VA Form 21-0960C-10
Seizure Disorders (Epilepsy)
You have or are claiming Grand mal seizures 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: 8910-8914
- ▸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-10 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-10 (Seizure Disorders (Epilepsy) 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 Seizure Disorders (Epilepsy) 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 type of seizures does the Veteran have? WHY IT MATTERS: Major (grand mal) and minor (petit mal) have different rating criteria TIPS: Describe exactly what happens during a seizure 2. How frequent are the seizures? WHY IT MATTERS: Frequency directly determines rating percentage TIPS: Track every seizure with date, time, and duration 3. When was the last seizure? WHY IT MATTERS: Recent seizure activity supports higher rating TIPS: Bring seizure log or diary 4. What medications are used and are they effective? WHY IT MATTERS: Medication control affects rating assessment TIPS: List all anti-epileptic medications and dosages
Common mistakes
- ×Not keeping a seizure diary
- ×Failing to document witnesses to seizures
- ×Not reporting all seizure types
What VA Raters Look for in This DBQ
Rating-determining factors your doctor must document clearly
VA raters use the Seizure Disorders (Epilepsy) DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Major seizures: 1/year=20%, 1/4months=40%, 1/month=60%, 1+/month=80-100% 2. Minor seizures: 1-2/week=40%, 5+/week=60%, 10+/week=80% 3. Type of seizure (major vs minor) 4. Impact on employment and driving 5. Continuous medication requirement For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).
Common mistakes
- ×Minimizing post-seizure symptoms (confusion, fatigue)
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 Seizure Disorders (Epilepsy) DBQ exam: 1. Keep detailed seizure diary with dates, times, and descriptions 2. Have witness statements about seizure episodes 3. Bring EEG and neurologist reports 4. Document driving restrictions and employment impact 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.