Mental Disorders DBQ: Official VA Form

The public Mental Disorders 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.

Form Scope And Qualifications

• The form specifies professional qualifications for the examination; public availability does not mean every clinician may complete every type of examination.
• The form excludes PTSD and eating disorders. Use the specific public directory entries where applicable.

Related Diagnostic Code Subjects

30 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 9201: Schizophrenia
• DC 9208: Delusional disorder
• DC 9210: Other specified and unspecified schizophrenia spectrum and other psychotic disorders
• DC 9211: Schizoaffective disorder
• DC 9300: Delirium
• DC 9301: Major or mild neurocognitive disorder due to HIV or other infections
• DC 9304: Major or mild neurocognitive disorder due to traumatic brain injury
• DC 9305: Major or mild vascular neurocognitive disorder
• DC 9310: Unspecified neurocognitive disorder
• DC 9312: Major or mild neurocognitive disorder due to Alzheimer's disease
• DC 9326: Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder
• DC 9400: Generalized anxiety disorder
• DC 9403: Specific phobia; social anxiety disorder (social phobia)
• DC 9404: Obsessive compulsive disorder
• DC 9410: Other specified anxiety disorder
• DC 9412: Panic disorder and/or agoraphobia
• DC 9413: Unspecified anxiety disorder
• DC 9416: Dissociative amnesia; dissociative identity disorder
• DC 9417: Depersonalization/Derealization disorder
• DC 9421: Somatic symptom disorder
• DC 9422: Other specified somatic symptom and related disorder
• DC 9423: Unspecified somatic symptom and related disorder
• DC 9424: Conversion disorder (functional neurological symptom disorder)
• DC 9425: Illness anxiety disorder
• DC 9431: Cyclothymic disorder
• DC 9432: Bipolar disorder
• DC 9433: Persistent depressive disorder (dysthymia)
• DC 9434: Major depressive disorder
• DC 9435: Unspecified depressive disorder
• DC 9440: Chronic adjustment disorder

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