Veteran Benefits Blog

PTSD DBQ: What the Form Asks and How VA Rates PTSD

PTSD is diagnostic code 9411. Codes 9201 to 9440 are rated under one formula in 38 CFR 4.130, and one summary line on the DBQ repeats that formula's wording.

Reviewed by TYFYS Editorial Team Updated June 1, 2026 National VA claim strategy and evidence guidance

Table of Contents

What a DBQ is, and which one applies to PTSD

A Disability Benefits Questionnaire is a VA form that reports medical findings in the language the rating schedule uses. It is not a therapy note and it is not a letter of support. The PTSD Review DBQ says so on page one: "this questionnaire is for disability evaluation, not for treatment purposes," and "This evaluation should be based on DSM-5 diagnostic criteria."

VA publishes some DBQs and holds others back. Three are posted under Psychological: Eating Disorders, Mental Disorders (Other Than PTSD and Eating Disorders), and PTSD Review. The initial PTSD DBQ is not one of them. VA's page states, "The following DBQs are not available for public use," and lists "Initial Post Traumatic Stress Disorder (PTSD)" there. That decides what a provider can hand you.

  • If PTSD is already service connected and you are seeking an increase, a qualified private provider can complete the PTSD Review DBQ. The copy on VA's site is stamped "Updated on: 2025-10-03 ~v25_1."
  • If you are claiming PTSD for the first time, there is no public PTSD DBQ. The initial examination is done by a VA or VA-contracted examiner. The Mental Disorders DBQ, stamped "Updated on: 2025-10-14 ~v25_2," excludes PTSD in its own title.

For a first-time claim you can still put private evidence in the file. Ask your provider for a narrative report covering diagnosis, history, symptoms, and effect on work and daily life. Check the date stamp before writing starts, because VA reissues these forms.

How VA rates PTSD: diagnostic code 9411

PTSD is diagnostic code 9411 at 38 CFR 4.130. That section holds two formulas, and the regulation says which codes go where: "Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders."

9411 is in the first group. Anorexia nervosa (DC 9520) and bulimia nervosa (DC 9521) are rated instead on self-induced weight loss below expected minimum weight and on incapacitating episodes, which is why VA posts a separate Eating Disorders DBQ. If you are service connected for an eating disorder, the criteria below are not yours.

The diagnosis picks the code. It does not pick the percentage.

The formula does not pay by symptom count. Each level names a degree of occupational and social impairment, then lists symptoms as examples. The phrasing is "due to such symptoms as," so the lists illustrate a level rather than set a checklist.

Two rules shape how a rater reads the file. Under 38 CFR 4.126(a), "the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission." Under 38 CFR 4.126(b), "the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment." A record that describes symptoms but never touches work, school, family relations, judgment, thinking, or mood leaves a rater little to weigh.

The rating criteria, word for word

These six levels are the General Rating Formula for Mental Disorders, quoted from 38 CFR 4.130.

Criterion Rating Diagnostic code
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0% DC 9411 (38 CFR 4.130)
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10% DC 9411 (38 CFR 4.130)
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30% DC 9411 (38 CFR 4.130)
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50% DC 9411 (38 CFR 4.130)
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70% DC 9411 (38 CFR 4.130)
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100% DC 9411 (38 CFR 4.130)

The formula lists those six levels and nothing between them. Three other sections of 38 CFR Part 4 affect where a veteran lands.

  • 38 CFR 4.7. Where there is a question as to which of two evaluations applies, "the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating."
  • 38 CFR 4.16. A total disability rating may be assigned where the schedular rating is less than total, when the veteran is "unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities." Paragraph (a) sets the percentage standards: one disability at 60 percent or more, or two or more with one at 40 percent or more and a combined rating of 70 percent or more.
  • 38 CFR 4.129. When a mental disorder that develops in service from a highly stressful event is severe enough to bring about release from active service, the rating agency "shall assign an evaluation of not less than 50 percent," with an examination within six months of discharge.

Some of that wording is hard to read about yourself. If you are in crisis, call the Veterans Crisis Line at 988 and press 1.

What the PTSD DBQ captures

Diagnosis and differentiation

Item 1 asks whether PTSD has ever been diagnosed. Item 2 has room for four mental disorder diagnoses and for medical diagnoses relevant to managing the condition, including traumatic brain injury. Item 3 asks whether the examiner can differentiate which symptoms belong to which diagnosis, and requires a reason when the answer is no. Items 3C and 3D ask the same about TBI. Left blank, those items give a rater no basis for separating PTSD from anything else.

The DSM-5 criteria and the stressor

Section 2, item 3 walks Criterion A through Criterion H. The form's wording for Criterion A is "Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways." B through H cover intrusion, avoidance, negative changes in cognitions and mood, altered arousal, duration of more than one month, and whether symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The form instructs the examiner: "Do NOT mark symptoms below that are clearly not attributable to the Criterion A stressor/PTSD." Overlapping symptoms go under item 6, "Other symptoms."

