VA OIG Report: 69% of Public DBQ Claims Flagged — How to Build a Bulletproof VA Disability Claim

On January 4, 2024, the VA Office of Inspector General released a report that should concern every veteran who has filed — or plans to file — a disability compensation claim. The findings were stark: of an estimated 31,900 claims completed from January 1 through December 31, 2022, that included public disability benefits questionnaires, approximately 69 percent contained one or more indicators of potential fraud risk. The estimated monetary risk to VA from these claims topped $390 million. While the OIG was careful to note that the presence of fraud indicators does not mean fraud actually occurred, the sheer scale of the problem has triggered a fundamental rethinking of how VA handles these forms — and what that means for the millions of veterans navigating the claims process.

For the overwhelming majority of veterans who file honest, legitimate claims, this report is both a warning and an opportunity. Fraud in the disability benefits system doesn't just cost taxpayers money — it erodes public trust in programs that veterans have earned through their service, and it inevitably leads to tighter controls and greater scrutiny that affect everyone. The veterans who will fare best in this evolving landscape are those who build well-documented, evidence-based claims from the very start. Understanding what the OIG found, why it matters, and how to construct a claim that stands up to any level of review isn't just good strategy — it's the best way to protect your benefits and the integrity of the system that serves all veterans.

Understanding the Problem: What the VA OIG Found

What Are Public Disability Benefits Questionnaires?

Public disability benefits questionnaires, commonly known as DBQs, are standardized forms that veterans can download from the VA website and bring to their own private medical providers for completion. These forms document the medical information that VA claims processors need to determine whether a veteran has a service-connected disability and, if so, how severe that disability is. Each questionnaire corresponds to a specific type of disability or body system, and collectively they cover the full range of medical conditions that veterans commonly claim.

The concept behind public DBQs is straightforward and, in principle, veteran-friendly. Rather than requiring every veteran to undergo a VA-scheduled examination — which can involve long wait times and travel to unfamiliar facilities — public DBQs allow veterans to work with their own trusted medical providers. The forms were first made available for public use, were removed from the VA website in April 2020, and were reinstated by Congress through the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020.

The critical distinction that the OIG report highlights, however, is the difference in oversight between internal and public questionnaires. When a VA medical provider completes an internal questionnaire, that provider has been vetted through a credentialing process that includes background checks, a review of their medical standing, and recurring credential reviews. VA examiners also receive specific training on examination requirements, the claims process, how to review veteran records, and how to formulate medical opinions or Nexus. Completed internal questionnaires are then reviewed to ensure they are accurate, complete, and meet VA's requirements.

None of these safeguards apply to public questionnaires. Non-VA providers who complete public DBQs are not vetted by VA, are not required to take any VA-specific training, and their completed forms are not subject to the same quality review process. The questionnaires do inform providers that the patient is applying for VA benefits and that the provider's signature constitutes a certification that the information is accurate, complete, and current — but there is no mechanism to verify that this is actually the case.

Key Fraud Risk Indicators Identified by the OIG

Because VBA had no existing guidance on identifying potentially fraudulent public questionnaires, the OIG review team developed its own set of fraud risk indicators. These were drawn from indicators used by other federal Offices of Inspector General, previous VA OIG reports, hotline complaints, and red flags identified by the VA OIG Office of Investigations. The indicators were discussed with VBA claims-processing staff, quality review specialists, and managers, who broadly agreed that they highlight an increased fraud risk.

The six indicators the OIG identified were:

Signs of alteration — This includes different appearances of text and formatting within a single questionnaire, such as varying typefaces and font sizes, evidence of physical cutting and pasting of information, and examiner signature pages that look visually different from the rest of the document. An estimated 10,800 claims contained questionnaires with signs of alteration.

Contact information discrepancies — When the contact information listed on the questionnaire doesn't match what's found in provider registries or through independent verification, it raises questions about whether the listed provider actually completed the form. This was the most common indicator, appearing in an estimated 15,000 claims.

Examiner's address more than 100 miles from the veteran's address for in-person examinations — When a questionnaire indicates an in-person examination was conducted, but the examiner practices hundreds of miles from where the veteran lives, it raises obvious questions about whether the examination actually took place as described. An estimated 6,100 claims had this indicator.

