Compliance VA DBQ (Wrist Conditions)
Validation Checks by Instafill.ai
1
Patient/Veteran Identification Fields Present (Name, SSN, Exam Date)
Validates that the Patient/Veteran name, Social Security Number, and Date of examination are all provided and not left blank. These fields are essential to correctly associate the DBQ with the correct claimant and to establish the timing of the medical findings. If any are missing, the submission should be rejected or routed to an exception queue because the form cannot be reliably matched to a claim or used for rating.
2
Social Security Number Format and Plausibility
Checks that the SSN is exactly 9 digits (optionally allowing standard hyphen formatting) and is not an obviously invalid value (e.g., all zeros, 123456789). This prevents misidentification and downstream matching failures with VA systems. If validation fails, the system should block submission and prompt for correction, since an invalid SSN can cause the record to be misfiled or rejected.
3
All Date Fields Use Valid Date Format and Are Chronologically Reasonable
Ensures all dates (Date of examination, Date of diagnosis, surgery dates, Date Signed, diagnostic test dates) are valid calendar dates in an accepted format (e.g., YYYY-MM-DD) and not in the future (except where explicitly allowed by policy). It also checks that key dates are logically ordered (e.g., Date Signed should be on/after Date of examination; surgery date should not be after exam date if described as historical). If a date is invalid or illogical, the form should be flagged for correction because it undermines medical timeline credibility and can affect adjudication.
4
Requestor Type Completeness (Veteran/Third Party/Other)
Validates that exactly one requestor option is selected (Veteran/Claimant, Third party, or Other). If 'Third party' is selected, at least one organization/individual name must be provided; if 'Other' is selected, a description must be provided. If this fails, the submission should be returned for completion because the provenance of the DBQ request affects authenticity review and recordkeeping.
5
Provider Status and Examination Modality Consistency
Checks that 'Are you a VA Healthcare provider?' and 'Was the Veteran examined in person?' are answered, and if 'Was the Veteran examined in person?' is 'No', the 'how was the examination conducted' field is completed. This ensures the VA can interpret the evidentiary weight of the findings and whether limitations apply to remote assessments. If inconsistent or incomplete, the form should be flagged because missing modality details can invalidate ROM and physical exam sections.
6
Evidence Review Selection Requires Supporting Details
Validates that one of 'No records were reviewed' or 'Records reviewed' is selected. If 'Records reviewed' is selected, the evidence types and date range must be provided (non-empty and date range formatted). If this fails, the system should request correction because the basis for medical opinions (history, diagnosis dates, imaging confirmation) depends on documented evidence review.
7
Dominant Hand Selection Required and Single-Choice
Ensures exactly one dominant hand option is selected (Right, Left, Ambidextrous). Dominance is used in rating considerations and functional impact interpretation for upper extremity conditions. If missing or multiple selections occur, the submission should be flagged for correction to avoid incorrect disability evaluation assumptions.
8
Claimed Conditions (1A) Must Be Provided
Checks that the clinician lists at least one claimed wrist-related condition in Section 1A. This anchors the scope of the DBQ and ensures the subsequent diagnoses and findings are tied to the claimed issues. If blank, the form should be rejected or routed for completion because the DBQ cannot be reliably interpreted without the claimed condition context.
9
Diagnosis Selection Logic (1B) and Required Side/ICD/Date Fields
Validates that either 'Veteran does not have a current diagnosis...' is selected OR at least one diagnosis row is selected, but not both. For each selected diagnosis, the affected side (Right/Left/Both) must be specified, and if the form captures ICD code and date of diagnosis, those fields must be populated in valid formats (ICD pattern and valid date). If this fails, the system should flag the record because incomplete diagnosis metadata prevents accurate coding, rating, and medical record integration.
10
Other Diagnosis Free-Text Required When 'Other' or 'Inflammatory other types' Selected
Ensures that when 'Other (specify)', 'Other diagnosis #1/#2', or 'Inflammatory other types (specify)' is selected, the corresponding free-text specification is not empty and is sufficiently descriptive (not just 'N/A' or a single character). This is important for clinical clarity and for mapping to appropriate diagnostic codes. If missing, the submission should be returned for clarification because unspecified 'Other' diagnoses are not actionable for adjudication.
