Prevent and Avoid DBQ Fraud
The VA’s Office of Inspector General (OIG) is asking for help in identifying public Disability Benefits Questionnaire (DBQ) fraud schemes that target veterans. Public DBQs are medical forms veterans submit to their healthcare providers in order to help VA evaluate disability benefit claims.
DBQ fraud schemes include attempts to obtain payment from veterans for assistance in getting physicians to complete DBQs and filing a related claim. VA and accredited individuals offer these services free of charge. No-cost assistance is available to help veterans file their initial application for benefits; fees may apply for appeals of VA decisions.
It is not appropriate for unaccredited “claims consultants” or other parties to charge veterans a percentage of future payments or fees to assist with filing initial benefit claims. Veterans should decline assistance from anyone proposing such an arrangement.
Watch for these telltale signs of fraud:
• Unaccredited individuals who improperly promise to send veterans to private healthcare providers that will increase the chance of successful decisions or higher benefits, or inappropriately advise veterans to avoid exams from a VA provider. Veterans should never agree to have VA benefit payments directly deposited into the bank account of a claims consultant.
• Unaccredited individuals who guarantee a large increase in the veteran’s military service-connected disability rating that would lead to larger monthly monetary benefits. Only VA can determine disability ratings.
• Healthcare providers that charge a fee with promises that they can find a diagnosis or exaggerate an existing medical condition to secure a successful claims decision or a higher rating than the evidence warrants.
If you have any reason to suspect fraud, do the following:
• Search VA’s database to ensure you are using an accredited representative.
• Work with the identified accredited representative when submitting public DBQs to physicians or claims to VA.
• Verify any potential charges (such as those related to filing an appeal) with accredited representatives in advance. Accredited representative fees that seem excessive can be challenged by filing a motion for review with VA (va.gov).
• Ensure that only accurate information regarding your disability claim is provided to VA. Knowingly providing, or having false information provided to VA on your behalf, may be a violation of federal law.
For additional information on avoiding fraud, check out the following resources:
• Accredited Representatives Information
• VA OIG