VA Lupus (SLE) and Autoimmune Diseases DBQ

Systemic lupus erythematosus and other autoimmune diseases, including Sjogren's syndrome, scleroderma, Goodpasture's syndrome, Guillain-Barre syndrome, polymyalgia rheumatica, giant cell arteritis and Wegener's granulomatosis, are documented for VA disability claims on this 9-page questionnaire. The clinician records medications over 12 months, exacerbations per year and their duration, cutaneous lupus and body area affected, and involvement of joints, blood, lungs, heart, nerves, kidneys and vessels.

Who completes it

The Veteran's treating or examining clinician completes the form and signs the Section IX examiner's certification. Each organ system involved is also documented on its own DBQ.

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.
Who pays
VA will not pay or reimburse the cost of completing the lupus and autoimmune DBQ; any fee is arranged between the Veteran and the provider.

Good to know

  • Type 1 diabetes goes on the Diabetes DBQ and HIV on the HIV DBQ instead of this form; discoid lupus also needs the Skin Diseases questionnaire.
  • Exacerbations are counted per year (0 to more than 3) and their average duration recorded as under a week or a week or more.
  • Cardiac, renal, pulmonary, hematologic and vascular findings, such as Libman-Sacks endocarditis, glomerulonephritis or recurrent thrombosis, each trigger the matching questionnaire.
  • Lab items include CBC with differential, ESR, CRP, ANA titer, anti-Smith, anti-Ro, double-stranded DNA, antiphospholipid, complement C3 and C4, BUN, creatinine and eGFR.

Get the official form

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

Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases 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.

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Frequently asked questions

Is there a VA DBQ for lupus?

Yes. Systemic lupus erythematosus is documented on the Systemic Lupus Erythematosus and Other Autoimmune Diseases DBQ. Subacute cutaneous lupus is also listed, and its skin findings, including malar rash, body and exposed area affected, and scarring alopecia, are recorded in Section III.

Does rheumatoid arthritis go on the lupus and autoimmune DBQ?

It is listed here, together with juvenile RA, with a note to also complete the questionnaires for any joints, lungs or skin it affects. VA also publishes a separate Non-Degenerative Arthritis DBQ that covers rheumatoid arthritis as an active multi-joint process.