The DBQ is not where an in-service stressor gets established. That is the work of your service records, statements from people who were there, and VA Form 21-0781, "Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s)," revised March 2024. VA discontinued the separate personal-assault form, 21-0781a, on June 28, 2024.

The symptom list, and everything after it

Item 4 of Section 2 says: "For VA rating purposes, check all symptoms that apply to the Veteran's diagnoses." The choices come from the rating formula. Marking what is documented and observed is the examiner's job. Boxes checked without support make an otherwise sound report look unreliable, and the certification block carries a penalty notice covering "the willful submission of any statement or evidence of a material fact, knowing it to be false."

Item 5 records behavioral observations, item 6 other symptoms, item 7 whether you can manage your own financial affairs, and item 8 remarks. Section 3 is the certification: signature, name and title, area of practice, date signed, National Provider Identifier, and license number and state. A DBQ missing those identifiers leaves a rater no way to confirm who wrote it.

The summary line that repeats the schedule's wording

Item 4A in Section 1 asks: "Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses?" The instruction is "Check only one."

Each choice repeats the opening clause of one criterion in the formula, without the symptom examples that follow it there. "Occupational and social impairment with reduced reliability and productivity" opens the 50 percent criterion. The checkbox quotes the criterion. It does not assign it.

The rest of 38 CFR 4.126(a) says as much: "The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." Your treatment notes, your work history, and statements from people who live with you are all evidence of record.

4A is a summary of the examination, not a recommendation. If the narrative describes steady full-time work while 4A marks deficiencies in most areas, a rater has a contradiction to resolve. They should agree because they describe the same person.

A private DBQ alongside the C&P exam

The form contemplates private completion: "It is intended that this questionnaire will be completed by the Veteran's healthcare provider." Its opening notice states that VA will not pay or reimburse the cost of completing or submitting it.

Credentials are set on the form: Review Posttraumatic Stress Disorder examinations must be conducted by one of the following.

  • A board-certified or board-eligible psychiatrist.
  • A licensed doctorate-level psychologist.
  • A non-licensed doctorate-level psychologist working toward licensure, under close supervision.
  • A psychiatry resident, under close supervision.
  • A VHA psychology trainee, under close supervision, completing an internship or residency toward a doctorate.
  • A licensed clinical social worker, under close supervision.
  • A nurse practitioner, clinical nurse specialist, or physician assistant, under close supervision and clinically privileged by VHA for these examinations.

"Under close supervision" means the individual is supervised by a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist "who must meet with the Veteran, confer with the supervised individual in providing the diagnosis and the final assessment, and co-sign the examination report." Five of those seven categories therefore need a psychiatrist or doctorate-level psychologist to meet with you and sign. Ask whose signature goes on it before you pay.

A private DBQ does not replace a C&P exam and does not cancel one. It sits in the file as evidence. A provider who can describe how frequently symptoms happen, how long they last, and what they cost you at work and at home is answering the questions 4.126(a) tells the rater to ask.

What makes a DBQ weak

These gaps show up on the form itself.

  • Functional impact left blank. Checked symptoms with nothing about work, school, family relations, judgment, thinking, or mood. The formula is written in those terms.
  • No frequency, severity, or duration. "Panic attacks" tells a rater less than how frequently they happen, how long they last, and what you cannot do while they do. Those are the terms 4.126(a) names.
  • Contradicts the treatment record. Under 38 CFR 4.2, the rating specialist reads reports "in the light of the whole recorded history, reconciling the various reports into a consistent picture." An examiner describing near-total impairment while your notes for the same period describe stable mood and full-time work has to account for the difference.
  • Differentiation questions skipped. With multiple diagnoses or a TBI, the form asks whether symptoms can be separated and wants a reason when they cannot.
  • Missing evidence review. Section 2 opens with "Evidence reviewed" and asks which records were read and over what date range. Under 4.2, a report that "does not contain sufficient detail" is returned as inadequate.
  • Unsigned or unidentified. No NPI, no license number, no date signed.

What this page is not

TYFYS is not VA-accredited representation. We do not file claims or represent you before VA. Nothing here is legal advice, and nothing here promises a rating or a percentage. VA decides ratings and effective dates on the whole record. The criteria on this page come from 38 CFR Part 4: the General Rating Formula for Mental Disorders at 4.130, with 4.2, 4.7, 4.16, 4.126, and 4.129, as published on eCFR and current through the August 6, 2026 edition. Check the current text before relying on it.

What we can help with

We coordinate private medical evidence with licensed providers: DBQs where a public form exists, independent medical opinions, and nexus letters. Our part is scheduling with a provider who holds the credentials the form requires, getting your records to them before the appointment, and returning a complete, signed document you can submit. What the provider writes is theirs, based on their examination and your records. If your file already has recent, thorough evidence, we will tell you.

Related next steps

Official references