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hi everyone welcome to cck live today we're discussing dbqs and Nexus letters
and VA claims so to start let's talk about what each of these things is we're going
to start with dbqs DBQ stands for disability benefits questionnaires dbqs are forms that
are created for veterans use in the evaluation process for vaa disability
benefits you can find these forms on va's website and we'll just know at the outset
there was a time in the not so distant past when VA actually removed DBQ forms from its
website and because of that we've also made DBQ forms available on our website at cck-law
forms if you're interested so these DBQ forms were created to answer important questions about
a veteran's disability and to collect information about the symptoms the severity the causes and the
functional impairment caused by the veterans disability um sometimes also its relation to
other disabilities so dbq's capture information required to assign ratings under the VA schedule
for rating disabilities DBQ form are supposed to help standardize the processing of VA claims and
make it easier to gather medical evidence that Raiders need to decide claims while veterans
are able to access DBQ forms they generally cannot fill them out themselves right and DBQ
forms are really best suited for completion by clinicians or doctors which is why we say
that veterans generally speaking are not going to have a whole lot of luck filling these out
themselves and submitting them in support of their case VA examiners typically fill out DBQ
forms in the setting of a compensation and pension examination or a CNP exam veterans out there who
have been through the CNP exam process know that examiners are typically working off of a checklist
when asking a a veteran questions about their disability those checklists typically come from
the prompts in the DBQ forms that the examiner uses to complete the veteran file and to capture
the information that they're meant to to gather in those appointments private clinicians can
also fill out DBQ forms and this is important to know so just like VA examiners are asked
to complete these forms to put together evidence for a veteran's case and for evaluation of their
disability private doctors can also do that too which can be a useful thing to know especially if
a veteran has a treating doctor that is willing to fill out the form VA relies very heavily on
DBQ forms and it is VA is able to recognize these forms in claims files during the the VA disability
benefits process so we definitely don't want folks out there to forget that uh private doctors might
also be well suited to fill out a DBQ form on a veteran's behalf and those are admissible and can
be submitted to the VA for um a pending claim or an appeal yes and the type of DBQ that you will
want to obtain from your doctor or the type that VA will order at a CNP exam is going to depend on
your condition and the claim that you're pursuing for example example if you're seeking an increased
rating the DBQ will focus on the severity nature and history of your condition if a claim is for
service connection a DBQ will prompt The Examiner to give an opinion about whether a condition is
at least as likely as not linked to service and I think we've mentioned this but we'll say it
again because it's an important Point dbqs are critical because they are heavily relied upon
by the VA as medical evidence that assists the disability adjudication process based on our
practice we know that VA directs its examiners to use DBQ forms we know that Raiders recognize
them can easily spot them when they're reviewing claims files and adjudicating appeals and for that
reason since these are such critical pieces of evidence it's really important for veterans to be
honest during their VA exams or when working with their private doctors to be honest about their
symptoms this will ensure that the documentation in their accurately reflects their circumstances
such as the severity of their disability or the date that their disability began to affect them
during or after service so it's really critical that if you're in the position of having a VA
exam or working with a doctor to capture medical information on your behalf it's really an accurate
picture of your disability circumstances right so related to that we'll talk about Nexus letters
next a Nexus letter is a document prepared for a veteran by by a medical professional
that explicitly connects an inservice event to the current condition for which a veteran is seeking
VA compensation so Nexus letters can be submitted with an initial claim during the development of a
claim or during the appeals process ultimately a Nexus letter should address whether it is at
least as likely as not that a veteran's disability was incurred during service or caused by service
because of this a Nexus letter can also be called an independent medical opinion or an IMO and dbqs
can provide the same information that an IMO or a Nexus letter would contain if VA requests the
completion of a DBQ or CMP exam while processing a claim for service connection however if a veteran
is not going through the CMP exam process or if a veterans doctor is unable to utilize a DBQ
form veterans should know that they can still submit a less formal Nexus letter speaking to
their entitlement to benefits it's key that these letters use VA standard of proof which is again
whether it is at least as likely as not that there is a Nexus between service and a claimed condition
so it doesn't have to be more likely than not although that is also useful um as long as the
evidence is relatively equal that's the standard that VA looks for right and as Claire mentioned
veterans can certainly ask their Physicians or Healthcare Providers to write a Nexus letter
for their claim on their behalf typically these letters will cite the Veterans Medical Records
they might cite other research or data and any other supporting evidence that would be needed
to bolster the opinion that the doctor is putting together the Nexus letter if a veteran out there
is trying to obtain one it can and should draw on information from the Veteran's particular service
medical and sometimes Personnel records and of course the veterans relevant medical history
that's a really important thing that we um encourage folks out there to ensure that your
Nexus letter does talk about your relevant medical history and whether you submit a DBQ a Nexus
letter an IMO or any combination of these things it's important to keep in mind no matter what the
form of the evidence that you're submitting is there are some core features that make a piece of
medical evidence probative or helpful in VA cases so as we mentioned before one of those things is
the appropriate standard of proof dbqs or Nexus letters need to adhere to VA standard of proof
which is the at least as likely as not standard they need to be premised on a thorough review
of the veterans relevant medical records which we mentioned and often their claims vile as well they
need to be signed and dated by the Doctor Who's filling out the evidence and they should also
reflect the name and credentials of the clinician completing the evidence and really importantly
I know Claire and I have worked on cases where this is really critical in the case the medical
evidence needs to contain an adequate rationale whatever opinion the clinici reaches it needs
to be supported by evidence research data or just an otherwise logical opinion this is a really key
piece of um a med a piece of medical evidence that makes it helpful or not in the VA adjudication
process yeah so sometimes VA decides to favor its own examiners dbqs over private dbqs despite the
fact that the VA exam might be lacking in one or more of these areas that more mentioned so in our
practice we often see VA accepting DBQ opinions that are not supported by an adequate rationale
that are overly General that don't consider a veterans medical history or are just based on
inaccurate facts and we think VA seems to prefer its own forms like DBQ forms um even if there's
other private evidence that is maybe more helpful more accurate VA also prefers evidence that is
framed in the terms that are contained in its own rating schedule and its own rating criteria
so that's another reason VA might Overlook a private medical opinion even if that opinion is
probative and well supported if it doesn't use kind of the magic words in va's regulations um
but ultimately putting that aside VA does have a duty to review and weigh all of the evidence in a
veterans file and that includes Nexus letters and other reports that come from private clinicians
thanks Claire for more information if you need it on Nexus letters dbqs CMP exams how to use each of
these in your case we've got a lot of content on our website our blog and even our YouTube
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