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Disability Benefits Questionnaires (DBQs)

The Department of Veterans Affairs encourages all Veterans to submit their private medical records for consideration during the processing of their benefits claim.  VA values evidence from your private treatment providers because they are familiar with your medical history, often over a long period of time.  VA appreciates the trusted and special relationship between private treatment providers and their Veteran/patients. 

How To Submit Private Medical Evidence for Your VA Claim
Talk to your healthcare provider (family physician, urgent care visits, any Tricare covered treatment after discharge) and explain that you are filing a claim for VA benefits; discuss the conditions for which you are filing a claim. 

    1. If required, complete your healthcare provider’s release of information form, obtain your records, and submit with your claim, or
    2. Complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA) and VA For 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA); submit completed forms with your claim and VA will attempt to obtain your records through our Private Medical Records contract.  VA Forms 21-4142 and 21-4142a are used in conjunction with each other and both forms must be completed in order to obtain treatment records.

Click here to view or fill out VA Form 21-4142 and 21-4142a.

How To Incorporate Federal Records With Your VA Claim
Tell us about your Federal records (i.e. from the Social Security Administration and any federal agency) and we will gather these on your behalf.  It is not necessary for you to submit your Service Treatment Records (STRs) or treatment records from a VA medical facility as we have access to these records.  If you received treatment at a Military Hospital or Clinic after your discharge, please include the date ranges of your medical treatment records for your claimed conditions along with VA Form 21-8359, Information RE Veteran in Uniformed Service Hospital (Request by Department of Veterans Affairs). 

Click here to view or fill out 21-8359.

We encourage all Veterans to work with an accredited organization for assistance in completing claims for VA benefits.  A list of accredited organizations can be found on the Office of General Counsel site at this link:  Search the VA Office of the General Counsel’s list 

VBA has discontinued the use of public facing Disability Benefits Questionnaires (DBQs).  Originally, public facing DBQs were designed to assist Veterans living overseas to obtain medical evidence in support of their benefit claims where limited options were available.  Today, VA works with contracted providers in more than 30 foreign countries to conduct disability medical examinations.