Your doctor will complete VA Form 21-0960C-4 (Diabetic Peripheral Neuropathy 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.

• ×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 Diabetic Peripheral Neuropathy 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. Which nerves and extremities are affected? WHY IT MATTERS: Each nerve and extremity is rated separately TIPS: Report all four extremities if affected 2. What is the severity - mild, moderate, or severe? WHY IT MATTERS: Severity classification directly sets the rating TIPS: Describe numbness, tingling, burning, and weakness specifically 3. Are there EMG/nerve conduction study results? WHY IT MATTERS: Objective testing confirms diagnosis and severity TIPS: Bring EMG/NCS reports if available 4. How does neuropathy affect gait and balance? WHY IT MATTERS: Lower extremity neuropathy affecting gait increases severity TIPS: Report falls, tripping, and difficulty with stairs

• ×Not claiming each extremity separately
• ×Minimizing symptoms
• ×Not getting EMG/nerve conduction studies

VA raters use the Diabetic Peripheral Neuropathy DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Which specific nerve(s) affected 2. Severity: mild, moderate, moderately severe, or severe 3. Complete vs incomplete paralysis 4. Sensory vs motor involvement 5. Each extremity rated separately For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

• ×Forgetting to link to diabetes as secondary condition

Preparation checklist for the Diabetic Peripheral Neuropathy DBQ exam: 1. Get EMG/nerve conduction studies before the exam 2. File as secondary to diabetes if applicable 3. Report symptoms in each extremity separately 4. Describe impact on walking, balance, and daily tasks Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

• ×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.