Veterans claiming narcolepsy for VA compensation use this short 4-page questionnaire, which centers on episode frequency. The clinician confirms the diagnosis and medications, checks symptoms such as excessive daytime sleepiness, sleep attacks, cataplexy, sleep paralysis and hypnagogic hallucinations, counts cataplectic episodes over the past 6 months with their average weekly frequency, and records any major or minor seizures and sleep study results.
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 part.
Download the current version from the source each time; forms change without notice.
Narcolepsy Disability Benefits Questionnaire
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Item 5A lists polysomnogram (PSG), Multiple Sleep Latency Test (MSLT) and hypocretin level in cerebrospinal fluid, each with date and results, plus space for other studies. If results in the medical record reflect the current condition, repeat testing is not required.
Items 3C and 3D ask about major tonic-clonic seizures and minor seizures such as staring spells, myoclonic jerks or sudden loss of postural control, with how many occurred and their average frequency. The form uses the same seizure-frequency questions as the Seizure Disorders DBQ, so episode counts are central to the evaluation.