Peripheral Nerve Conditions DBQ explained

What this DBQ covers

The Peripheral Nerves DBQ documents a diagnosed peripheral nerve condition, its symptoms, and examination findings. The clinician assesses the affected nerves and sides, using findings such as strength, reflexes, and sensation. Pain, tingling, or weakness can have more than one cause, so the form should not treat those symptoms alone as proof of a particular nerve diagnosis. VA also publishes a separate questionnaire for diabetic peripheral neuropathy.

The important sections, explained

Describe the map of symptoms

The symptom section distinguishes pain, tingling, numbness and other findings by extremity. Identify the affected side and the area involved, such as particular fingers, part of the foot or a strip along a limb. That location helps the clinician compare your history with the examination. You do not need to name the nerve yourself. Similar symptoms can arise from different conditions, and a broad term such as neuropathy may not answer the specific diagnosis question.

Read the official form: page 2

Examination findings and nerve severity

The form combines strength, reflex, sensation and other clinical findings with separate evaluations of upper and lower extremity nerves. Describe what happens during walking, handling objects or other relevant tasks. Keep reduced feeling, pain-limited movement and weakness distinguishable where possible. The examiner identifies the nerve and clinical severity; choosing a category from how intense the pain feels is not a substitute for that assessment or a reliable way to predict a rating.

Read the official form: page 6

How to prepare useful information

Bring neurological evaluations, relevant surgery records, and nerve-conduction or EMG results if already available. Explain where symptoms occur and how they affect specific tasks, such as walking, fastening clothing, or holding objects. Describe changes over time and any treatment or equipment used. The examiner determines the nerve involvement and clinical severity; you do not need to assign yourself a severity label to give a useful history.

Records to gather

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

• Clinical records naming the nerve condition and affected side
• Existing nerve studies and relevant surgery or treatment records
• Examples of changes in strength, sensation, walking, or fine hand tasks

A detail that is easy to miss

Do not merge both limbs into one account if the symptoms differ. Keep test dates and the diagnosis in the report clear, and mention any surgery or treatment that changed the pattern. A prior nerve test may describe one period while the current examination describes another. If a cause remains uncertain, preserve that uncertainty instead of assigning it from an online diagram.

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 2
3. SECTION III - SYMPTOMSPage 2
4. SECTION IV - MUSCLE STRENGTH TESTINGPage 3
5. SECTION V - REFLEX EXAMPage 4
6. SECTION VI - SENSORY EXAMPage 4
7. SECTION VII - TROPHIC CHANGESPage 5
8. SECTION VIII - GAITPage 6
9. SECTION IX - SPECIAL TESTS FOR MEDIAN NERVEPage 6
10. SECTION X - NERVES AFFECTED: Severity Evaluation for Upper Extremity Nerves and Radicular GroupsPage 6
11. SECTION XI - NERVES AFFECTED: Severity Evaluation for Lower Extremity NervesPage 8
12. SECTION XII - ASSISTIVE DEVICESPage 11
13. SECTION XIII - REMAINING EFFECTIVE FUNCTION OF THE EXTREMITIESPage 11
14. SECTION XIV - OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS AND/OR SYMPTOMSPage 12
15. SECTION XV - DIAGNOSTIC TESTINGPage 13
16. SECTION XVI - FUNCTIONAL IMPACTPage 14
17. SECTION XVII - REMARKSPage 14
18. SECTION XVIII - EXAMINER'S CERTIFICATION AND SIGNATUREPage 14

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

Do I need to choose mild, moderate, or severe myself?

No. Describe the symptoms and functional problems accurately, with examples and supporting records where available. The clinician assesses the examination findings and the affected nerves. A self-selected severity label is less useful than a clear account of what has changed and how it affects you.

Does numbness alone tell me which nerve is affected?

No. Its location is useful history, but the clinician considers the examination and relevant testing to identify the nerve and cause. Point out the affected area and describe the pattern. Avoid selecting a nerve solely because a diagram appears similar.

Should I bring an EMG or nerve-conduction report?

Bring a relevant report if one has already been performed, including its date and interpretation. The examiner decides how it informs the current assessment and whether further testing is appropriate. You do not need to arrange new testing independently just to read or prepare for this form.