C&P Exam for Lupus erythematosus, systemic (DC 6350)
Read the C&P exam preparation guideWhat happens at the exam, what 38 CFR Part 4 requires the examiner to record, and what to bring.
Which form the examiner uses
For lupus erythematosus, systemic (DC 6350), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):
- DBQ RHEUM Systemic Lupus Erythematosus and Other Autoimmune Diseases (examiner-only DBQ. Link opens VA Find-A-Form search)
DBQs are Department of Veterans Affairs Form 21-0960 series documents. Public DBQs are hosted on benefits.va.gov. A handful are examiner-only and are not posted publicly.
What the examiner records
The fields below are reproduced from the DBQ form the examiner completes for this diagnostic code. This is the structural map of the form, showing what the examiner is asked to measure, observe, and record. It is a factual reproduction of the public DBQ, not advice on how to answer.
This DBQ evaluates systemic lupus erythematosus (SLE) and other autoimmune diseases including cutaneous manifestations, findings, and signs/symptoms.
How DC 6350 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-III and V-VIII of this form. Section III is the condition-specific section for this code. Section IV covers an unrelated condition on this DBQ and is skipped.
7 of 8 sections apply to DC 6350 on this DBQ
DIAGNOSIS (Section I)
- 1A. Does the Veteran have a systemic or localized autoimmune disease, including systemic lupus erythematosus (SLE)? (This is the condition the Veteran is claiming or for which an exam has been requested) Yes No Systemic Lupus Erythematosus (SLE)
- 1B. If yes, select the Veteran's condition: Autoimmune polyglandular syndrome ICD Code: Date of diagnosis: (If this condition affects multiple endocrine glands, ALSO complete appropriate questionnaire(s) for those conditions) Diabetes Mellitus Type I ICD Code: Date of diagnosis: (If checked, complete Diabetes Questionnaire in lieu of this questionnaire) Discoid lupus erythematosus ICD Code: Date…
- 1C. If there are additional diagnoses that pertain to autoimmune diseases, list using above format: For all checked diagnoses, ALSO complete additional questionnaires as appropriate to fully describe effects of the condition. If the Veteran has been diagnosed with HIV, complete the HIV Questionnaire in lieu of this questionnaire. If the Veteran has been diagnosed with Diabetes Mellitus Type I,…
MEDICAL HISTORY (Section II)
- 2A. Describe the history (including onset and course) of the Veteran's autoimmune disease, including SLE (brief summary): Systemic Lupus Erythematosus (SLE)
- 2B. Over the past 12 months, has the Veteran's treatment plan included oral or topical medications for any autoimmune disease or autoimmune disorder-related skin condition, including systemic, cutaneous or discoid lupus? Yes No (If "Yes," check all that apply): Oral corticosteroids (If checked, list medications): (Specify the condition medication is used for):
- 2C. Indicate status of the Veteran's autoimmune disease, including SLE: Acute Chronic Other (describe): Systemic Lupus Erythematosus (SLE)
- 2D. Does the Veteran have exacerbations of an autoimmune disease, including SLE? Yes No (If "Yes," describe exacerbations (brief summary)): Indicate average frequency of exacerbations per year: 0 1 2 3 More than 3 exacerbations per year Indicate average duration of symptoms during each exacerbation: Lasting less than one week
- 2E. Does the Veteran's autoimmune disease, including SLE, currently produce severe impairment of health? Yes No (If "Yes," describe the severe impairment of health):
CUTANEOUS MANIFESTATIONS (Section III)
- 3A. Does the Veteran have any cutaneous manifestations of an autoimmune disease, including systemic, cutaneous or discoid lupus erythematosus? Yes No (If "Yes," complete the following section):
- 3B. Specify the cutaneous manifestations (check all that apply): Discoid lupus erythematosus Subacute cutaneous lupus erythematosus Other, describe:
- 3C. Indicate areas affected by cutaneous manifestations (check all that apply): Malar rash over bridge of nose and bilateral cheeks, sparing nasolabial folds Cheeks (If checked, specify which side): Right Left Both Ears (If checked, specify which side): Right Left Both Nose Hands Chin Feet Lips and mouth, causing ulcers and scaling Scalp, causing scarring alopecia
- 3D. Indicate approximate TOTAL body area affected by cutaneous manifestations of an autoimmune disease on current examination: None < 5% 5% to < 20% 20% to 40% > 40%
- 3E. Indicate approximate total EXPOSED body area (face, neck and hands) affected by cutaneous manifestations of an autoimmune disease on current examination: None < 5% 5% to < 20% 20% to 40% > 40%
- 3F. Do the cutaneous manifestations of the autoimmune disease cause scarring alopecia? Yes No (If "Yes," indicate percent of scalp affected): < 20% 20% to 40% > 40%
- 3G. Does the Veteran have any scars or other disfigurement (of the skin) related to any conditions or to the treatment of any conditions listed in the diagnosis section? Yes No (If "Yes," also complete appropriate Dermatological DBQ)
- 3H. Comments, if any:
FINDINGS, SIGNS AND SYMPTOMS (Section IV)
- 4A. Does the Veteran have any findings, signs or symptoms (other than cutaneous manifestations) attributable to an autoimmune disease, including SLE? Yes No (If "Yes," complete the following section):
- 4B. Has the Veteran had any symptoms (other than cutaneous manifestations) attributable to an autoimmune disease, including SLE, in the past 2 years? Yes No
- 4C. Does the Veteran have arthritis attributable to an autoimmune disease, including SLE? Yes No (If "Yes," list affected joints and describe effect of autoimmune disease on each joint (brief summary) and ALSO complete the appropriate questionnaire for each affected joint):
