C&P Exam Terminology Glossary — DBQ & Examiner Language

Mental health (§4.130 DBQ)

• Affect — the outward expression of emotion. 'Flattened' means almost no expression; 'restricted' means narrower-than-normal range; 'labile' means rapidly shifting.
• Anhedonia — loss of pleasure in activities normally enjoyed.
• Avoidance — going out of one's way to bypass reminders of trauma.
• Circumstantial speech — excessive unnecessary detail before arriving at the point.
• Circumlocutory speech — talking around a topic without addressing it directly.
• Stereotyped speech — repetitive, rigid phrasing.
• Dissociation — a sense of detachment from oneself or the surroundings.
• Emotional numbing — reduced range of feeling, including positive feelings.
• Flight of ideas — thoughts moving rapidly from one topic to another with thin connections.
• Hypervigilance — constant scanning for threats; an exaggerated startle response.
• Ideation, suicidal — thoughts of suicide, with or without a plan or intent.
• Intrusive thoughts / re-experiencing — unwanted memories, flashbacks, nightmares.
• Mood — sustained emotional state ('depressed,' 'anxious,' 'irritable,' 'euthymic').
• Psychomotor agitation — restlessness, pacing, inability to sit still.
• Psychomotor retardation — slowed movement and speech.
• Thought broadcasting/insertion — believing one's thoughts are heard by others or placed in one's mind.

Functional capacity

• ADLs (Activities of Daily Living) — bathing, dressing, feeding, toileting, transferring, continence.
• IADLs (Instrumental Activities of Daily Living) — managing finances, medications, transportation, meals, housekeeping.
• Occupational impairment — effect on the ability to obtain and maintain substantially gainful employment.
• Social impairment — effect on the ability to maintain effective relationships.

Musculoskeletal (§4.71a DBQ)

• Range of motion (ROM) — measured in degrees; compared against normal values.
• DeLuca factors — pain, weakness, fatigability, incoordination, and lack of endurance during flare-ups and repetitive use. VA must consider functional loss beyond initial ROM (DeLuca v. Brown, 1995; Mitchell v. Shinseki, 2011).
• Flare-ups — periodic worsening; the examiner should estimate additional functional loss during a flare even if not observed at exam.
• Crepitus — palpable or audible grinding or crackling in a joint.
• Effusion — swelling from fluid accumulation.
• IVDS (Intervertebral Disc Syndrome) — disc-related spine condition rated by frequency and duration of incapacitating episodes.
• Bilateral factor — a 10% additional adjustment when paired left/right extremities are both service-connected (38 CFR §4.26).
• Painful motion — pain on motion that limits function is rated as if the joint were limited at that point of pain (Mitchell).

Neurological

• Paresthesia — abnormal sensation (tingling, pins-and-needles, numbness).
• Hyperesthesia / hypoesthesia — increased / decreased sensitivity to stimuli.
• Radiculopathy — nerve root irritation producing pain or numbness along a nerve distribution.
• Sciatica — radiculopathy of the sciatic nerve.
• Vertigo — sensation of spinning or movement.
• Aura — sensory disturbance preceding a migraine.
• Prostrating attack — a migraine severe enough to require lying down and avoiding all stimuli.

Respiratory

• FEV1 — forced expiratory volume in 1 second (pulmonary function test).
• FVC — forced vital capacity.
• FEV1/FVC — ratio used to characterize obstructive disease.
• DLCO — diffusing capacity of the lungs for carbon monoxide.
• Exacerbation — flare-up of a chronic condition (asthma, COPD).
• PRN (pro re nata) — as-needed medication, in contrast to scheduled daily medication; affects respiratory ratings.

Cardiac

• METs (metabolic equivalents) — measure of exertional capacity used in cardiac ratings.
• Ejection fraction — percentage of blood pumped out of the left ventricle with each beat (normal ~55-70%).
• NYHA class — functional classification of heart-failure severity.

Audiological

• Puretone threshold — softest sound heard at each frequency (in decibels).
• Speech discrimination (Maryland CNC) — percentage of single-syllable words correctly identified at a controlled volume.
• Tinnitus — perception of sound (ringing, buzzing) without an external source.

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