11
Flare-Ups and Functional Loss Narrative Required When Answered 'Yes'
Checks that if the Veteran reports flare-ups (2B = Yes), the flare-up description includes at least frequency and duration (or an explicit statement that details are unknown). Similarly, if functional loss/impairment is reported (2C = Yes), a narrative description must be provided in the Veteran’s own words or clearly attributed summary. If absent, the form should be flagged because VA rating often depends on functional loss during flare-ups and repeated use over time.
12
ROM Testing Feasibility Requires Explanation When Not Performed
Validates that for each wrist, if ROM is marked 'Unable to test' or 'Not indicated', an explanation is provided. It also checks the 'Can testing be performed? Yes/No' prompts: if 'No', an explanation must be present and the contralateral/unclaimed joint damaged/undamaged selection must be consistent with whether ROM testing is required. If this fails, the submission should be flagged because missing rationale for absent ROM testing can render the exam inadequate.
13
ROM Degree Values Are Numeric and Within Physiologic Bounds
Ensures all entered ROM endpoints (dorsiflexion, palmar flexion, ulnar deviation, radial deviation) are numeric (allowing decimals if permitted) and within reasonable physiologic limits (e.g., not negative, not implausibly high such as >180). This prevents data entry errors that could distort severity assessment. If out of range or non-numeric, the system should block submission or require correction because invalid ROM values can directly affect disability evaluation.
14
Pain/Functional Loss Checkboxes Require Comments When Indicated
Validates that if 'evidence of pain' is 'Yes' and 'causes functional loss' is checked, the Comments field is completed with a brief description of how pain contributes to functional loss. It also checks that if localized tenderness is 'Yes', the explanation includes location and relationship to the condition. If missing, the form should be flagged because VA requires narrative support to interpret checkbox selections and to support medical conclusions.
15
Repetitive Use and Repeated Use Over Time Sections Require Estimates or Justified Infeasibility
Checks that if additional loss after three repetitions is 'Yes', the post-test ROM degrees and contributing factors are provided. For repeated use over time and flare-up estimate sections, if the examiner indicates significant limitation is suggested, estimated ROM values must be provided; if the examiner cannot provide an estimate, a case-specific explanation must be entered (not a generic refusal). If validation fails, the submission should be flagged because missing estimates/rationales are a common reason DBQs are deemed inadequate.
16
Muscle Atrophy Measurements Required When Atrophy Present
Validates that if muscle atrophy is 'Yes', the causation question (4B) is answered, and if atrophy is due to the claimed condition, the location and both circumference measurements (normal and atrophied side) are provided in centimeters and are positive numbers. If 4B is 'No', a rationale must be present. If missing, the form should be returned because atrophy findings require objective measurements to be clinically meaningful and rateable.
17
Ankylosis Severity Requires Degree Values/Descriptions When Applicable
Ensures that if ankylosis is 'Yes', exactly one severity category is selected and any category requiring degrees (palmar flexion/ulnar deviation/radial deviation) includes numeric degree values. If 'Any other position except favorable' is selected, a descriptive position statement must be provided. If this fails, the submission should be flagged because ankylosis classification is highly specific and directly impacts rating.
18
Surgical Procedure Details Required When Surgery Indicated
Validates that if 'Total wrist joint replacement' is selected, the date of surgery and residuals category are completed, and if 'Other residuals' is selected, a description is provided. If 'Arthroscopic or other wrist surgery' is selected, type of surgery, date, and residuals description must be present. If incomplete, the form should be flagged because surgical history and residual severity are critical for correct evaluation and may trigger additional required questionnaires.
19
Diagnostic Testing and Arthritis Confirmation Consistency
Checks that if diagnostic imaging/procedures were performed or reviewed (10A = Yes), then the type/date/results (10C) are provided. If degenerative or post-traumatic arthritis is documented (10B = Yes), a side (Right/Left/Both) must be selected and the imaging results should support the diagnosis; conversely, if an arthritis diagnosis is selected in Section I, the system should prompt for imaging documentation or a remark explaining prior documentation. If inconsistent, the submission should be flagged because arthritis diagnoses require imaging confirmation per the form instructions.
20
Examiner Certification Completeness (Signature, Credentials, Contact, NPI/License, Date Signed)
Validates that the examiner’s signature, printed name/title, specialty, date signed, and at least one contact number are present, and that NPI and medical license/state fields follow expected formats (NPI = 10 digits; license includes state). This supports authenticity verification and allows VA to contact the provider if clarification is needed. If missing or malformed, the submission should be rejected or held because an unsigned/uncredentialed DBQ may be considered invalid.