Yes! You can use AI to fill out Knee and Lower Leg Disability Benefits Questionnaire
The Knee and Lower Leg Disability Benefits Questionnaire (DBQ) is a standardized U.S. Department of Veterans Affairs medical form intended to be completed by a healthcare provider to report clinical findings for knee and lower leg conditions. It captures diagnoses, medical history, objective testing (including range of motion and stability), imaging results, and how the condition affects occupational functioning. VA uses the information to help determine service connection and assign a disability rating, and the examiner’s certification supports the credibility of the medical evidence submitted with the claim.
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Form specifications
| Form name: | Knee and Lower Leg Disability Benefits Questionnaire |
| Number of pages: | 15 |
| Language: | English |
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How to Fill Out VA DBQ (Knee and Lower Leg) Online for Free in 2026
Are you looking to fill out a VA DBQ (KNEE AND LOWER LEG) form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your VA DBQ (KNEE AND LOWER LEG) form in just 37 seconds or less.
Follow these steps to fill out your VA DBQ (KNEE AND LOWER LEG) form online using Instafill.ai:
- 1 Enter Veteran/patient identifiers and exam details (name, SSN, date of examination) and indicate who requested the DBQ and whether the examiner is a VA provider.
- 2 Complete the Evidence Review section by listing which records were reviewed (service, VA, private) and the applicable date ranges.
- 3 Fill out Section 1 (Diagnosis) by selecting all applicable knee/lower leg diagnoses, specifying side affected, ICD codes, and diagnosis dates; add any additional diagnoses as needed.
- 4 Document Section 2 (Medical History) including onset/course, flare-ups, functional loss, instability/subluxation history, and effusion details.
- 5 Record Section 3 (ROM and Functional Limitation) for each knee: active/passive ROM, pain with weight-bearing/nonweight-bearing, repetitive-use testing results, estimated limitations after repeated use and during flare-ups, and any additional disability factors.
- 6 Complete remaining clinical sections as applicable: muscle atrophy, ankylosis, joint stability (including ligament tears and prescribed devices), tibial/fibular impairment, meniscal conditions, surgeries and residuals, scars/other findings, assistive devices, remaining effective function, and diagnostic testing/imaging results.
- 7 Finish Section 14 (Functional Impact), add any Section 15 remarks, then complete Section 16 examiner certification with signature, credentials, specialty, contact information, NPI, license details, and address before generating the final submission copy.
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Frequently Asked Questions About Form VA DBQ (Knee and Lower Leg)
This DBQ provides medical evidence about a Veteran’s knee and/or lower leg condition(s) for the VA to consider when evaluating a disability benefits claim. It documents diagnoses, symptoms, functional limitations, and test results in a standardized format.
The form is intended to be completed by the Veteran’s healthcare provider (examiner). The Veteran can provide symptom history and descriptions (like flare-ups and functional loss), but the clinician must record findings, measurements, and certify the form.
No. The form states that the VA will not pay or reimburse any expenses or costs incurred to complete and/or submit this DBQ.
No. The form asks whether the examiner is a VA provider, but it can also be completed by a non-VA (private) clinician as long as they can perform the evaluation and provide the required information.
Not always, but the form asks whether the Veteran was examined in person and, if not, how the examination was conducted. The examiner should document the method used and ensure the findings are supportable.
The examiner should indicate whether records were reviewed and list what was reviewed (for example, service treatment records, VA treatment records, and/or private treatment records) along with the date range. If no records were reviewed, that must be selected.
The examiner can select that the Veteran does not have a current diagnosis associated with the claimed condition(s). The form instructs the examiner to explain the findings and reasons in the Remarks section.
In Section 1 (Diagnosis), each diagnosis includes a “Side affected” choice (Right/Left/Both). The examiner should select the correct side and, when applicable, provide ICD code and date of diagnosis.
If flare-ups are reported, the examiner should document the Veteran’s description, including frequency, duration, characteristics, triggers, relieving factors, severity, and the functional impact during flare-ups. This information is used later to estimate functional loss during flare-ups.
