VA Infectious Diseases DBQ (Malaria, Lyme, Q Fever)

Infectious diseases claimed for VA disability, other than HIV-related illness, chronic fatigue syndrome and tuberculosis, are documented on this 7-page questionnaire. It lists more than two dozen conditions, from malaria, Lyme disease, Q fever and brucellosis to leprosy, schistosomiasis, syphilis and West Nile virus. For each disease the clinician records whether it is active or inactive, when treatment stopped, current symptoms and residuals, and how the diagnosis or any relapse was confirmed.

Who completes it

The Veteran's treating or examining clinician completes the form and signs the Section VIII examiner's certification. The Veteran does not fill in any section.

Submitting and payment

How to submit it
The clinician gives the signed DBQ to the Veteran, who uploads it with the claim on VA.gov or mails it to the VA Evidence Intake Center; a representative may submit it for them.
Who pays
VA does not pay or reimburse the cost of completing the infectious diseases DBQ; any fee is between the Veteran and the provider.

Good to know

  • VA requires diagnostic confirmation of the initial diagnosis and of any relapse or recurrence, and some diseases need specific methods, such as blood smear or antigen or PCR testing for malaria.
  • For VA purposes a relapse is a full return of disease after improvement; a recurrence is a separate episode after full recovery.
  • Symptoms or residuals each need their own questionnaire; potential residuals for each disease are listed in 38 C.F.R. 4.88(b) and 3.317(d).
  • HIV-related illness, chronic fatigue syndrome and tuberculosis have their own DBQs, and Gulf War or Afghanistan service infections use the Persian Gulf and Afghanistan Infectious Diseases DBQ.

Get the official form

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

Infectious Diseases (Other Than HIV-Related Illness, Chronic Fatigue Syndrome, or Tuberculosis) Disability Benefits Questionnaire

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

How must malaria be confirmed on the VA infectious diseases DBQ?

Item 5B asks whether the initial diagnosis or relapse was confirmed by finding malarial parasites in blood smears or by other specific laboratory tests such as antigen detection, immunochromatographic tests or polymerase chain reaction. The test type, date and results are recorded.

Is Lyme disease rated on this DBQ?

Yes. Lyme disease is one of the listed diagnoses. The examiner records whether it is active or inactive, the date treatment ended or the condition became inactive, and any current symptoms or residuals, and states how active infection was confirmed. Residuals such as joint or nerve problems need their own questionnaires.