Breaking News: The VBA No Longer Trusts Your Doctor

The VBA recently announced internally that they will no longer be making their Disability Benefit Questionnaires (DBQs) available to the public. This is very bad news for Veterans. This policy change is not being widely announced in the typical VA manner.  Read on to find out why.

Below is the link where the DBQs used to be. As you can see, they are no longer available:

https://www.benefits.va.gov/compensation/dbq_disabilityexams.asp

Disability Benefit Questionnaires, or “DBQs” have been an invaluable tool for Veterans to be evaluated fairly by medical providers. I wrote a considerable amount about making the best use of DBQs for your claim in Succeed With VA Compensation (see the excerpt at the end of this article). The sad truth is, many of the providers the VBA uses for exams are simply biased against Veterans (because most have never served and don’t know what it means to have done so), or because let’s face it, some doctors are just arrogant and lazy.

DBQs have allowed Veterans to have their family doctors submit valid evidence of Veterans’ medical conditions. However, because some doctors have unfortunately taken advantage of this as a loophole to make money, by providing favorable answers on a DBQ form for a fee for Veteran “patients” they have barely seen (or in some cases never seen), the Office of the Inspector General (OIG) has become overwhelmed with investigations of doctors engaging in potential fraud.

Well, that is the real reason for discontinuing access to DBQs. The alleged “reason” stated by the VBA is that “keeping the public websites updated with the latest version of the forms is too cumbersome and time consuming for VBA staff.” Of course this is just a cover story so the VBA doesn’t look bad to the general public. The VBA has a huge staff and resources, and they publicly maintain a large number of documents that are updated much more frequently than DBQs. (Also, as a result of COVID-19, I know for a fact that VBA workloads are currently below normal levels.) But like any political institution, the VBA has to try to paint a pretty picture by making it sound like this is good for Veterans, when the opposite is true.

So the unethical behavior of a few bad apples is resulting in the punishment of all Veterans, since evidence provided by “outside” doctors is no longer fully trusted by the VBA for rating purposes. The latest I heard on this is, any DBQs that are completed by non-VA doctors, or non-VA contract examiners, are still to be considered as “evidence”, but not accepted as a valid exam; meaning the VBA will now likely still send the Veteran to one of their examiners to complete the very same form. And the answers provided by “VA approved” doctors will be accepted as more accurate, despite the fact such examiners only meet Veterans one time, compared to Veterans’ family doctors who know Veterans’ complete and ongoing medical histories.

It’s not the fault of Veterans that some people used the DBQs as a tool to gain compensation to which they were not entitled. But removing the DBQs because of a few bad apples essentially implies that all Veterans and their private doctors are guilty of fraud. Whatever happened to innocent until proven guilty? In this case Veterans weren’t even given the opportunity to prove their innocence, nor do they any longer have a recourse for a poorly executed compensation and pension exam conducted by one of the VBA’s “approved” examiners. Taking a legitimate and useful tool away from all Veterans is not the solution to this problem.

There is another critical aspect to public disclosure of DBQs and it is this: transparency and objectivity of the VBA rating decision process. Providing DBQs to the public allows anyone to see the medical standards used for rating decisions, and this provides transparency and evidence of objectivity in rating decisions. Removing the DBQs from public access makes it look like the VBA is trying to hide something (no transparency), and it adds to the impression among Veterans that decisions are possibly not being made objectively (regardless of whether this is true or not). In short, this change definitely damages trust in and credibility of the VBA. Perhaps that is why the VBA quietly just removed the DBQs from the public site rather than making their typical public announcements.

This change in VBA policy should be considered wholly unacceptable by Veterans and their doctors. If you are a Vet, especially a disabled Vet, and you care about your rights in dealing with the VBA, you should plan to take action to defend those rights.

There are unfortunately few ways one can change policy at the VBA. Since I haven’t yet seen an official law change regarding the DBQs not being publicly available  (I will provide an update if that changes), it’s time to call your Congressional Representative. Communicate your concern that the DBQs are no longer available publicly, and now your family doctor can’t complete one on your behalf. Point out that this is a big problem.

If you have a claim denied because an ignorant “VA approved” examiner under-represented your disability on the DBQ they completed, (for example you told them you have headaches daily, and they put down once a month), then it’s time to appeal. And if that appeal is denied, then it’s time to take the VBA to court to force them to change the law on this.

This is a disgrace to take away one of Veterans’ few resources to be properly evaluated for their disabilities. This is especially bad timing due to COVID, while most claims are on hold pending the re-opening of VHA and contract exam facilities. This will certainly add to the appeals backlog, forcing Veterans to wait even longer for compensation for their disabilities.

