Central Nervous System and Neuromuscular Diseases DBQ explained

What this DBQ covers

This questionnaire covers central nervous system and neuromuscular conditions for which it is the appropriate form. It collects a diagnosis, medical history, and findings involving functions such as movement, speech, swallowing, and bladder or bowel control. Some neurological conditions have their own dedicated questionnaires. The right form depends on the diagnosed condition, so a symptom such as weakness does not by itself identify which questionnaire should be used.

The important sections, explained

The effects of the diagnosed neurological condition

The symptom section covers possible effects across several body systems, including movement, swallowing, sleep and bowel or bladder function. The relevant findings depend on the diagnosed central nervous system condition. Describe the changes you experience and bring the evaluations already completed. You do not need to select every symptom listed. The clinician determines what belongs to this condition and whether another examination is needed to document a separate problem.

Read the official form: page 4

When more than one diagnosis affects function

The differentiation section addresses symptoms or neurological effects when conditions overlap. Weakness, poor balance or fatigue may have more than one possible contributor. Identify the established diagnoses and provide a timeline showing when the changes occurred. If medical records do not clearly separate the causes, preserve that uncertainty. The examiner should explain the medical assessment rather than asking you to allocate a percentage of each limitation to different conditions.

Read the official form: page 11

How to prepare useful information

Bring neurological evaluations, hospital records from a major event, imaging already performed, and rehabilitation notes describing current abilities. Explain what improved, what remains limited, and whether symptoms fluctuate. Examples involving walking, communication, self-care, or work can make the effects easier to understand. Your clinician should connect those effects to the relevant diagnosis and identify any additional condition-specific assessment needed rather than treating every symptom as part of one disease.

Records to gather

Start with records you already have. Bring the relevant information to your clinician and explain any gaps or uncertain dates.

• Neurology and hospital records identifying the condition and relevant dates
• Imaging and rehabilitation assessments of remaining functional problems
• Examples of daily tasks requiring extra time, equipment, or assistance

A detail that is easy to miss

A broad label such as nerve damage may not identify whether the problem belongs to the brain, spinal cord, peripheral nerves or another structure. Use the full diagnosis from the records where available. Include relevant testing and treatment dates. If another condition has its own VA questionnaire, discuss the appropriate assessment rather than assuming this broad form replaces every neurological DBQ.

Find your way around the official form

These section headings come from the linked VA PDF. Each link opens the page where the section begins. Read the form's own instructions for the full questions and any required attachments.

1. SECTION I - DIAGNOSISPage 1
2. SECTION II - MEDICAL HISTORYPage 4
3. SECTION III - CONDITIONS, SIGNS AND SYMPTOMS DUE TO CNS CONDITIONPage 4
4. SECTION IV - NEUROLOGIC EXAMPage 8
5. SECTION V - TUMORS AND NEOPLASMSPage 10
6. SECTION VI - OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARSPage 11
7. SECTION VII - MENTAL HEALTH MANIFESTATIONS DUE TO A CNS CONDITION OR ITS TREATMENTPage 11
8. SECTION VIII - DIFFERENTIATION OF SYMPTOMS OR NEUROLOGIC EFFECTSPage 11
9. SECTION IX - ASSISTIVE DEVICESPage 11
10. SECTION X - REMAINING EFFECTIVE FUNCTION OF THE EXTREMITIESPage 12
11. SECTION XI - DIAGNOSTIC TESTINGPage 12
12. SECTION XII - FUNCTIONAL IMPACTPage 13
13. SECTION XIII - REMARKSPage 13
14. SECTION XIV - EXAMINER'S CERTIFICATION AND SIGNATUREPage 13

Who completes the clinical sections?

The healthcare provider completes the clinical assessment, identifies the records reviewed, and signs the questionnaire. You can gather records and describe symptoms and daily limitations. Measurements, diagnoses, and clinical conclusions belong to the examiner.

Check the official form's instructions with your provider before the appointment, including any examination or testing requirements. VA does not pay or reimburse the costs of having a private DBQ completed or submitted.

A completed DBQ can help document the medical condition. Whether it also answers a particular service-connection question depends on its content and the other evidence. VA may verify the form or request another examination.

Common questions

Is this the form for every neurological condition?

No. VA publishes separate questionnaires for several conditions, including ALS, multiple sclerosis, Parkinson's disease, and seizures. A clinician can identify the appropriate form based on the diagnosis and the examination being requested. This guide does not replace that clinical choice.

Is this the same as a peripheral nerves form?

No. The central nervous system and peripheral nerves questionnaires address different diagnoses and findings. Your clinician should select the form that matches the documented condition. Similar symptoms, such as weakness or numbness, do not make the two assessments interchangeable.

What if the cause of a symptom is still uncertain?

Say that clearly and bring the evaluations performed so far. Describe the symptom's timing and effect without assigning its cause yourself. The form includes a place for the clinician to consider overlapping neurological effects and explain the limits of differentiation.