Functional MRI is done with abnormal pathways, or a coxiella burnetii titer is elevated and endocarditis or hepatitis exists. Vietnam veterans are now in their 70’s and suffering age related diabetes, which is covered under agent orange exposure. Atomic Veterans and SHAD veterans are also older.
    Korean War and WWII veterans are unfortunately a generation, that will soon be gone.
    Having worked for the VA after returning from Desert Storm, I can only say that hearing the physicians discount the veterans claims of potential chemical warfare and unusual exposures, as all in their head, was common. The demolition of the bunkers and creation of Sarin Plumes finally was verified in 1996. The rest of the documents should be released, since it has been over 25 years. The VA Health Care System should most likely be dismantled, and it’s services should be handed over to the local community hospitals. Perhaps the Local Community Outpatient Clinic could exist on a small scale in conjunction with community based hospitals and clinicians. But the VA, is an antiquated medical system, that usually provides sub standard care in an effort to maintain cost effectiveness, while its managers and executives make poor decisions and outlandish salaries. I tested the system recently, and got an appointment 5 months down the road. The appointments are scheduled and then canceled, but the scheduler in MyhealheVet, does not designate if the veteran canceled the appointment, or if the clinician cancelled the appointment. I had 2 appointments canceled by the clinicians, whereby the scheduler does not stipulate “Clinician Canceled” or “Patient Cancelled”. The VA disability rating system is not standardized across the country, and in some cases ” Active Duty” officers are receiving VA compensation for more than 10 years, in addition to their salaries. If the American public were aware of the monetary waste, and amount of poor medical care, and failures to follow Joint Commission guidelines on a daily basis, rather than trying to prove compliance during an inspection, the VA Medical Centers, would simply be privatized by congressional legislation.

  16. I tried to get one of my DBQs filled out today at the VA in North Chicago, IL (April 26th), and I was told that the VA is doing away with paper DBQs within the next few weeks. I can’t find any information on a timeline for this happening. I was told to wait, but I am hesitant to sit around and wait this summer to file for an increase in some of my ratings until the paper DBQs are gone unless someone can point me toward some concrete news on this. Thanks in advance for any info.

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