Initial ROM records measured motion at the exam; repetitive-use testing records changes after at least three repetitions observed during the exam. “Repeated use over time” and “flare-ups” may require the examiner to estimate ROM loss based on the Veteran’s statements, records, and medical judgment even if not directly observed.
The examiner should select “No” for whether testing can be performed and provide a clear explanation (for example, severe pain or risk of further injury). The form specifically requires an explanation when testing is not done or is medically contraindicated.
Yes, the form notes that examiners should address pain on both passive and active motion and on both weight-bearing and nonweight-bearing. If any of these tests cannot be performed, the examiner must explain why.
Instability is addressed in Section 6 (Joint Stability), including ligament tears, repairs, recurrent subluxation, and patellar instability. The form also asks whether the Veteran requires a prescription from a medical provider for devices like a brace, cane, crutches, or walker for ambulation.
The form states that degenerative arthritis (osteoarthritis) or post-traumatic arthritis must be confirmed by imaging studies. Once arthritis has been documented (even in the past), the VA does not require new imaging solely to confirm it again.
The examiner should describe how the diagnosed knee/lower leg condition(s) affect the Veteran’s ability to perform occupational tasks such as standing, walking, lifting, or sitting. The form instructs the examiner to discuss only the impact of the diagnosed conditions, not other factors like age or unrelated medical issues.
Compliance VA DBQ (Knee and Lower Leg)
Validation Checks by Instafill.ai
1
Patient/Veteran Identification Completeness (Name + SSN)
Validates that the Patient/Veteran name and Social Security Number are both present and not left blank. These identifiers are required to correctly associate the DBQ with the correct claimant and prevent misfiling into the wrong medical/claims record. If either field is missing, the submission should be rejected or routed to an exception queue for manual resolution before acceptance.
2
SSN Format and Plausibility Validation
Ensures the Veteran’s SSN is exactly 9 digits (optionally allowing hyphens in the ###-##-#### format) and is not an invalid placeholder (e.g., 000000000, 123456789) or contains non-numeric characters. This reduces downstream matching errors and prevents ingestion of obviously incorrect identifiers. If validation fails, the form should be blocked and the submitter prompted to correct the SSN.
3
Date Fields Format and Chronology (Exam Date, Signature Date, Diagnosis/Surgery Dates)
Checks that all dates (Date of examination, Date signed, Date of diagnosis, Date of surgery, diagnostic test dates) follow an accepted format (e.g., YYYY-MM-DD or MM/DD/YYYY) and represent real calendar dates. Also enforces logical chronology: signature date should be on/after exam date, and surgery/diagnosis/test dates should not be in the future relative to the exam date unless explicitly allowed by system policy. Failures should trigger a hard error for impossible dates and a soft/hard error for inconsistent chronology depending on business rules.
4
Requester Type Conditional Details (Third Party/Other)
Validates that when 'Third party' is selected, at least one organization/individual name is provided, and when 'Other' is selected, a description is provided. This is important for auditability and to document who initiated the DBQ, which can affect evidentiary handling. If the required conditional text is missing, the submission should be flagged as incomplete and returned for correction.
5
Examination Modality Consistency (In-Person vs Not In-Person)
Ensures that if 'Was the Veteran examined in person?' is marked 'No', the 'If no, how was the examination conducted?' field is completed with a meaningful method (e.g., telehealth, records review). This supports clinical credibility and VA review requirements for how findings were obtained. If 'No' is selected without a method, the form should fail validation due to missing required context.
6
Evidence Review Selection and Details
Checks that the 'Evidence reviewed' section is internally consistent: if 'Records reviewed' is selected, the evidence types and date range are provided; if 'No records were reviewed' is selected, the evidence list/date range should be empty. This prevents contradictory documentation and supports adjudicators in understanding the basis of the opinion. If inconsistent, the system should prompt the examiner to correct the selection or supply the missing evidence details.
7
Diagnosis Selection vs 'No Current Diagnosis' Mutual Exclusivity
Validates that 'The Veteran does not have a current diagnosis...' cannot be selected at the same time as any specific diagnosis checkbox in Section 1B. This is a core logical consistency rule because it directly contradicts the presence of selected diagnoses. If both are present, the submission should be rejected until the contradiction is resolved.
