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VA Diabetes Mellitus DBQ (Diabetes Disability Form)

A Veteran claiming type 1 or type 2 diabetes for VA compensation can bring this 6-page questionnaire to their own clinician. It captures the diagnosis and the tests behind it, treatment by diet, oral agents or insulin injections per day, any medically required regulation of activities, ketoacidosis and hypoglycemia visits and hospitalizations, weight loss, and complications caused or aggravated by diabetes. VA rates the condition from these answers.

Who completes it

The Veteran's treating or examining clinician completes Sections 1 to 7 and signs the Section 8 examiner's certification. Diabetic retinopathy or other eye complications need the Eye Conditions questionnaire, which must be completed by an ophthalmologist or optometrist.

Submitting and payment

How to submit it
The Veteran receives the signed DBQ and uploads it with the claim on VA.gov or mails it to the VA Evidence Intake Center; a representative may file it instead. VA's DBQ page asks that the form be printed to PDF before uploading.
Who pays
VA will not pay or reimburse the cost of completing the diabetes DBQ; any provider fee is between the Veteran and the clinician.

Good to know

  • For VA purposes, regulation of activities means avoiding strenuous occupational and recreational activities to prevent hypoglycemic episodes, and item 2B asks for examples of how the Veteran must do this.
  • Section 3 separates complications caused by diabetes from conditions aggravated by it; each checked complication, such as neuropathy, nephropathy, heart disease or stroke, needs its own DBQ too.
  • Existing lab results in the record need not be repeated, and a glucose tolerance test is not required for VA purposes; report one only if already done.
  • Hypertension counts as a complication caused by diabetes only in the presence of diabetic renal disease; otherwise it is listed among conditions aggravated by diabetes.

Get the official form

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

Diabetes Mellitus 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.

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Frequently asked questions

What lab results does the VA diabetes DBQ ask for?

Item 5A asks which results established the diagnosis, with dates: fasting plasma glucose of 126 mg/dl or more twice, A1C of 6.5% or more twice, a 2-hour glucose tolerance result of 200 mg/dl or more, or a random glucose of 200 mg/dl or more with classic symptoms. Item 5B asks for the most recent A1C and fasting glucose.

Does diabetic neuropathy need a separate VA form?

Yes. If diabetic peripheral neuropathy is checked as a complication in item 3A, the Diabetic Peripheral Neuropathy DBQ must also be completed. The same rule applies to nephropathy (Kidney DBQ) and retinopathy (Eye Conditions DBQ, completed by an ophthalmologist or optometrist).

How does the form define baseline weight?

For VA purposes, baseline weight is the average weight for the two-year period before the disease began. Item 2E asks whether the Veteran has had progressive unintentional weight loss and loss of strength from diabetes and, if so, the percentage of baseline weight lost.