VA Form 21-0960C-9
Peripheral Nerve Conditions (Not Diabetic)
You have or are claiming Sciatic nerve and need your doctor to complete a DBQ to support your VA disability claim.
- Who fills it
- doctor
- Journey phase
- Evidence & Statements
- Estimated time
- 10-15 minutes to review this walkthrough; doctor typically needs 20-40 minutes to complete the DBQ itself.
- When to file
- Before your C&P exam or when scheduling a private DBQ with your treating physician.
Official VA form page: https://www.benefits.va.gov/COMPENSATION/dbq_publicdbqs.asp
Gather before you start
- ▸Your treating physician contact information
- ▸Relevant medical records for the condition being examined
- ▸Diagnostic codes relevant to your claim: 8510-8730
- ▸List of current medications and dosages
- ▸Description of your worst functional days (not average)
- ▸Blank DBQ form to give your doctor (download from VA.gov)
Attach with the form
- ▸Completed VA Form 21-0960C-9 signed by treating physician
- ▸Supporting medical records
Before the Exam: What to Tell Your Doctor
How to brief your doctor so they document what VA raters need
Your doctor will complete VA Form 21-0960C-9 (Peripheral Nerve Conditions (Not Diabetic) 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.
Key Questions Your Doctor Must Answer on the DBQ
Checklist of the DBQ's most important questions
These are the key clinical questions from the Peripheral Nerve Conditions (Not Diabetic) 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 specific nerve(s) are affected? WHY IT MATTERS: Each nerve has its own diagnostic code and rating schedule TIPS: Know specific nerve from EMG/NCS results 2. Is the paralysis complete or incomplete? WHY IT MATTERS: Complete paralysis receives much higher rating TIPS: Describe all sensory and motor deficits 3. What are the EMG/nerve conduction study results? WHY IT MATTERS: Objective testing confirms nerve involvement and severity TIPS: Bring EMG/NCS reports - these are critical evidence
Common mistakes
- ×Not getting EMG/nerve conduction studies
- ×Failing to identify the specific nerve
- ×Not claiming each affected nerve separately
What VA Raters Look for in This DBQ
Rating-determining factors your doctor must document clearly
VA raters use the Peripheral Nerve Conditions (Not Diabetic) DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Specific nerve affected 2. Complete vs incomplete paralysis 3. Severity: mild, moderate, moderately severe, or severe 4. Sensory vs motor involvement 5. Dominant vs non-dominant (for upper extremity nerves) For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).
Common mistakes
- ×Forgetting to distinguish dominant vs non-dominant arm
Authority
- 38 CFR 4.1 - Functional impairment as the basis for rating.
Exam Day Preparation Checklist
What to bring and do before your C&P exam or private DBQ appointment
Preparation checklist for the Peripheral Nerve Conditions (Not Diabetic) DBQ exam: 1. Get EMG/NCS testing before your exam 2. Know which specific nerve(s) are affected 3. Describe sensory and motor deficits separately 4. State dominant hand for upper extremity nerve conditions 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.
Statutory and regulatory authority
- 38 CFR 4.1 - Functional impairment as the basis for rating.