Other available evidence contradicting the questionnaire findings — When a public DBQ reports findings that conflict with the veteran's existing medical records — for instance, when treatment records show normal function but the questionnaire reports severe impairment — it creates a credibility problem. An estimated 13,700 claims had this indicator.

Veterans refusing to report for subsequent VA examinations — When VA orders a follow-up examination and the veteran refuses to attend, it can suggest that the veteran doesn't want their condition evaluated by a VA provider who might reach different conclusions than what was reported on the public questionnaire. An estimated 5,100 claims had this indicator.

Assignment of a 100 percent disability rating without evidence of current medical treatment confirming severity — Receiving the highest possible disability rating based solely on a public questionnaire, with no supporting evidence of ongoing treatment for a condition severe enough to warrant that rating, raises significant questions. An estimated 3,200 claims had this indicator.

The Scope of the Problem

The numbers in the OIG report paint a troubling picture. Of the estimated 31,900 claims completed during the review period that included public DBQs, approximately 22,000 (69 percent) had one or more potential fraud indicators, 17,500 (55 percent) had two or more indicators, and 7,600 (24 percent) had three or more indicators. Despite these red flags, VBA accepted and used 97 percent of the estimated 66,000 public questionnaires when determining entitlement to benefits.

The review also uncovered patterns that, while not formally classified as fraud indicators, raised additional concerns. Fifty-five of the 207 questionnaires reviewed were outdated versions that may not provide the same level of information as current forms. Perhaps more troubling, 57 of 207 questionnaires contained identical or nearly identical language used by different examiners practicing in different states — suggesting that someone other than the listed examiner may have been involved in completing the forms.

The consequences of these findings were significant. Fifty-five of the 100 sampled claims resulted in increases of two or more disability rating levels, and in 44 of those cases, the public questionnaire was the only evidence submitted in support of the increase. Thirty-five of the 100 claims resulted in 100 percent total disability ratings based on public questionnaires, and 33 of those were assigned permanent evaluations — meaning the highest possible rating would continue for the veteran's lifetime without further review.

Why Claims Without Strong Medical Evidence Raise Red Flags

The Gap Between Internal and Public Questionnaires

The disparity in oversight between internal and public questionnaires creates a vulnerability that the OIG report makes abundantly clear. VA examiners operate within a structured system of credentialing, training, and quality review. Non-VA providers completing public DBQs operate with essentially no VA oversight at all.

This gap is compounded by the guidance — or lack thereof — that claims processors receive. According to the VA Adjudication Procedures Manual, claims processors are instructed to generally accept public questionnaires at face value. While the manual notes that questionnaires should be reviewed to ensure the information is "seemingly authentic, consistent with the evidentiary record, and free from improper alteration," it provides no indicators of potential fraud risk and no guidance on how to evaluate evidence for possible fraud issues.

The situation actually worsened after the OIG's first report in 2022. In response to a recommendation that VBA clarify steps for ensuring certification elements are authentic, VBA replaced the requirement for claims processors to authenticate information with an instruction to merely consider authenticity. Previous versions of the manual had included specific requirements for claims processors to authenticate signature and qualification information and confirm the information provided — those requirements were removed in 2022.

The result, as the OIG found, is that claims processors are left without meaningful tools to identify or respond to potentially fraudulent questionnaires. Eighteen out of 25 VBA staff interviewed said they were unaware of any steps in the manual that would help them identify fraud. One claims processor explained that he didn't know how to identify fraud or how to report it.

What Makes a Claim Look Suspicious

Understanding what triggers scrutiny is essential for veterans who want to file strong, credible claims. The OIG's findings reveal a clear pattern: claims that rely heavily or exclusively on a single public questionnaire, without corroborating medical evidence, are the ones most likely to contain fraud risk indicators.

Large jumps in disability ratings — increases of two or more levels — without accompanying treatment records or other supporting medical evidence are a significant red flag. When a veteran's condition supposedly deteriorates dramatically, but there's no trail of medical treatment documenting that decline, it raises legitimate questions about the accuracy of the questionnaire.

Similarly, claims for severe disability ratings where there is no evidence of ongoing medical care create a credibility problem. If a condition is genuinely severe enough to warrant a 100 percent disability rating, one would expect to see evidence that the veteran is receiving treatment for that condition. The absence of such evidence was one of the OIG's six fraud indicators.

