Elbow and Forearm Conditions

Your doctor will complete VA Form 21-0960M-4 (Elbow and Forearm Conditions 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 Elbow and Forearm Conditions 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 range of motion for flexion, extension, pronation, and supination? WHY IT MATTERS: Each movement is rated separately - flexion/extension under one code, pronation/supination under another TIPS: Stop at the point of pain for each movement; Normal flexion is 145 degrees, full extension is 0 degrees 2. Is this the dominant or non-dominant arm? WHY IT MATTERS: Dominant arm (major) receives higher rating percentages than non-dominant (minor) TIPS: Clarify which hand is your dominant hand at the start of the exam 3. Is there pain with repetitive use, and does motion decrease after repetition? WHY IT MATTERS: Additional functional loss after repetitive use can support a higher rating TIPS: Report honestly if movements become more painful or limited with repetition 4. Is there any ankylosis (complete fixation) of the elbow? WHY IT MATTERS: Ankylosis is rated at higher percentages than limitation of motion TIPS: If your elbow is fused or cannot move at all, ensure this is documented

Common mistakes

• ×Not realizing flexion, extension, and pronation/supination can be rated separately
• ×Failing to identify dominant vs non-dominant arm
• ×Pushing through pain during range of motion measurements

VA raters use the Elbow and Forearm Conditions DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Limitation of flexion and extension (rated under DC 5206/5207) 2. Limitation of pronation and supination (rated under DC 5213) 3. Whether the dominant or non-dominant arm is affected 4. Presence of ankylosis and the angle of fixation 5. Additional functional loss from pain, weakness, fatigue after repetitive use 6. Flare-ups and their impact on elbow function For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Not describing the impact of repetitive motion on elbow function

Authority

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

Preparation checklist for the Elbow and Forearm Conditions DBQ exam: 1. Know your dominant hand and make sure the examiner records it 2. Avoid pain medication before the exam if safely possible 3. Describe how your elbow condition affects daily tasks (lifting, gripping, turning) 4. Document flare-up frequency and what triggers them 5. Bring any imaging reports (X-rays, MRI) of the elbow 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.