Gynecological Conditions DBQ: Official VA Form

The public Gynecological Conditions 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

18 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 7610: Vulva or clitoris, disease or injury of (including vulvovaginitis)
• DC 7611: Vagina, disease or injury of
• DC 7612: Cervix, disease or injury of
• DC 7613: Uterus, disease, injury, or adhesions of
• DC 7614: Fallopian tube, disease, injury, or adhesions of (including pelvic inflammatory disease (PID))
• DC 7615: Ovary, disease, injury, or adhesions of
• DC 7617: Uterus and both ovaries, removal of, complete
• DC 7618: Uterus, removal of, including corpus
• DC 7619: Ovary, removal of
• DC 7620: Ovaries, atrophy of both, complete
• DC 7621: Complete or incomplete pelvic organ prolapse due to injury, disease, or surgical complications of pregnancy
• DC 7624: Fistula, rectovaginal
• DC 7625: Fistula, urethrovaginal
• DC 7627: Malignant neoplasms of gynecological system
• DC 7628: Benign neoplasms of gynecological system. Rate chronic residuals to include scars, lymphedema, disfigurement, and/or other impairment of function under the appropriate diagnostic code(s) within the appropriate body system
• DC 7629: Endometriosis
• DC 7630: Malignant neoplasms of the breast
• DC 7632: Female sexual arousal disorder (FSAD)

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