Ear (Including Vestibular And Infectious) DBQ: Official VA Form

The public Ear (including Vestibular and Infectious) Disability Benefits Questionnaire records medical information for VA evaluation. The form itself provides its current questions, definitions, examination and clinician requirements. A completed form is evidence; it does not establish service connection or guarantee an evaluation.

Related Diagnostic Code Subjects

10 code subjects are associated with this form in this educational directory. These editorial subject associations are not official VA assignments, and the form may not be appropriate for every examination or claim.

• DC 6200: Chronic suppurative otitis media, mastoiditis, or cholesteatoma (or any combination)
• DC 6201: Chronic nonsuppurative otitis media with effusion (serous otitis media)
• DC 6202: Otosclerosis
• DC 6204: Peripheral vestibular disorders
• DC 6205: Meniere's syndrome (endolymphatic hydrops)
• DC 6207: Loss of auricle
• DC 6208: Malignant neoplasm of the ear (other than skin only)
• DC 6209: Benign neoplasms of the ear (other than skin only)
• DC 6210: Chronic otitis externa
• DC 6211: Tympanic membrane, perforation of

Read The Form Before Arranging An Examination

Review who may complete the form, which conditions it includes or excludes, and whether testing is required. VA can still request a claim examination. Report actual findings; this reference does not provide suggested answers.

Read The Claim Examination Guide · Return To The Rating Schedule