For veterans who already have a VA mental health disability rating but believe they are not rated appropriately, there are two options that VMHA offers for presenting evidence backed by a licensed psychologist to the VA: the DBQ (Disability Benefits Questionnaire) and the Independent Medical Opinion (IMO). How do you know which of these documents is appropriate for your situation and will give you the best chance of getting an accurate rating from the VA?
The DBQ is a VA form that includes space to provide information about a veteran’s functioning in the areas of socialization, work/school functioning, mental health history, legal history, behavioral functioning, and substance use. The mental health assessment that is conducted to complete the DBQ is brief and intended to capture a summary of the veteran’s current functioning in the areas listed above, note the symptoms the veteran is currently experiencing (VA defined symptoms that correspond with rating levels), and recommend a rating.
An IMO is a more comprehensive evaluation with a more in depth look at the same areas of functioning, as well as some additional areas. It is a diagnostic clinical interview that functions beyond just a review of current functioning. A new diagnosis (or more) may be provided, as a thorough evaluation of symptoms is an important component of the interview. If you suspect you were misdiagnosed when you were first rated, think you may meet criteria for additional diagnoses, or believe your diagnosis may have changed, the IMO would provide an answer to that. Records such as your DD214 and medical records are reviewed by your provider and used to further support the information provided in the IMO. Additionally, you complete standardized questionnaires recognized by the mental health field, which assess symptoms of depression, anxiety, and response to trauma to provide further evidence for the diagnoses and narrative in the report. Most importantly, the IMO includes a Nexus statement. The Nexus statement is important because it establishes a link between your mental health condition and your military service. This is the culmination of the medical evidence your psychologist is providing and your official stated opinion from a medical expert explaining the link between your mental health status and your service. Providing this statement to the VA can impact whether your benefits will be approved.
If you feel your functioning at home and at work have depleted since your last rating, you’ll have a decision to make about which evaluation to choose.
The DBQ assessment is a brief evaluation of your functioning and how your current condition is impacting your quality of life. Typically, a diagnostic interview is not completed, but rather an overview of your daily life impact is provided, along with a recommended rating. We tailor the assessment to obtain the information the VA is looking for to provide an accurate rating for your mental health condition.
The IMO is a more in depth assessment that evaluates the impact your mental health condition has on your quality of life, plus it always includes a diagnostic interview, leaving room for a change of diagnosis or the addition of diagnoses, if appropriate. It also includes a Nexus statement, bolstering the evidence you are providing to the VA to support your claim. The IMO provides the most comprehensive evidence, giving you the highest likelihood of an increase, yet for a straightforward case, a rating increase can certainly be achieved with a DBQ assessment. Keep in mind, however, that if denied your increase with the DBQ, some veterans end up returning for the IMO to provide the most thorough set of evidence for their claim.
