FG·01 // Read before your exam

The Field Guide.

Everything here is about telling the whole truth, well. Nothing here is about telling anything else. Fifteen minutes of accuracy is worth more than an hour of performance.
01 / BEFORE YOU GO

The night-before checklist.

  1. Write down your worst week, not your best day

    Ratings are built on how bad it gets and how often — not on how well you held it together in the waiting room. Before the exam, write three concrete bad-day stories with dates if you can.

  2. Count everything countable

    Panic attacks per week. Hours of sleep. Days of work missed. Degrees you can bend. Examiners write numbers in boxes — arrive with your numbers ready so the boxes get filled by you, not by guesses.

  3. Bring the paper trail

    Sick-day records, written warnings, prescriptions, sleep-study results, your CPAP compliance report. One document outweighs ten adjectives.

  4. Tell the person who knows

    A spouse or buddy statement about what they see — the nightmares, the isolation, the limp — corroborates what you'll say in the room. Ask them this week, not the night before.

  5. Rehearse out loud, at least twice

    The words behave differently when they leave your mouth. That's the entire reason the simulator exists. Run it until "I'm fine" stops being your reflex.

02 / THE LANGUAGE THAT RATES

Same truth. Different words.
Different rating.

Both answers below are honest. Only one of them contains the information the rating schedule is listening for: frequency, severity, and functional impact.

— Understates (reflex)

  • "I'm doing okay, all things considered."Contains zero ratable information.
  • "I get headaches sometimes.""Sometimes" cannot be rated. Frequency can.
  • "Work's work, you know."The examiner does not know. Say what happened.
  • "My back acts up now and then."No range of motion, no flare frequency, no aids.
  • "I sleep fine with the machine."Buries the lede — the machine IS the criterion.

+ States (rehearsed)

  • "Two or three panic attacks a week; more when I can't sleep."Frequency → §4.130 50% band.
  • "Once a month a migraine puts me in a dark room for a full day."Prostrating + monthly → DC 8100 30%.
  • "I've used all my sick days and got a written warning."Documented occupational impact.
  • "I can bend about 40 degrees before it stops me; spasms change how I walk."ROM + gait → §4.71a 20%.
  • "I was prescribed a CPAP and use it nightly."The DC 6847 50% criterion, stated plainly.
03 / CONDITION BRIEFS

What the examiner listens for.

PTSD / Mental health

38 CFR §4.130
  • Panic frequency: weekly (30%) vs. more than weekly (50%) vs. near-continuous (70%)
  • Work reliability: missed days, warnings, jobs lost
  • Relationships: strained (50%) vs. unable to maintain (70%)
  • Suicidal ideation is a 70% criterion — the examiner must hear the truth
  • Hygiene, routines, leaving the house

Back / Spine

§4.71a DC 5237–5243
  • Forward flexion in degrees — the single biggest criterion (≤30° → 40%)
  • Muscle spasm or guarding that changes your gait → automatic 20%
  • Doctor-prescribed bed rest days (IVDS alternative path)
  • Pain radiating into legs = radiculopathy, rated separately per leg

Knee

§4.71a DC 5257/5260/5261
  • Flexion in degrees (45°→10%, 30°→20%, 15°→30%)
  • Instability and giving way rate separately on top of pain
  • Braces and falls are evidence — mention every one
  • Locking and swelling episodes have their own code (DC 5258)

Migraines

§4.124a DC 8100
  • "Prostrating" is the key word — must stop all activity
  • Frequency: monthly prostrating attacks → 30%
  • Missed work / economic impact pushes toward the 50% cap
  • Treatments tried and failed show persistence

Sleep apnea

§4.97 DC 6847
  • No sleep study, no rating — get the study first
  • Prescribed breathing device (CPAP) → 50%, stated plainly
  • Daytime sleepiness despite treatment → 30% criterion

Tinnitus

§4.87 DC 6260
  • Recurrent ringing → 10%, the cap, quickly granted
  • The real move: pair it with a hearing-loss exam (DC 6100, rated separately)
  • Note sleep and concentration interference for the record
04 / THE QUESTION BANK

Every question, before they ask it.

The exact questions the simulator's examiner asks, condition by condition — generated from the same engine that scores you, so it never drifts. Read them the night before. Better: rehearse them out loud.

PTSD / Mental health

38 CFR §4.130 · General Rating Formula
  • Thanks for coming in. In your own words — how have things been for you lately, day to day?
  • How are you sleeping? Walk me through a typical night.
  • Do you get panic attacks — sudden intense fear, heart racing, hard to breathe? If so, how often?
  • How is work going? Missed days, warnings, trouble keeping up or getting along with coworkers?
  • Tell me about your relationships — spouse or partner, family, friends. Do you keep in touch, go out?
  • Any trouble with memory or concentration — forgetting appointments, names, losing track of tasks?
  • Are you taking anything for it — medication, therapy? And does it actually keep things under control?
  • I have to ask this of everyone, and it stays between us: have you had any thoughts of hurting yourself, or that life isn't worth living?
  • Last one. Routine things — showering, appointments, errands, leaving the house. Anything slipping?

Back / Spine

38 CFR §4.71a · DC 5237–5243
  • So it's your back. Tell me about the pain — where it sits and what it stops you from doing.
  • Bend forward for me as far as you comfortably can. How far do you get — toes, shins, knees? Where does it stop you?
  • Do you get muscle spasms or guarding — and has it changed how you walk? Limp, cane, anything like that?
  • Has it cost you anything at work — missed days, light duty, a job you had to give up?
  • In the last 12 months, has a doctor ever put you on prescribed bed rest for it? Any flare-ups that take you off your feet?
  • Does the pain travel — shooting down your buttock or leg, numbness or tingling in the foot?