8
Diagnosis Detail Completeness (Side, ICD Code, Date of Diagnosis)
For each selected diagnosis, verifies that the side affected (Right/Left/Both) is specified and that ICD code and date of diagnosis are provided when required by the implementation. This ensures the diagnosis is actionable for rating and reduces ambiguity about laterality. If any selected diagnosis lacks required details, the form should be flagged as incomplete and not accepted until corrected.
9
‘Other Diagnosis’ Requires Free-Text Specification
Ensures that if any 'Other (specify)' or 'Other diagnosis #1/#2/#3' option is used, the corresponding free-text diagnosis name is populated and not generic (e.g., 'knee pain'). This is important because adjudication and clinical interpretation require a specific condition label. If missing or too vague, the system should require clarification before submission.
10
History/Flare-ups/Functional Loss Conditional Narratives
Validates that when the Veteran reports 'Yes' to flare-ups (2B), functional loss (2C), instability/subluxation history (2D), or frequent effusion (2E), the associated narrative description fields are completed. These narratives are required to interpret severity, frequency, and functional impact beyond checkboxes. If 'Yes' is selected without narrative, the submission should be returned for completion.
11
ROM Testing Feasibility and Explanation Requirements
Checks that if ROM testing 'Cannot be performed' is marked 'No' (i.e., cannot be performed) for either knee, an explanation is provided, and that 'Unable to test'/'Not indicated' selections in 3A include an explanation. This is required for compliance with VA examination standards and to justify missing objective measurements. If explanations are missing, the form should fail validation as incomplete.
12
ROM Numeric Range and Unit Validation (Flexion/Extension)
Ensures ROM degree entries are numeric and within plausible clinical bounds (e.g., flexion typically 0–140; extension typically -10 to 0 to small hyperextension depending on policy) and that required degree fields are not blank when testing is performed. This prevents data entry errors like text in numeric fields or impossible values (e.g., flexion 500). If out of range or non-numeric, the system should block submission and request correction.
13
Pain/Functional Loss Consistency in ROM Sections
Validates that if 'Is there evidence of pain?' is 'Yes', at least one applicable context checkbox (weight-bearing, nonweight-bearing, active, passive, rest) is selected, and if 'causes functional loss' is checked, a comment/description is provided. This ensures the record clearly states how pain manifests and whether it affects function, which is central to rating decisions. If inconsistent or missing required detail, the form should be flagged for correction.
14
Repetitive-Use Testing Logic (3B) and Required Follow-Ups
Checks that if the Veteran is not able to perform repetitive-use testing, an explanation is provided; and if additional loss after three repetitions is 'Yes', then post-test flexion/extension values and at least one causal factor (pain, fatigability, etc.) are selected. This ensures the repetitive-use component is complete and interpretable. If required follow-ups are missing, the submission should be rejected as incomplete.
15
Repeated Use Over Time / Flare-Up Estimation Requirements (3C/3D)
Validates that when procured evidence suggests significant limitation with repeated use over time or flare-ups is 'Yes', the examiner provides estimated ROM values in degrees or a case-specific explanation for why an estimate is not feasible, including cited evidence. This aligns with the form’s explicit instruction that estimates should be provided when possible and not omitted without justification. If neither estimates nor an adequate rationale are provided, the form should fail validation.
16
Examiner Certification Completeness and Credential Validation (Signature, NPI, License, Contact)
Ensures Section 16 is complete: examiner signature, printed name/title, specialty, date signed, phone/fax, NPI, and medical license number/state are present and properly formatted (e.g., NPI is 10 digits; phone/fax follows a valid pattern). This is critical for authenticity verification and for VA follow-up if clarification is needed. If any required credential fields are missing or malformed, the submission should be blocked or routed for credential correction before acceptance.
Common Mistakes in Completing VA DBQ (Knee and Lower Leg)
People often leave the header fields blank or enter identifiers that don’t match the Veteran’s claim file (e.g., nickname, transposed SSN digits, or missing exam date). This can delay processing because VA staff may be unable to confidently associate the DBQ with the correct claimant or encounter. Always enter the Veteran’s legal name as used in VA records, verify the SSN digit-by-digit, and include the actual date the exam was performed (not the date the form was started or signed).
