Federal form
Veterans Affairs Canada medical questionnaire
Veterans Affairs Canada (VAC) uses medical questionnaires when a Veteran or still-serving member applies for disability benefits. The form in the envelope is condition-specific more often than not (hearing, PTSD, knees, tinnitus). You describe diagnoses, onset, current findings, and function. VAC applies its Table of Disabilities and entitlement rules. This is not CPP-D, not T2201, and not a CAF periodic health exam.
What VAC is asking you for
Entitlement (is this related to service?) and assessment (how severe is it now?) are VAC decisions. Your job is the medical file: diagnosis, first documentation, current exam, treatment, and how the condition limits work and daily life. Do not write “should be 40%” unless the questionnaire actually asks you to grade against a table you have in front of you.
Use the questionnaire VAC sent. Hearing loss is not the PTSD form. If the Veteran only has a letter asking for a narrative, answer the letter. Do not invent a form code.
Service relationship is not yours to invent
You may record what the Veteran reports about noise, blast, or deployment, and what you find now. You usually do not have the service health records. If you never saw them in service, say when you first saw them. VAC has the military file.
Who completes it
The clinician VAC named, or the treating physician, nurse practitioner, audiologist, or psychologist for that condition — matching the questionnaire’s profession list. Do not complete an audiology grid without an audiogram. Do not complete a psychiatry questionnaire from a single walk-in if the form expects longitudinal mental-health care.
How to complete the questionnaire
- Diagnosis with DSM or clinical language the form uses — not slang.
- Date of onset as the chart or the Veteran’s history supports, labelled as history versus your observation.
- Current findings: audiogram, PHQ/PCL if you use them, joint measurements, gait.
- Treatment and residual limitation on treatment.
- Function: sleep, work, relationships, hearing in noise, stairs — examples.
- Other conditions that overlap (depression plus chronic pain) so VAC does not double-count or ignore.
- Your identifiers and how long you have followed this person.
Worked example (fictional)
VAC questionnaire — bilateral tinnitus and hearing, family practice plus audiology
Fictional 45-year-old Veteran. Do not copy into a real VAC form.
Dx: bilateral sensorineural hearing loss and constant tinnitus. First seen by me 2021; Veteran reports onset after years of armour-crew noise — I do not have CAF records. Audiogram 2026-07 (attached from audiology): high-frequency loss both sides. Tinnitus interferes with sleep most nights; uses white noise. Function: cannot hear conversation in the Legion hall without looking; work as a mechanic needs visual confirmation of verbal instructions. Tx: hearing aids trial 2025, mixed adherence. Not a CPP-D form. Not T2201. I am the FP; audiology completed the grid. VAC decides entitlement.
Why VAC asks for more
- Wrong condition questionnaire.
- No current findings, only a service story.
- Grading a percentage you were not asked to grade.
- Unsigned, or a profession the form does not accept for that condition.
- Copying a CPP Disability report including Service Canada letterhead language.
Draft the VAC questionnaire from the visit
In Scribeberry, open Forms, search for Veterans Affairs medical questionnaire, or upload VAC’s current PDF. Generate from the encounter and your notes, then review every field before you sign. Scribeberry does not pre-map this form. You still review and sign. Scribeberry does not file with Veterans Affairs Canada.
Frequently asked questions
Do I decide if the condition is service-related?
No. You report medical facts and history as told and as recorded. VAC decides entitlement against service records and policy.
Is this the same as CPP Disability?
No. CPP-D is Service Canada and a different medical report. A Veteran may apply to both. Complete the VAC questionnaire in front of you.
What if I only have civilian records?
Say so. Complete what you can from your chart. VAC still has the military file. Do not fabricate in-service notes.
Does Scribeberry submit this to VAC?
No. Scribeberry helps you complete the PDF. You or the Veteran return it through VAC’s process. Keep a copy in the chart.
Forms
