Amputations

Your doctor will complete VA Form 21-0960M-1 (Amputations DBQ) after examining you. This walkthrough helps you prepare them. The DBQ is a standardized questionnaire; your doctor's answers directly determine your VA rating. Brief them on these specific points before the exam so nothing important is missed or underdocumented.

Common mistakes

• ×Asking your doctor to just "fill out the VA form" without briefing them - an uninformed completion is often generic and leads to lower ratings.
• ×Bringing the DBQ to a provider who has never seen you before - your treating physician who knows your history will write the most credible documentation.
• ×Going to the exam and waiting for the doctor to ask questions - come prepared with specific examples of your worst days and functional limitations.

These are the key clinical questions from the Amputations DBQ. Help your doctor understand what each question is asking and give them concrete examples for your situation. Print this section and bring it to the appointment. 1. What is the exact level of amputation? WHY IT MATTERS: The specific level (above/below knee, above/below elbow, etc.) directly determines the rating percentage TIPS: Be precise about where the amputation occurred; Surgical reports should document the exact level 2. Does the Veteran use a prosthetic device and how functional is it? WHY IT MATTERS: Prosthetic use and fit issues affect functional capacity and may support additional ratings TIPS: Bring your prosthetic to the exam; Describe any fit problems, skin breakdown, or limitations 3. Is there phantom limb pain? WHY IT MATTERS: Phantom pain is a recognized complication that affects quality of life and functional ability TIPS: Describe frequency, severity, and triggers; Note any treatments tried and their effectiveness 4. What is the condition of the residual limb? WHY IT MATTERS: Skin breakdown, neuromas, bone spurs, or poor healing at the residual limb can warrant additional consideration TIPS: Report any skin problems, pain at the stump, or difficulty with prosthetic fitting 5. What functional limitations exist in daily activities? WHY IT MATTERS: Functional impact determines eligibility for special monthly compensation (SMC) and aid/attendance TIPS: Describe activities you cannot perform or need help with; Mention if you need assistance with dressing, bathing, etc.

Common mistakes

• ×Not claiming special monthly compensation (SMC) for loss of use
• ×Failing to report residual limb complications as part of the disability
• ×Not documenting phantom limb pain and its functional impact

VA raters use the Amputations DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Exact anatomical level of amputation 2. Whether it is the dominant or non-dominant extremity (for upper extremity) 3. Residual limb condition and complications 4. Eligibility for special monthly compensation (SMC) for loss of use 5. Combined effect with other service-connected disabilities For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Overlooking the need for aid and attendance benefits

Authority

• 38 CFR 4.1 - Functional impairment as the basis for rating.

Preparation checklist for the Amputations DBQ exam: 1. Bring your prosthetic device to the exam 2. Document all residual limb complications (skin breakdown, neuromas, bone spurs) 3. Research special monthly compensation (SMC) - you may qualify for additional benefits 4. Describe how the amputation affects your ability to work and perform daily tasks 5. If you have phantom pain, keep a pain diary with frequency and severity Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

Common mistakes

• ×Describing your best days or average functioning instead of your worst - VA rates the full range of disability.
• ×Minimizing symptoms out of stoicism or pride - accurate documentation is not exaggeration; it is honesty.
• ×Not mentioning secondary symptoms, side effects, or additional conditions the doctor may not ask about.