A common error is checking “Third party” but not listing the organization/individual, or selecting “Other” without describing it. This creates questions about the purpose and provenance of the report and can trigger follow-up requests. If a third party requested it, list the full legal name(s) and, if relevant, the role (e.g., attorney, VSO, insurer); if “Other,” provide a clear one-sentence explanation.
Providers sometimes check “Was the Veteran examined in person? No” but then complete detailed physical findings (ROM, palpation tenderness, crepitus) as if an in-person exam occurred, or they fail to describe how the exam was conducted. This inconsistency can undermine credibility and lead VA to discount the DBQ or order a new C&P exam. If not in-person, clearly state telehealth/records review method and limit objective findings to what can be supported, explaining any sections that cannot be reliably completed.
Many submissions check “Records reviewed” but don’t identify which records were reviewed or the date range, or they check “No records were reviewed” even though they reference imaging or prior notes later. VA relies on this section to understand the foundation for diagnoses and historical timelines. List specific sources (e.g., STRs, VA treatment records, private ortho notes) and include an approximate date range; ensure later references match what you said you reviewed.
It’s common to select a diagnosis (e.g., meniscal tear, osteoarthritis) but leave the side affected, ICD code, and/or diagnosis date blank, or to mark “Both” without clarifying right vs left details. This can cause rating errors because VA ratings are side-specific and depend on confirmed diagnoses and timelines. For each diagnosis, specify right/left/both, provide the ICD code if available, and give a reasonable diagnosis date (exact, approximate, or “date of current evaluation” if newly diagnosed).
Some clinicians check “The Veteran does not have a current diagnosis…” but do not explain why symptoms do not meet diagnostic criteria or how prior diagnoses were ruled out. Without a rationale, VA may view the DBQ as incomplete or inconsistent with the record. If no diagnosis is present, document the key negative findings, differential considerations, and why the claimed condition is not supported, and reference relevant evidence in the Remarks section.
A frequent data-entry issue is recording ROM in percentages, writing narrative text instead of degrees, swapping flexion and extension values, or entering values outside physiologic plausibility (e.g., extension “140” or flexion “0”). These errors can directly change the disability evaluation because VA ratings are degree-based. Always record ROM in degrees, double-check that flexion is typically up to ~140 and extension is typically to 0 (or note hyperextension/limited extension correctly), and ensure right/left entries are not transposed.
The form specifically asks for pain on active/passive motion and weight-bearing/nonweight-bearing, but many submissions only provide one set of ROM numbers and leave the pain-testing checkboxes blank. VA may consider the exam inadequate if required testing is missing without a medical contraindication explanation. If any testing cannot be performed, explicitly state the reason (e.g., risk of injury, severe pain) and document what was done instead.
Examiners often avoid estimating ROM loss after repeated use over time or during flare-ups, or they provide a generic statement like “cannot determine without speculation.” The DBQ instructs that estimates should be based on procurable information, including the Veteran’s statements, and that the explanation must be case-specific. To avoid an inadequate exam finding, document the Veteran’s flare frequency/duration/severity, cite relevant records, and provide a reasoned estimate in degrees when possible; if not feasible, explain precisely what information is missing and why it prevents an estimate in this case.
People commonly report braces/canes in Section 11 but answer “No” to the prescription question in Section 6D/6G, or they check devices without clarifying whether a medical provider prescribed them. VA distinguishes between prescribed devices for ambulation and self-selected use, which can affect how instability is evaluated. Clarify whether each device is prescribed, for what condition, for which side, and how often it is used; keep Section 6 and Section 11 consistent.
A common omission is checking a surgery (meniscectomy, ligament repair, total knee replacement) but leaving the date blank or failing to describe residual symptoms and functional limitations. For total knee replacement, the residual category (none/intermediate/chronic severe) is often left unselected, which can materially affect rating. Provide the best available surgery date (month/year if exact date unknown), specify the procedure, and describe current residuals (pain, weakness, ROM limits, instability) tied to that surgery.
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