The C&P examiner’s clipboard, decoded.

The PTSD DBQ walks through eight symptom domains and a single 'overall level' rubric. The examiner picks one box on a 0/10/30/50/70/100 scale. The boxes are written in CFR vocabulary — your job is to ground every symptom you describe in that vocabulary.

â–¶The 70% trigger: occupational and social impairment with deficiencies in most areas.

The Sleep Apnea DBQ is short. The whole rating turns on three boxes: do you have a sleep study confirming OSA, are you prescribed CPAP, and is there respiratory failure or tracheostomy. The CPAP box is the 50% trigger.

â–¶The 50% trigger: prescribed use of a breathing assistance device (CPAP, BiPAP, APAP).

The thoracolumbar spine DBQ is a measurement DBQ. The examiner uses a goniometer to measure flexion in degrees. Without that tool present, the measurement is invalid. The numbers drive the tier directly: 30° forward flexion = 40%, 60° = 20%.

â–¶The 40% trigger: forward flexion of the thoracolumbar spine 30° or less.

The shortest DBQ in the schedule. There is no objective test for tinnitus — your lay report is the evidence. Two questions: do you have it, and when did it start. Everything else (severity, frequency, ear) does not affect the flat 10% rating.

â–¶The 10% trigger: a credible report of recurrent tinnitus, MOS with documented noise exposure.

The knee DBQ measures three things separately: flexion (DC 5260), extension (DC 5261), and stability/subluxation (DC 5257). Each can be a separately compensable rating. Painful motion under § 4.59 raises a 0% to 10%.

â–¶The under-rated combo: limitation of flexion + limitation of extension + instability stack.

The whole migraine rating turns on one word — 'prostrating' — and how often the attacks happen. The DBQ asks the examiner to characterize frequency and severity. Two attacks a month that stop you cold reads very differently from 'headaches.'

â–¶The 50% trigger: very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.

A pure-measurement DBQ. Two tests drive everything: the puretone audiogram and the Maryland CNC speech-discrimination score. Those numbers feed Table VI and Table VII, which set the percentage. No room for narrative — but the test must be done right.

â–¶The rule that matters: the Maryland CNC test is required, and § 4.86 covers exceptional patterns.

The TBI DBQ scores ten 'facets' of cognitive and behavioral function from 0 to 3 (plus 'total'). The single highest facet level sets your rating — a 0/10/40/70/100 scale. One severe facet drives the whole evaluation.

â–¶The rule: rate the highest facet — level 2 = 40%, level 3 = 70%, total = 100%.

Major depressive disorder uses the exact same General Rating Formula as PTSD. The examiner picks one 'overall level of occupational and social impairment' box on a 0/10/30/50/70/100 scale. Same rubric, same magic words, same tier triggers.

â–¶The 70% trigger: occupational and social impairment with deficiencies in most areas.

GERD is rated on a symptom cluster, not a single test. The 30% tier needs persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation. The magic words are clinical — use them, and document weight loss and impairment of health.

â–¶The 30% trigger: persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation + impairment of health.

The IBS DBQ is short — the entire rating hinges on three words the examiner must check: mild, moderate, or severe. Those words map directly to the 0/10/30 schedule under § 4.114. Get the frequency of bowel disturbance and whether abdominal distress is 'more or less constant' on the record and the tier follows.

â–¶The 30% trigger: diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress.

The Radiculopathy DBQ rates how severe the nerve involvement is — mild, moderate, moderately severe, or severe incomplete paralysis — for the specific nerve group (most often sciatic under DC 8520). Sensory loss alone lands lower; motor weakness, atrophy, or reflex changes push the rating higher.

â–¶The 40% trigger: moderately severe incomplete paralysis with clear motor involvement, atrophy, or significant weakness.

The Hypertension DBQ is driven by numbers. The rating hinges on your predominant diastolic and systolic readings over time and whether you require continuous medication. Get the actual BP values and medication history on the record and the tier follows.

â–¶The 10% trigger: diastolic predominantly 100 or more, OR systolic predominantly 160 or more, OR history of diastolic ≥100 requiring continuous medication.

The Flat Feet DBQ measures weight-bearing alignment, pronation, pain on manipulation, callosities, and response to orthotics. Tiers split on unilateral vs bilateral findings — and the 30% tier has two routes: severe bilateral OR pronounced unilateral.

â–¶The 30% trigger has two routes: severe in BOTH feet OR pronounced in ONE foot (marked pronation, extreme tenderness, severe tendo achillis spasm, not improved by orthotics).

The Asthma DBQ rates on PFT numbers (FEV-1 and FEV-1/FVC) and on the level of medication therapy you require. Tiers stack — daily controller inhalers, monthly exacerbations, or systemic corticosteroid courses all map directly to rating percentages.

â–¶The 60% trigger: FEV-1 40-55%, OR monthly visits for exacerbations, OR at least 3 courses of systemic corticosteroids per year.

Anxiety disorders use the same General Rating Formula as PTSD and major depression. The examiner picks one 'overall level of occupational and social impairment' box on a 0/10/30/50/70/100 scale. Same rubric, same magic words, same tier triggers — but documenting the worry, panic, and avoidance patterns specific to anxiety is what wins.

â–¶The 70% trigger: occupational and social impairment with deficiencies in most areas — near-continuous panic affecting independent functioning.

The Sinusitis DBQ rates on frequency of non-incapacitating and incapacitating episodes per year, plus presence of radical surgery residuals. The 30% trigger requires 3+ incapacitating episodes per year (or 6+ non-incapacitating); the 50% trigger requires post-surgical chronic osteomyelitis or near-constant sinusitis.

â–¶The 30% trigger: 3 or more incapacitating episodes per year requiring prolonged antibiotic treatment, OR 6 or more non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting.

The Wrist DBQ measures range of motion (dorsiflexion, palmar flexion) and presence of ankylosis. Ratings split dominant vs non-dominant: limitation of motion under DC 5215 is 10% either side; ankylosis under DC 5214 climbs to 30-40% (favorable) or 40-50% (unfavorable) depending on position and dominance.

â–¶The 30%/40% trigger: favorable wrist ankylosis (20-30° dorsiflexion). 30% non-dominant, 40% dominant. Unfavorable ankylosis adds another tier.