Contradictions between the public questionnaire and the rest of the veteran's medical record are particularly damaging to a claim's credibility. The OIG provided a telling example: a veteran submitted a public questionnaire showing significant reduction in range of motion in both knees, but an annual physical examination conducted less than a year earlier showed normal ranges of motion in the extremities. This kind of inconsistency doesn't just raise a fraud flag — it fundamentally undermines the questionnaire's evidentiary value.

The Real-World Consequences

The consequences of widespread fraud in the disability benefits system extend far beyond the individuals involved. The estimated $390 million in monetary risk identified by the OIG represents resources that could be serving veterans with legitimate needs. As of the end of fiscal year 2022, VA's compensation program provided benefits to more than 5.4 million veterans totaling approximately $112 billion in annual payments. Every dollar diverted by fraud is a dollar that isn't available for the veterans who have earned it.

When headlines about disability benefits fraud make the news, they don't distinguish between the small minority of bad actors and the vast majority of honest veterans. The result is increased skepticism from the public and from lawmakers, which can translate into tighter restrictions and more burdensome processes for everyone.

For individual veterans, filing a claim that later comes under scrutiny can have serious consequences. If a claim is found to have been based on fraudulent or inauthentic evidence, benefits can be reduced or terminated, and overpayments can be subject to recoupment. Even if a veteran was not personally involved in any fraud — for instance, if a provider submitted inaccurate information — the disruption to benefits can be devastating.

Building a Bulletproof Claim: The Right Way to File

The OIG's findings make one thing abundantly clear: the era of filing a disability claim supported by nothing more than a single public questionnaire is coming to an end. Veterans who invest the time and effort to build comprehensive, well-documented claims will not only have a better chance of success — they'll be protected against the increasing scrutiny that VA is implementing. Here's what that looks like in practice.

Start with a Diagnosis — Before You File

The single most important foundation for a credible disability claim is an established diagnosis from a treating provider. When a veteran has a documented diagnosis before filing a claim, it creates a baseline of medical evidence that anchors the entire claim in the evidentiary record. It demonstrates that the condition is real, that it has been evaluated by a medical professional, and that the veteran has been engaged with the healthcare system.

This is one area where proper preparation makes an enormous difference. At Veteran AI, we've seen that veterans who use our AI-powered claim-preparation platform have a diagnosis approximately 80 percent of the time before filing. This stands in stark contrast to the pattern identified in the OIG report, where claims were often supported by nothing more than a single public questionnaire completed by a provider with no prior treatment relationship with the veteran.

A pre-existing diagnosis from a treating provider accomplishes several things simultaneously. It establishes that the veteran has a legitimate medical condition. It creates a treatment record that claims processors can cross-reference against any questionnaire findings. And it makes it far less likely that the claim will be flagged for one of the OIG's key fraud indicators — specifically, the indicator involving other available evidence contradicting the questionnaire findings. When the questionnaire findings are consistent with an established diagnosis and treatment history, the claim's credibility is dramatically strengthened.

The contrast with claims that rely solely on a single public DBQ without prior medical history could not be more stark. Those are precisely the claims that the OIG found most likely to contain fraud risk indicators, and they are the claims that will face the greatest scrutiny as VA implements its planned reforms.

Maintain Consistent Medical Treatment

The OIG specifically identified the assignment of high disability ratings without evidence of current medical treatment as a fraud indicator. This finding underscores a principle that should guide every veteran's approach to the claims process: if your condition is severe enough to warrant compensation, it should be severe enough that you're seeking treatment for it.

Among veterans who use Veteran AI's platform to prepare their claims, approximately 60 percent have treatments within the 12 months prior to filing. This pattern of recent, consistent medical care directly addresses one of the OIG's most significant concerns and creates a powerful evidentiary foundation.

Ongoing treatment records serve multiple purposes in the claims process. They document the severity of a condition over time, showing claims processors that the disability is not a one-time finding on a single questionnaire but a persistent medical reality. They demonstrate continuity — that the condition has been present and affecting the veteran's life in a sustained way. And they provide independent medical evidence that either corroborates or contextualizes the findings on any public questionnaire.

