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VA Bones and Other Skeletal Conditions DBQ

This seven-page public DBQ documents skeletal conditions such as skull fracture or loss, costochondritis, rib fracture or resection, coccyx removal, and benign or malignant bone neoplasms for a VA compensation claim. The provider records history, specific findings, neoplasm treatment and residuals, assistive devices, remaining function of the extremities, imaging and impact on work. VA uses it to decide service connection and the rating.

Who completes it

The Veteran's treating or examining clinician (MD, DO, NP, PA or other licensed clinician) completes the form and signs Section XII with name and title, specialty, NPI, medical license number and state.

Submitting and payment

How to submit it
Return the completed DBQ to the Veteran to upload on VA.gov with the claim or mail to VA's Evidence Intake Center; a representative may submit it.
Who pays
VA does not pay or reimburse any cost of completing a DBQ; any provider fee is between the Veteran and the provider.

Good to know

  • Section III asks whether skull loss or fracture comes with a brain hernia, and the size of any area of skull loss.
  • Section IV covers costochondritis, rib removal or resection (including resection without regeneration), and partial or complete coccyx removal with painful residuals.
  • For bone neoplasms, Section V asks whether treatment is complete or ongoing, the type and dates of radiation, chemotherapy, surgery or other therapy, and any residuals.
  • Section VIII asks whether so little function remains that an amputation with prosthesis would serve equally well; it does not ask whether amputation is advised.

Get the official form

Download the current version from the source each time; forms change without notice.

Bones and Other Skeletal Conditions Disability Benefits Questionnaire

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What diagnoses are on the VA bones and skeletal DBQ?

The checklist includes skull fracture, skull loss, costochondritis, rib fracture, rib resection, malignant primary or secondary bone neoplasms, benign bone neoplasms, and removal of the coccyx, with side, ICD code and date of diagnosis. Other diagnoses can be added in the same format.

What imaging does the bones DBQ ask about?

Section IX asks whether imaging was performed in conjunction with the exam, with date and results for bone scan, X-ray, MRI, biopsy or culture, or other studies. It also asks for other significant test findings and how any abnormal results relate to the diagnosed conditions.

Who signs the VA bones and other skeletal conditions DBQ?

The clinician who examined the Veteran or reviewed the evidence, in Section XII, with printed name and title, area of practice, NPI, medical license number and state, address and phone or fax. VA may verify the form's authenticity and still schedule its own exam.