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Esophageal Conditions

Online Disability Benefits Questionnaires

This Disability Benefits Questionnaire (DBQ) is used mainly for Gastroesophageal Reflux Disease (GERD), Hiatal Hernia, Esophageal Stricture, Spasm, Diverticulum, and other esophageal conditions. 

This Disability Benefits Questionnaire is available online and accepted by the Veterans Administration because the disability examination falls under the Acceptable Clinical Evidence process. This process was developed by the Office of Disability and Medical Assessment and can be used by disability examiners when the medical evidence that currently exists in the Veteran's medical record is sufficient to complete the questionnaire along with veteran interview.