When a veteran has a treatment history that aligns with what a public questionnaire reports, the claim becomes almost impervious to fraud-related challenges. Claims processors reviewing the evidence will see a consistent picture: a veteran with a documented condition, receiving ongoing treatment, whose questionnaire findings match what their treatment records show. This is the opposite of the pattern the OIG found problematic — claims where questionnaire findings contradicted the available medical evidence.

Generate Personal and Buddy Statements to Substantiate Claims

One of the most underutilized tools in a veteran's claims arsenal is lay evidence — personal statements from the veteran and buddy statements from fellow service members, family members, or friends who can corroborate the veteran's account. At Veteran AI, our platform guides veterans through generating personal statements and buddy statements as a core part of claim preparation, creating exactly the kind of multi-layered evidentiary record that the claims process is designed to evaluate.

Personal statements matter because they document how a condition affects the veteran's daily life in ways that medical records alone may not capture. A medical record might note that a veteran has limited range of motion in their knee; a personal statement can describe how that limitation prevents the veteran from playing with their children, climbing stairs in their home, or performing their job duties. This kind of functional impact evidence is exactly what claims processors need to evaluate the severity of a disability.

Buddy statements add another layer of credibility by providing third-party corroboration. When a fellow service member describes witnessing the incident that caused an injury, or a spouse describes the daily challenges they observe, it creates evidence that is independent of both the veteran's own account and the medical provider's findings. This triangulation of evidence — medical records, personal statements, and buddy statements — creates a comprehensive picture that is far more persuasive than any single piece of evidence standing alone.

The importance of this approach is amplified by the OIG's findings. The report emphasized that VA decision makers are expected to be appropriately critical of the evidence, including assessing competency and probative value, and to make credibility determinations when credibility is raised by the available evidence. Claims supported by multiple types of evidence from multiple sources are inherently more credible than claims resting on a single questionnaire. When claims processors weigh the totality of the evidence — as the manual instructs them to do — a comprehensive package of diagnosis records, treatment history, personal statements, and buddy statements presents a far more compelling case than a lone public DBQ ever could.

How a Comprehensive Evidence Package Protects Veterans

Aligning with What the VA Is Looking For

The VA Adjudication Procedures Manual requires claims processors to weigh all evidence of record when making benefit entitlement decisions. This means that claims processors are supposed to consider every piece of evidence in a veteran's file — not just the public questionnaire, but also treatment records, service records, personal statements, buddy statements, and any other documentation.

Claims supported by multiple types of evidence are inherently more credible in this framework. When a claims processor reviews a file and finds a consistent story told across multiple independent sources — a diagnosis from a treating provider, ongoing treatment records showing the condition's progression, a personal statement describing its functional impact, and buddy statements corroborating the veteran's account — the claim practically evaluates itself.

The OIG recommended that claims processors be informed of their authority to assign low or no probative value to suspicious questionnaires. This means that going forward, a public questionnaire that stands alone, without corroborating evidence, may be given little or no weight in the decision-making process. Veterans who have built comprehensive evidence packages won't be affected by this change — their claims don't depend on any single piece of evidence.

Reducing the Risk of Delays and Denials

Claims that raise fraud indicators can trigger additional development actions that significantly delay the process. When a claims processor encounters a suspicious questionnaire, the manual instructs them to determine whether additional steps are necessary — which can include validating results with the treatment provider, obtaining medical records, and requesting a VA examination. Each of these steps adds time to the claims process and creates additional hurdles for the veteran.

A strong evidentiary package dramatically reduces the likelihood of this kind of additional scrutiny. When the evidence is consistent, comprehensive, and credible, there is simply less reason for a claims processor to question the claim. The veteran's treatment records align with the questionnaire findings. The personal and buddy statements corroborate the medical evidence. The diagnosis predates the claim. Everything fits together in a way that gives the claims processor confidence in the decision.

Veterans with established treatment histories and corroborating statements are also less likely to face challenges to their claims on appeal. If a claim is initially denied or rated lower than expected, the comprehensive evidence package provides a strong foundation for any reconsideration or appeal.

