Documentation Guidance For DBQs

Required Documentation for DBQs

DBQs assess the severity and functional impact of a diagnosed condition. To complete these forms accurately and in accordance with VA expectations, the following materials are recommended:

Current diagnostic records, recent evaluations, progress notes, or psychiatric assessments confirming diagnosis and symptomatology.
Functional impact evidence that includes documentation of occupational, social, or daily life impairments related to the condition.
Medication and Treatment History.
Records of pharmacological and therapeutic interventions, including response and side effects.
VA Correspondence or prior DBQs (if applicable). This helps to ensure consistency and identify changes over time.
DBQs are completed with clinical precision and objective documentation, avoiding speculation and ensuring regulatory compliance

Confidentiality and Record Maintenance: All submitted documentation is maintained with strict confidentiality and stored securely in accordance with HIPAA and professional standards. Nexus Bridge does not share records without explicit consent and maintains professional independence in all evaluations.

Client Intake Checklist

Please provide the following information before your scheduled consultation. This ensures efficient review and accurate documentation aligned with VA standards.

Identification & Service Documentation

Medical & Mental Health Records

Supporting
Materials

Logistics & Consent

Personal Summary

Intake Form

Please prepare the following items before your scheduled consultation. This ensures efficient review and accurate documentation aligned with VA standards.

Section 1: Identity & Service Verification

Full Legal Name*

Date of Birth*

Full Mailing Address*

VA Claim Number (if known)

Branch of Service, Rank at Discharge, and Dates of Active Duty*

Type of Discharge (Honorable, General, Other Than Honorable, etc.)

DD-214 Status (Submitted / Pending / Assistance Needed)*

Job Specialty/ Title*

Section 2: Service-Connected Incident History

Did you experience any physical, psychological, or environmental exposures during service that you believe contributed to your current condition(s)? (Include deployments, accidents, trauma events, occupational hazards)*

Please describe the most relevant incident(s) related to your current claim. Include approximate date/location, your role, and immediate aftermath.*

Were formal reports filed (e.g., incident reports, Line of Duty Determinations)? If yes, attach or describe.*

Do you have buddy statements, military evaluations, or letters referring to these events? If so, please submit.*

Section 3: Medical Condition & Diagnostic History

List the condition(s) you are claiming for compensation. Include current diagnoses if available.*

When did symptoms first appear—and how have they progressed since?*

Do you currently receive treatment for this condition? List provider(s), specialties, and approximate dates.*

Have you undergone VA C&P examinations for this condition? Provide date(s) and outcomes*

Do you have any private evaluations or second opinions? Submit relevant files if available.*

Is this condition documented in active-duty or service treatment records? Attach excerpts if applicable.*

Section 4: Functional Impact Evaluation

Describe how your condition affects:
Your ability to work or maintain employment
Daily living activities (e.g. sleep, memory, focus, mobility)
Social and family relationships

Have you experienced episodes of hospitalization, crisis, or emergency treatment due to this condition?*

Have any providers linked this condition to military service in writing or verbally?*

Do you believe you have secondary conditions (e.g. depression from chronic pain)? List them if known.*

Section 5: Supporting Evidence & Prior Submissions

Have you previously submitted a Nexus Letter or DBQ for this condition? If yes, please attach or summarize.*

Do you possess service records, evaluations, or other materials that support causation or aggravation?*

Do you have any lay statements (from family, peers, colleagues) that document observable symptoms or service impact?*

Section 6: Consent & Logistics

Do you consent to an independent, non-treatment-based evaluation for Nexus and/or DBQ purposes?*

Preferred format for receiving documents: (Email) *

Would you like your evaluation to include recommendations for future care or additional documentation to strengthen your claim? *

Is there anything else you’d like me to know before your consultation? *

Documentation Guidance For DBQs

Required Documentation for DBQs

Client Intake Checklist

Identification & Service Documentation

Medical & Mental Health Records

Supporting
Materials

Logistics & Consent

Personal Summary

Intake Form

Section 1: Identity & Service Verification

Section 2: Service-Connected Incident History

Section 3: Medical Condition & Diagnostic History

Section 4: Functional Impact Evaluation

Section 5: Supporting Evidence & Prior Submissions

Section 6: Consent & Logistics

Pages

Services

Help

Documentation Guidance For DBQs

Required Documentation for DBQs

Client Intake Checklist

Identification & Service Documentation

Medical & Mental Health Records

Supporting Materials

Logistics & Consent

Personal Summary

Intake Form

Section 1: Identity & Service Verification

Section 2: Service-Connected Incident History

Section 3: Medical Condition & Diagnostic History

Section 4: Functional Impact Evaluation

Section 5: Supporting Evidence & Prior Submissions

Section 6: Consent & Logistics

Pages

Services

Help

Form Submitted Successfully

Supporting
Materials