Knee

38 CFR §4.71a · DC 5257/5260/5261
  • Tell me about the knee. What does it do to you on a normal day — stairs, kneeling, distance walking?
  • Is this one knee, or both?
  • How far can you bend it? Can you squat, or get your heel toward your backside?
  • Does it ever give way or buckle on you? Do you wear a brace or use anything for support?
  • Any locking, swelling after activity, or times it's stopped you from work or duties?

Migraines

38 CFR §4.124a · DC 8100
  • Tell me about the headaches. When one hits, what actually happens — can you push through, or does it put you down?
  • How often do you get one that bad — the kind where you have to stop everything?
  • How long do they last, and what's the fallout — missed work, cancelled plans?
  • Are you on anything for them — preventives, triptans? Do they control it?

Sleep apnea

38 CFR §4.97 · DC 6847
  • Have you had a sleep study? What did they find?
  • Were you prescribed a CPAP or similar breathing device? Do you use it?
  • During the day — do you fight sleepiness? Nodding off at a desk, at lights, mid-conversation?
  • Does the tiredness leak into function — naps to get through the day, focus slipping, any close calls driving?

Tinnitus

38 CFR §4.87 · DC 6260
  • Tell me about the ringing — is it there most days? One ear or both?
  • Does it mess with sleep or concentration? And any trouble hearing people in noisy rooms?

Hypertension

38 CFR §4.104 · DC 7101
  • Do you know your typical blood pressure — recent readings, like one-forty over ninety?
  • Are you on blood pressure medication? And were the high readings on record before the meds started?
  • Any symptoms that come with it — headaches, dizziness — or doctor visits about it this year?

GERD / Acid reflux

38 CFR §4.114 · DC 7346
  • How often does the reflux actually hit — the burning, the acid coming up?
  • Are you on medication for it — and does it actually control it?
  • Any trouble swallowing, food sticking, choking at night, or pain that runs into your chest, arm, or shoulder?
  • Anything bigger — weight you've lost without trying, vomiting, ever any blood?

Shoulder

38 CFR §4.71a · DC 5201
  • Which shoulder — and is that your dominant side?
  • Raise the arm for me as far as it goes. Where does it stop — over your head, shoulder height, below that?
  • What does it cost you day to day — overhead work, lifting, sleeping on that side?
  • Any dislocations, or a feeling it's going to pop out? Clicking, guarding?

Ankle

38 CFR §4.71a · DC 5271
  • Tell me about the ankle — stiffness, pain, how far it moves compared to the other one.
  • Does it roll or give out on you? Braces, wraps, careful on stairs?
  • What does it change — running, distance walking, uneven ground, work on your feet?

Plantar fasciitis

38 CFR §4.71a · DC 5269
  • One foot or both? And walk me through the first steps out of bed in the morning.
  • What have you tried — inserts, stretching, injections, surgery? Did any of it actually fix it?
  • How long can you stand or walk before it forces you off your feet?

Asthma

38 CFR §4.97 · DC 6602
  • How often are you actually using the inhaler — every day, or just when it flares?
  • In the last year — any courses of oral steroids like prednisone, ER trips, or doctor visits for flare-ups?
  • What sets it off, and what does it stop you from doing — stairs, exertion, cold air, work?

Painful scars

38 CFR §4.118 · DC 7804
  • How many scars are we talking about — and which ones actually hurt to the touch, or break down?
  • Any of them on your head, face, or neck? Any that are wide, raised, or that people notice?
  • Do any of them limit motion or function — tightness when you bend, reach, grip?

Any other condition

38 CFR Part 4 · your condition's own DC applies
  • Tell me what we're looking at today — the condition, and when it started relative to your service.
  • How often does it hit, and how long does it last when it does?
  • On a bad day with it — what does it actually stop you from doing?
  • What's the treatment — meds, devices, therapy — and does it actually control it?
  • Last one — has it cost you at work? Days, duties, a job?

Hearing loss

38 CFR §4.85 · DC 6100
  • How is your hearing in daily conversations — do you ask people to repeat themselves, turn up the TV, or struggle in noisy rooms?
  • Do you use hearing aids, and do they fully correct the problem or still leave gaps?
  • If you've had an audiogram, what did they tell you about your decibel loss or word recognition scores?

Diabetes mellitus

38 CFR §4.119 · DC 7913
  • How is your diabetes managed — restricted diet, oral pills, or daily insulin injections?
  • Has your doctor ordered regulation of activities — like avoiding strenuous physical exertion, scheduled meals, or stress avoidance to prevent severe low blood sugar?
  • How often do you see your doctor for your diabetes, and have you had any episodes of ketoacidosis or ER visits?

Radiculopathy / Nerve pain

38 CFR §4.124a · DC 8520
  • Do you have shooting pain, numbness, or tingling radiating down your leg or arm — and how far down does it go?
  • Does the nerve damage cause weakness — like tripping, foot drop, dropping coffee cups, or legs giving out?
  • How often does the nerve pain flare up, and does it interfere with walking, driving, or sleeping?

Traumatic Brain Injury (TBI)

38 CFR §4.124a · DC 8045
  • Tell me about the head injury or blast exposure — did you lose consciousness, get dazed, or diagnosed with a concussion in service?
  • How are your memory, concentration, and executive function now — following multi-step tasks, managing money, remembering names?
  • Have you experienced mood changes, irritability, light/noise sensitivity, or frequent headaches since the injury?

Reading is recon.
Rehearsal is training.

Run the simulator until the whole truth is your first answer. Run a mock appointment