C&P Exam for Epilepsy, petit mal (DC 8911)

Diagnostic code: 8911Condition: Epilepsy, petit malRegulation: 38 CFR § 4.124aDBQ: DBQ NEURO Seizure Disorders Epilepsy

Which form the examiner uses

For epilepsy, petit mal (DC 8911), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQ NEURO Seizure Disorders Epilepsy (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 seizure disorders (epilepsy), documenting diagnosis type, medication, frequency of seizure activity, and functional impact.

DIAGNOSIS (Section I)

DOES THE VETERAN HAVE OR HAS HE OR SHE EVER BEEN DIAGNOSED WITH A SEIZURE DISORDER (epilepsy)?
TONIC-CLONIC SEIZURES OR GRAND MAL EPILEPSY (generalized convulsive seizures) - ICD Code / Date of diagnosis
ABSENCE SEIZURES OR PETIT MAL OR ATONIC SEIZURES (generalized nonconvulsive seizures) - ICD Code / Date of diagnosis
JACKSONIAN (simple partial seizures) - ICD Code / Date of diagnosis
FOCAL MOTOR - ICD Code / Date of diagnosis
FOCAL SENSORY - ICD Code / Date of diagnosis
DIENCEPHALIC EPILEPSY - ICD Code / Date of diagnosis
PSYCHOMOTOR EPILEPSY (complex partial seizures, temporal lobe seizures) - ICD Code / Date of diagnosis
OTHER (specify) - Other diagnosis #1 - ICD Code / Date of diagnosis
OTHER (specify) - Other diagnosis #2 - ICD Code / Date of diagnosis
IF THERE ARE ADDITIONAL DIAGNOSES THAT PERTAIN TO SEIZURE DISORDERS (epilepsy), LIST USING ABOVE FORMAT

MEDICAL HISTORY (Section II)

DESCRIBE THE HISTORY (including onset and course) OF THE VETERAN'S SEIZURE DISORDER (epilepsy) (brief summary)
IS CONTINUOUS MEDICATION REQUIRED FOR CONTROL OF EPILEPSY OR SEIZURE ACTIVITY?
If 'Yes,' list only those medications required for the Veteran's epilepsy or seizure activity
HAS THE VETERAN HAD ANY OTHER TREATMENT (such as surgery) FOR EPILEPSY OR SEIZURE ACTIVITY?
HAS THE DIAGNOSIS OF A SEIZURE DISORDER BEEN CONFIRMED?
HAS THE VETERAN HAD A WITNESSED SEIZURE? (If 'Yes,' describe, including relationship of witnesses to Veteran)
HAS THE VETERAN HAD A CONFIRMED DIAGNOSIS OF EPILEPSY WITH A HISTORY OF SEIZURES?

FINDINGS, SIGNS AND SYMPTOMS (Section III)

DOES THE VETERAN HAVE OR HAS HE OR SHE HAD ANY FINDINGS, SIGNS OR SYMPTOMS ATTRIBUTABLE TO SEIZURE DISORDER (epilepsy) ACTIVITY?
Generalized tonic-clonic convulsion
Episodes of unconsciousness
Brief interruption in consciousness or conscious control
Episodes of staring
Episodes of rhythmic blinking of the eyes
Episodes of nodding of the head
Episodes of sudden jerking movement of the arms, trunk or head (myoclonic type)
Episodes of sudden loss of postural control (akinetic type)
Episodes of complete or partial loss of use of one or more extremities
Episodes of random motor movements
Episodes of psychotic manifestations
Episodes of hallucinations
Episodes of perceptual illusions
Episodes of abnormalities of thinking
Episodes of abnormalities of memory
Episodes of abnormalities of mood
Episodes of autonomic disturbances
Episodes of speech disturbances
Episodes of impairment of vision
Episodes of disturbances of gait
Episodes of tremors
Episodes of visceral manifestations
Other
Residuals of Injury during seizure
(For all checked conditions describe)

TYPE AND FREQUENCY OF SEIZURE ACTIVITY (Section IV)

DOES THE VETERAN HAVE OR HAS HE OR SHE EVER HAD ANY TYPE OF SEIZURE ACTIVITY, INCLUDING MAJOR, MINOR, PETIT MAL OR PSYCHOMOTOR SEIZURE ACTIVITY?
PROVIDE APPROXIMATE DATE OF FIRST SEIZURE ACTIVITY (Month, Year)
PROVIDE DATE OF MOST RECENT SEIZURE ACTIVITY (Month, Year)
HAS THE VETERAN EVER HAD MINOR SEIZURES (characterized by a brief interruption in consciousness or conscious control...)?
Number of minor seizures over past 6 months: 0-1 / 2 or more
If 2 or more over the past 6 months, indicate the average frequency of minor seizures: 0-4 per week / 5-8 per week / 9-10 per week / More than 10 per week
HAS THE VETERAN EVER HAD MAJOR SEIZURES (characterized by the generalized tonic-clonic convulsion with unconsciousness)?
Number of major seizures: None in past 2 years / At least 1 in past 2 years / At least 2 in the past year
Average frequency of major seizures: Less than 1 in past 6 months / At least 1 in past 6 months / At least 1 in 4 months over past year / At least 1 in 3 months over past year / At least 1 per month over past year
HAS THE VETERAN EVER HAD MINOR PSYCHOMOTOR SEIZURES (characterized by brief transient episodes of random motor movements, hallucinations, perceptual illusions, abnormalities of thinking, memory or mood, or autonomic disturbances)?
Number of minor seizures over past 6 months: 0-1 / 2 or more
If 2 or more over the past 6 months, indicate the average frequency of minor seizures: 0-4 per week / 5-8 per week / 9-10 per week / More than 10 per week
HAS THE VETERAN EVER HAD MAJOR PSYCHOMOTOR SEIZURES (major psychomotor seizures are characterized by automatic states and/or generalized convulsions with unconsciousness)?
Number of major psychomotor seizures: None in past 2 years / At least 1 in past 2 years / At least 2 in past year
Average frequency of major psychomotor seizures: Less than 1 in past 6 months / At least 1 in past 6 months / At least 1 in 4 months over past year / At least 1 in 3 months over past year / At least 1 per month over past year
HAS THE VETERAN EVER HAD EPILEPSY ASSOCIATED WITH A NONPSYCHOTIC ORGANIC BRAIN SYNDROME?
HAS THE VETERAN EVER HAD EPILEPSY ASSOCIATED WITH A PSYCHOTIC DISORDER, PSYCHONEUROTIC DISORDER OR PERSONALITY DISORDER?

OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS (Section V)

DOES THE VETERAN HAVE ANY OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS OR SYMPTOMS RELATED TO THE CONDITIONS LISTED IN THE DIAGNOSIS SECTION ABOVE?
IF YES, DESCRIBE (brief summary)
DOES THE VETERAN HAVE ANY SCARS (surgical or otherwise) RELATED TO ANY CONDITIONS OR TO THE TREATMENT OF ANY CONDITIONS LISTED IN THE DIAGNOSIS SECTION ABOVE?
IF YES, ARE ANY OF THESE SCARS PAINFUL OR UNSTABLE; HAVE A TOTAL AREA EQUAL TO OR GREATER THAN 39 SQUARE CM (6 square inches); OR ARE LOCATED ON THE HEAD, FACE OR NECK?
IF NO, PROVIDE LOCATION AND MEASUREMENTS OF SCAR IN CENTIMETERS: LOCATION / MEASUREMENTS: length cm X width cm
5C. COMMENTS, IF ANY

DIAGNOSTIC TESTING (Section VI)

HAVE ANY IMAGING STUDIES OR DIAGNOSTIC PROCEDURES BEEN PERFORMED?
Magnetic resonance imaging (MRI) - Date / Results
Computed tomography (CT) - Date / Results
Cerebrospinal fluid CSF examination - Date / Results
Electroencephalography (EEG) - Date / Results
Neuropsychologic testing - Date / Results
Other, specify - Date / Results
ARE THERE ANY OTHER SIGNIFICANT DIAGNOSTIC TEST FINDINGS AND/OR RESULTS? (If 'Yes,' provide type of test or procedure, date and results (brief summary))

FUNCTIONAL IMPACT (Section VII)

DOES THE VETERAN'S EPILEPSY OR SEIZURE (epilepsy) DISORDER IMPACT HIS OR HER ABILITY TO WORK?
If 'Yes,' describe the impact of the Veteran's seizure (epilepsy) disorder, providing one or more examples

REMARKS (Section VIII)

8A. REMARKS (If any)

Rating Levels for DC 8911

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.

What the Board discussed in granted decisions for DC 8911

The themes below were extracted by clustering 154 grant-factor sentences from published Board of Veterans Appeals decisions for this diagnostic code. Frequencies indicate how often each theme appeared in the sample. This is a factual aggregate of the public record, not advice or strategy for any specific claim.

36% Benefit of the doubt applied or noted as applicable
The Board recorded that it considered, applied, or resolved the benefit of the doubt doctrine in the Veteran's favor in reaching its conclusions.
55 of 154 sample sentences
14% Evidence found in equipoise supporting grant
The Board found the positive and negative evidence approximately balanced on a material issue, warranting a grant of the claimed benefit.
22 of 154 sample sentences
14% Benefit of the doubt doctrine stated as legal standard
The decision recited the statutory or regulatory rule that an approximate balance of positive and negative evidence requires the benefit of the doubt to be given to the claimant.
22 of 154 sample sentences
12% Preponderance of evidence against claim; benefit of doubt inapplicable
The Board recorded that the weight of the evidence persuasively favored denial, making the benefit of the doubt doctrine inapplicable.
19 of 154 sample sentences
12% VA or private examiner nexus opinion cited as at least as likely as not
A VA or private medical examiner's opinion stating that a disability or condition was at least as likely as not related to service or a service-connected condition was noted in the record.
19 of 154 sample sentences
5% Seizure frequency or severity finding supporting rating level
The Board recorded specific findings about the frequency or severity of the Veteran's seizures as the basis for assigning a particular disability rating percentage.
8 of 154 sample sentences
4% TDIU or unemployability evidence found in equipoise or supported
The Board found the evidence sufficient or in equipoise to support a finding that service-connected disabilities rendered the Veteran unable to secure and follow substantially gainful employment.
6 of 154 sample sentences
2% Examiner opinion request for nexus or unemployability noted
The decision recorded instructions to an examiner to opine whether a condition was at least as likely as not related to service or whether the Veteran was unable to sustain gainful employment.
3 of 154 sample sentences

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.