Future-Proofing Your Claim

The VA's approach to public questionnaires is evolving rapidly, and the changes outlined in the OIG report will make comprehensive evidence packages more important than ever. VBA is developing data analytics systems to identify patterns of potentially fraudulent activity — systems that will be able to flag claims with characteristics similar to those the OIG identified as fraud indicators. The OIG recommended adding penalty-of-perjury language to the examiner certification section of public DBQs, and VBA is also planning to require examiners to disclose any organizations that requested they complete the examination.

Furthermore, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, enacted on January 2, 2025, requires the digitization of all disability benefits questionnaires submitted by non-VA healthcare providers. The electronic capture of all future DBQ data will significantly enhance anti-fraud oversight of the program.

Claims processors will receive new training on fraud identification and authentication, and they will be explicitly informed of their authority to assign low or no probative value to questionnaires they find suspicious. The procedural manual will be updated with specific guidance on identifying potentially fraudulent questionnaires and the steps to take when suspicion arises.

All of these changes point in one direction: greater scrutiny of public questionnaires and higher expectations for the evidence supporting disability claims. Veterans who file with comprehensive, honest documentation — a pre-filing diagnosis, consistent treatment records, personal statements, and buddy statements — will be well-positioned regardless of how oversight evolves. Their claims won't depend on the credibility of a single questionnaire because they'll be supported by a body of evidence that tells a consistent, verifiable story.

The Changing Landscape: What Veterans Should Know Going Forward

VBA's Planned Reforms

In response to the OIG's findings, the Under Secretary for Benefits concurred with all five of the report's recommendations and provided action plans for implementation. These reforms represent the most significant changes to public questionnaire oversight since the forms were reinstated.

VBA's Office of Financial Management is developing a digital system for capturing, analyzing, and monitoring public questionnaires. As part of this effort, the office released an internal Public Use DBQ dashboard in September 2023 and planned to continue improving its capabilities through ongoing data extraction, report usability enhancements, and data cleansing. Separately, the Benefits Delivery, Protection, and Remediation division within the Office of Financial Management had extracted data from over 750,000 public questionnaires as of June 2023, but at that time the division did not yet have an analytics environment to store the data, which prevented meaningful analysis. The division had requested $500,000 in funding for cloud storage options, though a senior advisor noted this request had not been prioritized. Despite these challenges, the direction is clear: VA is building the infrastructure to systematically identify suspicious questionnaires rather than relying on the limited manual review process that has been in place.

The Medical Disability Examination Office is updating the examiner certification and signature section on public questionnaires to include a statement that the form is being completed under the penalty of perjury. The updated forms will also include a section for examiners to list any organizations that requested they complete the examination on the veteran's behalf — a change that could help identify patterns of third-party involvement in questionnaire completion.

Compensation Service is updating the Adjudication Procedures Manual with specific guidance on how to identify potentially fraudulent public questionnaires and the steps claims processors should take when they suspect a questionnaire may be inauthentic. This addresses one of the most significant gaps identified in the OIG report — the fact that claims processors had virtually no guidance on what fraud looks like or what to do about it.

Claims processors will also be explicitly informed, through quality calls and procedural updates, that they have a duty to review and weigh all evidence of record and that assigning low or no probative value to suspicious questionnaires is not only appropriate but expected. This addresses the finding that 80 percent of interviewed claims processors and quality specialists believed their colleagues were accepting potentially fraudulent questionnaires because the manual instructed them to take evidence at face value.

Finally, VBA is developing and will provide training on authentication and fraud related to public questionnaires. This training will give claims processors the knowledge to identify inauthentic or potentially fraudulent questionnaires and will include specific steps they should take when they make that determination. This addresses the finding that 22 of 25 staff interviewed had received no training on fraud related to public questionnaires, despite all 25 believing that such questionnaires pose a fraud risk.

Meanwhile, the OIG has noted that while VBA conducts validation reviews to detect and prevent fraud, these reviews remain very limited in scope, lack robust methodology and follow-up, and do not safeguard against physician-assisted fraud.

What This Means for Veterans Filing Claims

The message for veterans is clear: greater scrutiny of public DBQs is here, and preparation is more important than ever. Claims that rely on a single, unsupported questionnaire face increasing risk of being flagged, delayed, or given reduced evidentiary weight. The days when a public questionnaire was virtually guaranteed to be accepted at face value are numbered.

This doesn't mean that public questionnaires are going away or that veterans shouldn't use them. The questionnaires remain a valuable tool that allows veterans to work with their own trusted providers. But a public questionnaire should be one piece of a comprehensive evidence package — not the entire package.

