Hematologic and Lymphatic Conditions

Your doctor will complete VA Form 21-0960B-1 (Hematologic and Lymphatic 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 Hematologic and Lymphatic 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 are your current blood count abnormalities? WHY IT MATTERS: Specific lab values (hemoglobin, platelet count, WBC) directly determine rating levels for hematologic conditions TIPS: Bring CBC results from the past 6-12 months; Bring serial results to show trends and stability 2. Do you require blood transfusions? WHY IT MATTERS: Need for transfusions indicates severe disease and supports higher ratings (70-100%) TIPS: Document frequency of transfusions; Bring transfusion records from blood bank 3. How frequently do you experience episodes of crisis or exacerbation? WHY IT MATTERS: For sickle cell disease and other conditions, crisis frequency determines rating level TIPS: Track every crisis episode with dates and treatment needed; Note if episodes require ER visits or hospitalization 4. Do you require continuous medication for your condition? WHY IT MATTERS: Need for continuous medication or immunosuppressive therapy supports higher ratings TIPS: List all medications with dosages and frequency; Note any chemotherapy or immunosuppressive agents 5. Do you experience fatigue or other debilitating symptoms? WHY IT MATTERS: Fatigue, weakness, and recurrent infections document functional impact of the condition TIPS: Describe how fatigue affects your ability to work and function daily; Note frequency of infections or other complications

Common mistakes

• ×Not bringing serial lab results to show disease pattern over time
• ×Failing to document crisis episodes with dates and treatment records
• ×Not mentioning fatigue and its impact on daily functioning

VA raters use the Hematologic and Lymphatic Conditions DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Specific lab values (hemoglobin for anemia, platelet count for thrombocytopenia) 2. Need for blood transfusions and their frequency 3. Frequency of crises or exacerbations requiring medical treatment 4. Need for continuous medication or immunosuppressive therapy 5. For lymphoma in remission: any residual symptoms or treatment side effects 6. Presence of splenomegaly and associated complications For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Overlooking residual effects of chemotherapy or radiation
• ×Not claiming secondary conditions caused by the hematologic disorder

Authority

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

Preparation checklist for the Hematologic and Lymphatic Conditions DBQ exam: 1. Bring 6-12 months of CBC and related lab results 2. Document all crisis episodes, ER visits, and hospitalizations 3. List all medications including any chemotherapy or immunosuppressive drugs 4. Describe fatigue severity and its impact on work and daily activities 5. If in remission from lymphoma, document any residual symptoms or treatment effects 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.