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VA Thyroid and Parathyroid Conditions DBQ

Veterans claiming service connection for a thyroid or parathyroid condition can ask their own clinician to complete this public questionnaire. It records diagnoses with ICD codes, treatment history including radioactive iodine and surgery, exam findings, reflexes and labs such as TSH, free T4 and PTH. VA weighs it when deciding service connection and the rating, and may still order its own exam.

Who completes it

The Veteran's treating or examining clinician (MD, DO, NP, PA or other licensed provider) completes every section and signs the Section 12 certification with NPI, license number and specialty. There is no section for the Veteran, who simply receives the finished form to submit.

Submitting and payment

How to submit it
The clinician gives the signed form to the Veteran, who uploads it with the claim on VA.gov or mails it to the VA Evidence Intake Center; a representative may also submit it.
Who pays
The form states that VA will not pay or reimburse any cost of completing or submitting it, so any fee is arranged between the Veteran and the clinician.

Good to know

  • Items 3E and 4C ask which body systems the thyroid or parathyroid condition affects; each one checked means the matching DBQ (cardiovascular, eye, mental health and others) should also be completed.
  • For hyperparathyroidism the form lists specific hypercalcemia criteria, including bone density T-score, creatinine clearance below 60 mL/min and ionized or total calcium thresholds, and asks whether drug treatment was needed.
  • Myxedema is defined on the form as a rare, life-threatening state of severe hypothyroidism that needs hospital stabilization; the examiner gives the date it stabilized, if it has.
  • Repeat testing is not required when labs or imaging already in the record reflect the current condition. The current version is dated April 15, 2025 (v25_1), 10 pages.

Get the official form

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

Thyroid and Parathyroid 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

Who can complete the VA Thyroid and Parathyroid DBQ?

Any licensed clinician who treats or examines the Veteran can complete it, including MDs, DOs, nurse practitioners and physician assistants. The examiner certifies that the information is accurate, complete and current and adds NPI, license number and state, specialty and contact details. VA reserves the right to confirm the authenticity of any completed questionnaire.

Which lab results does the thyroid DBQ ask for?

Section 9 lists TSH, free T4, free T3, thyroid antibodies, parathyroid hormone, calcium and ionized calcium, each with a date, plus imaging such as thyroid scan, thyroid ultrasound, CT or MRI and any biopsy. Item 9E asks the examiner to relate any abnormal result to the diagnosed condition.

Does VA pay the doctor for completing a DBQ?

No. The form states that VA will not pay or reimburse any expense of completing or submitting it. Whether the clinician charges for the exam and paperwork is between the Veteran and the provider, and VA may still schedule its own examination after reviewing the form.