You can find your Congressional Representative here.

If you need a VA phone number, you can find it here.

In conclusion, DBQs are an invaluable tool for Veterans to achieve factual and unbiased medical exams from medical providers. Taking that tool away from Veterans not only definitely harms outcomes for Veterans, but it certainly perpetuates the impression (correct or not) that the VBA is just out to screw over Veterans.  Shame on VBA for imposing such a disservice on the Veterans that they are supposed to serve.

Book excerpt below:

Disability Benefit Questionnaires (DBQs)

DBQs are standard forms used with every C&P exam by medical
examiners. The VBA now allows some DBQs to be filled out by
private medical doctors. So if you file a claim, and your doctor
has already filled out the appropriate DBQ in it’s entirety, the
VBA will accept it for rating purposes – with exceptions of
course. Some types of exams are required to only be
completed
by VA examiners, and some require specific licensing. Unless the
doctor includes this information on the DBQ, there’s a good
chance you’ll be sent for a C&P exam anyway. This is not because
the VBA doesn’t respect your doctor’s opinion, but because the
law says that for some specific reason that DBQ can’t be
accepted. For the purpose of this book there are too many
exceptions to list regarding who can perform an exam and fill
out a DBQ. So if you want more information, you can go to this
website:

https://www.benefits.va.gov/compensation/dbq_disabilityexams.asp

If you do have your doctor fill out a DBQ, make sure s/he
completes the form in it’s entirety, and signs it. Without the
doctor’s signature, the form is not valid. If s/he is providing
a medical opinion, make sure s/he includes a rationale for that
opinion. Do your best to make sure that the doctor uses the
correct VBA lingo in describing that opinion. More often than
not, private doctors don’t provide the necessary rationale for
their opinions, unless you tell them to do so. Even if your
doctor reviews your military records, and provides an opinion
with a rationale, it still has to make sense, and be written
using the appropriate VBA language. The doctor has to

show s/he really read your file. So the rationale could be
something like:


“Veteran’s military records show that on 9/1/02 the Veteran was
hit in the head with a baseball bat during a baseball game. This
was followed by various visits complaining of severe migraines.
It is more likely than not that the patient’s current migraines
are a direct result of getting hit with the baseball bat in
service.”


If the VBA has such an opinion in your file along with a
completed DBQ, there is a chance that they might not even ask
for the C&P exam, since they have sufficient evidence to make a

determination. This all depends on several factors including: 1.
If the opinion provided by the private doctor meets VBA
requirements, 2. What type of doctor wrote the opinion, and 3.
If the DBQ being used is one allowed to be filled out by a non-­
VA examiner. If the VBA does ask for an additional opinion, the
C&P examiner will have to address the private doctor’s opinion
in his or her rationale. Hint hint: this is something you can
look for if you’ve been denied. See if the C&P examiner
addressed the evidence your doctor provided. Sometimes things
just get missed.


The easiest medical opinions to get are for secondary
conditions. Here is an example. Sam was already service
connected for a low back condition, and recently developed
radiculopathy. His doctor filled out the appropriate DBQ with a
medical opinion stating that his radiculopathy is “as likely as
not” due to his low back condition, and then provided a
rationale why this is true.


Finding a doctor who is willing to perform an exam and provide a
medical opinion is not easy. A lot of doctor’s just want to
treat your condition and don’t wish to be entangled in legal
battles with the VBA. There are also some doctors who will
happily charge you a ridiculous amount of money to provide the
opinion you need. However, be wary of those doctors, as often

the Office of Inspector General (OIG) is on to them, and they
are under investigation. The last thing you need is for your
claim to be considered fraud. If you’re going to ask a doctor to
write a medical opinion, make sure it is a doctor you trust,
such as your family doctor, or your chiropractor, or even your
VHA doctor.

 

This Post Has 2 Comments

    1. This is good information, however there are two qualifiers to this. First, these forms will no longer be updated by the VBA. In other words, as these forms are updated internally by the VBA, these posted forms will become outdated (or removed entirely). And as we all know, outdated forms are not accepted by VBA. Second, even if a non-expired DBQ is submitted to VBA, *it will still hold less weight than “VA approved” doctors, and possibly NONE*, relative to any rating decision. Going forward the VBA is not going to put much consideration into any DBQs completed by doctors who are not “VA approved”. So this policy change goes beyond just accessing the documents themselves. So in summary, you will be looking at outdated DBQ forms, and the VBA won’t put much value on any DBQs submitted by outside doctors. Mark my words, this policy is going to harm Veterans in the long run, it is just not yet obvious the degree to which this is true.

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