Veterans who invest in building complete evidence packages will benefit from a smoother, faster claims process. When claims processors see a file with consistent, corroborating evidence from multiple sources, they can make confident decisions without the need for additional development actions. The claim moves through the system efficiently, and the veteran receives their benefits without unnecessary delays.

The importance of working with your own treating providers — rather than unfamiliar examiners who have no prior relationship with you — cannot be overstated. A questionnaire completed by a provider who has been treating your condition over time carries inherent credibility that a questionnaire from a provider you've never seen before simply cannot match. That treating relationship, documented through your medical records, creates the kind of evidentiary consistency that the claims process is designed to reward.

Key Takeaways

The VA OIG found that nearly 70 percent of claims with public DBQs contained fraud risk indicators — this finding is driving the most significant changes to VA's claims processing oversight in years. Every veteran filing a claim should understand these changes and prepare accordingly.

A diagnosis before filing is foundational. Veterans who use Veteran AI to prepare their claims have a diagnosis approximately 80 percent of the time before submitting a claim, establishing credibility from the very start. This pre-existing diagnosis creates a medical baseline that anchors the entire claim in verifiable evidence.

Ongoing treatment records are essential. Approximately 60 percent of veterans using Veteran AI's platform have treatments within 12 months of filing, directly addressing one of the OIG's key fraud indicators — the absence of current medical treatment confirming the severity of a claimed condition.

Personal and buddy statements create a multi-layered evidence package. Veteran AI's application guides veterans through generating these statements as a core part of claim preparation, building exactly the kind of comprehensive evidentiary record that claims processors are trained to value. Multiple independent sources of evidence telling a consistent story is the gold standard for claims credibility.

The system is evolving toward greater scrutiny. With data analytics systems, updated procedural guidance, new training requirements, mandatory digitization of non-VA DBQs, and penalty-of-perjury language on the horizon, veterans who build well-documented, honest claims today will be best positioned as VA implements stronger fraud controls.

Fraud hurts all veterans. The estimated $390 million in monetary risk from potentially fraudulent claims represents resources that could serve veterans with legitimate needs. Every fraudulent claim makes the system harder to navigate for honest veterans.

Comprehensive preparation is the best protection. Claims supported by diagnoses, treatment records, personal statements, and buddy statements are far less likely to be flagged, delayed, or denied. This isn't about gaming the system — it's about doing the work to properly document what you've experienced and what you're living with.

Doing It Right Benefits Everyone

The vast majority of veterans filing disability claims are honest men and women seeking compensation they have earned through their service. They deserve a system that processes their claims fairly, efficiently, and accurately. The OIG's findings are not an indictment of veterans — they are an indictment of a system that has failed to implement adequate controls, leaving the door open for bad actors while providing insufficient guidance to the frontline employees responsible for evaluating claims.

Building a strong, well-documented claim is the single best thing a veteran can do to protect their interests in this environment. The combination of a pre-filing diagnosis, consistent medical treatment, and corroborating personal and buddy statements creates exactly the kind of evidence package that withstands any level of scrutiny. It's the approach that aligns with how the claims process is designed to work, and it's the approach that will serve veterans well regardless of how VA's oversight evolves.

As VA strengthens its fraud controls — developing data analytics, updating procedural guidance, training claims processors, digitizing non-VA questionnaire submissions, and adding accountability measures to public questionnaires — veterans who have done the work to substantiate their claims will move through the process more smoothly than ever. Their files will tell a clear, consistent, credible story supported by multiple independent sources of evidence. Claims processors will be able to make confident decisions. And the benefits that these veterans receive will be firmly grounded in the evidence.

The time to invest in building your evidence package is before you file — not after a problem arises. Get diagnosed. Stay in treatment. Write your personal statement. Gather your buddy statements. Build the kind of comprehensive, honest claim that reflects the reality of what you've experienced and what you're living with every day. It protects your claim, it protects your benefits, and it protects the system that serves all veterans who have earned the nation's support.

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References

1. Without Effective Controls, Public Disability Benefits ...
2. Statement to Congress October 29, 2025 - vaoig.gov
3. Annual Benefits Report Fiscal Year 2022