- 4D. Does the Veteran have recurrent ulcers on oral mucous membranes attributable to an autoimmune disease, including SLE? Yes No (If "Yes," do the recurrent ulcers result in impairment of mastication, a speech impairment or other signs or symptoms?) Yes No (If "Yes," describe and ALSO complete the appropriate questionnaire): Systemic Lupus Erythematosus (SLE)
- 4E. Does the Veteran have any hematologic or lymphatic manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," check all that apply and ALSO complete the appropriate questionnaire): General adenopathy Splenomegaly Anemia Leukopenia (usually lymphopenia, with < 1500 cells/uL)
- 4F. Does the Veteran have any pulmonary manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," check all that apply and ALSO complete the appropriate questionnaire): Pulmonary emboli Pulmonary hypertension Shrinking lung syndrome Recurrent pleurisy, with or without pleural effusion
- 4G. Does the Veteran have any cardiac manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," check all that apply and ALSO complete a Heart Questionnaire): Percardial effusion Myocarditis Coronary artery vasculitis Valvular involvement
- 4H. Does the Veteran have any neurologic manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," describe and ALSO complete the appropriate questionnaire):
- 4I. Does the Veteran have any renal manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," check all that apply and ALSO complete the appropriate Kidney and/or Hypertension Questionnaire): Glomerular nephritis Membranoproliferative glomerulonephritis Proteinuria Hypertension
- 4J. Does the Veteran have any obstetric manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," describe and ALSO complete the appropriate questionnaire):
- 4K. Does the Veteran have any gastrointestinal manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," describe and ALSO complete the appropriate questionnaire):
- 4L. Does the Veteran have any vascular (arterial or venous) manifestations of an autoimmune disease, including SLE? Yes No (If "Yes," check all that apply and ALSO complete the Artery and Vein Questionnaire): Recurrent arterial thrombosis Recurrent venous thrombosis Other, describe:
OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS AND/OR SYMPTOMS (Section V)
- 5A. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the diagnosis section above? Yes No (If "Yes," describe (brief summary)):
DIAGNOSTIC TESTING (Section VI)
- 6A. If imaging studies, diagnostic procedures or laboratory testing has been performed and reflects the Veteran's current condition, provide most recent results and no further studies or testing are required for this examination. (NOTE: When appropriate provide most recent results.)
- 6B. Have clinically relevant diagnostic imaging studies or other diagnostic procedures been performed or reviewed in conjunction with this examination? Yes No (If "Yes," check all that apply): Chest x-ray Date: Results: Magnetic resonance imaging (MRI) Date: Results: Systemic Lupus Erythematosus (SLE)
- 6C. Has clinically relevant laboratory testing been performed or reviewed in conjunction with this examination? Yes No (If "Yes," check all that apply): Hemoglobin (gm/100ml) Date: Results: Hematocrit Date: Results: Red blood cell (RBC) count Date: Results: White blood cell (WBC) count Date: Results:
- 6D. Has a urinalysis been performed or reviewed in conjunction with this examination? Yes No (If "Yes," complete the following): Date of most recent urinalysis: Results: Microalbumin: Not elevated Elevated to: Protein: None Trace 1+ 2+ 3+
- 6E. Are there any other clinically relevant diagnostic test findings or results related to the claimed condition(s) and/or diagnosis(es), that were reviewed in conjunction with this examination? Yes No (If "Yes," provide type of test or procedure, date and results (brief summary)):
- 6F. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions:
FUNCTIONAL IMPACT (Section VII)
- 7A. Does the Veteran's autoimmune disease impact his or her ability to work? Yes No (If "Yes," describe the impact of the Veteran's autoimmune disease, providing one or more examples):
REMARKS (Section VIII)
- 8A. Remarks (if any – please identify the section to which the remark pertains when appropriate).
Rating Levels for DC 6350
The following tiers are reproduced from 38 CFR Part 4, the VA Schedule for Rating Disabilities. Toggle between the official VA criteria and a Plain English explanation.
Plain-English summaries are AI-generated to explain the official criteria. The official 38 CFR language is the binding legal standard. When in doubt, ask a VSO.
Evidence cited in published BVA decisions for DC 6350
The counts below are aggregated from published Board of Veterans Appeals decisions for this diagnostic code. Each row reports how often a given evidence type was discussed in the decision text, broken down by outcome. This is a factual aggregate of the public record, not a prediction or recommendation about any specific claim.
- VA examination: appeared in 7 granted decisions (0 denied, 6 remanded; 13 total)
- Private medical opinion: appeared in 2 granted decisions (0 denied, 1 remanded; 3 total)
- Medical literature: appeared in 1 granted decision (0 denied, 1 remanded; 2 total)
- Buddy / lay statements: appeared in 1 granted decision (0 denied, 0 remanded; 1 total)
- Nexus letter: appeared in 0 granted decisions (0 denied, 2 remanded; 2 total)
Disclaimer: This page reproduces public Department of Veterans Affairs forms (DBQs) and verbatim text from 38 CFR Part 4 (the VA Schedule for Rating Disabilities). It is informational only and is not legal or medical advice. For guidance on a specific claim, contact a VA-accredited representative.