Eye Conditions

Your doctor will complete VA Form 21-0960N-4 (Eye 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 Eye 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 corrected visual acuity in each eye? WHY IT MATTERS: Visual acuity measurements directly determine rating TIPS: Bring recent eye exam results with best corrected acuity 2. Is there visual field loss? WHY IT MATTERS: Visual field defects are rated separately from acuity TIPS: Bring visual field testing results 3. Are there incapacitating episodes? WHY IT MATTERS: Some eye conditions rate based on incapacitating episodes TIPS: Document episodes requiring bed rest prescribed by doctor 4. How do eye conditions affect daily activities? WHY IT MATTERS: Functional impact supports rating determination TIPS: Describe difficulty with reading, driving, and recognizing faces

Common mistakes

• ×Not bringing recent comprehensive eye exam
• ×Forgetting visual field test results
• ×Not reporting each eye separately

VA raters use the Eye Conditions DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Corrected visual acuity in each eye 2. Visual field defects (contraction) 3. Incapacitating episodes for certain conditions 4. Combination of acuity and field loss 5. Unilateral vs bilateral involvement For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Failing to describe functional impact

Authority

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

Preparation checklist for the Eye Conditions DBQ exam: 1. Get comprehensive eye exam within 3 months of C&P exam 2. Bring visual field test results 3. Report acuity for each eye separately 4. Describe specific daily activities affected by vision loss 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.