DC 7305 · 38 CFR 4.114
Stomach and Duodenum (Ulcers / Gastritis) C&P Exam Prep
To document the current severity of your stomach or duodenal condition (ulcers, gastritis, or related disorders) so the VA can assign an accurate disability rating under 38 CFR - 4.114. The examiner will assess your diagnosis, symptom frequency and severity, treatment requirements, complications, and functional impact on daily life and work.
- Format:
- Interview + Physical
- Typical duration:
- 20-30 minutes
- DBQ form:
- stomach-and-duodenum (stomach-and-duodenum)
- Examiner:
- Gastroenterologist or Physician
What the examiner evaluates
- Current confirmed diagnosis (e.g., peptic ulcer disease, chronic gastritis, H. pylori infection, Zollinger-Ellison syndrome, drug-induced gastritis)
- Frequency, severity, and duration of symptom episodes including abdominal pain, nausea, vomiting, and diarrhea
- History of complications such as perforation, hemorrhage, obstruction, or anemia requiring hospitalization
- All current medications prescribed specifically for the stomach/duodenal condition
- Dietary modifications medically required due to the condition
- Surgical history including gastrectomy, vagotomy, pyloroplasty, or gastroenterostomy
- Post-gastrectomy syndrome symptoms including dumping syndrome, alkaline gastritis, and persistent diarrhea
- Laboratory results including CBC, hemoglobin, hematocrit, and H. pylori testing
- Endoscopy, radiographic, MRI, CT, and biopsy findings
- Functional impact on employment, daily activities, and quality of life
- Relationship of current condition to service or to a service-connected condition
The exam will consist of a structured interview reviewing your medical history and current symptoms, followed by a focused abdominal physical examination. Bring all current medications in their original bottles. The examiner will review service treatment records, VA treatment records, and any private medical records on file. You have the right to request that the exam be recorded in most states - check your state's laws beforehand.
Measurements and tests
Upper Endoscopy (EGD) Review
What it measures: Direct visualization of the stomach and duodenal lining to confirm ulcers, gastritis, erosions, bleeding sources, or stenosis
What to expect: The examiner will review the results of any prior upper endoscopy reports. A new endoscopy is unlikely to be ordered at the C&P exam itself but prior findings are critical documentation.
Critical thresholds
- Active ulcer or erosion confirmed Supports higher rating levels; confirms active disease for DC 7304/7305
- Post-surgical changes (gastrectomy, pyloroplasty) May trigger rating under DC 7303 chronic complications of upper GI surgery
- Stenosis confirmed May be rated under DC 7309, referenced to DC 7303 or 7304
Tips
- Bring copies of all endoscopy reports with dates and findings
- Note whether endoscopy was performed during a flare or between episodes
- If endoscopy showed normal findings during remission, mention that symptoms still occur between procedures
Pain considerations: N/A - diagnostic imaging review only
Complete Blood Count (CBC)
What it measures: Hemoglobin, hematocrit, white blood cell count, and platelets - used to assess for anemia secondary to GI bleeding or chronic disease
What to expect: The examiner may review recent lab results on file or order labs. Low hemoglobin or hematocrit values support a finding of anemia related to your stomach/duodenal condition.
Critical thresholds
- Hemoglobin below normal range (typically <12 g/dL for women, <13.5 g/dL for men) Supports finding of anemia; may require hospitalization, elevating severity rating
- Hematocrit below normal range Corroborates GI blood loss and severity of condition
Tips
- Bring copies of any recent CBC results from your treating provider
- Note any history of blood transfusions due to GI bleeding
- Mention if your doctor has monitored your blood counts specifically because of your stomach condition
Pain considerations: Anemia from GI blood loss can cause fatigue, weakness, and lightheadedness - describe these symptoms accurately as they reflect functional severity
H. pylori Testing
What it measures: Confirms the presence of Helicobacter pylori infection, which is a recognized cause of peptic ulcer disease and chronic gastritis (included under DC 7307)
What to expect: The examiner will review prior H. pylori test results (breath test, stool antigen, endoscopic biopsy, or serology). Document whether you were treated and whether eradication was confirmed.
Critical thresholds
- Positive H. pylori with persistent symptoms despite treatment Supports ongoing active disease and continued treatment requirement
- Eradicated but recurrent symptoms Supports residual chronic gastritis or peptic ulcer disease rating
Tips
- Know the date and type of your H. pylori test
- Know whether you completed eradication therapy and if a follow-up test confirmed clearance
- Report ongoing symptoms even after H. pylori treatment, as the gastritis or ulcer may persist
Pain considerations: N/A - laboratory test review
Upper GI Radiographic Studies / Barium Study
What it measures: Evaluates structural abnormalities of the stomach and duodenum including ulcer craters, stenosis, delayed gastric emptying, or post-surgical anatomy
What to expect: The examiner will review any upper GI series on file. These studies document objective structural findings that support your diagnosis.
Critical thresholds
- Demonstrated ulcer niche or deformity Objective confirmation of peptic ulcer disease
- Gastric outlet obstruction or stenosis Supports rating under DC 7309 or elevated rating under DC 7304
Tips
- Bring reports from any barium swallow or upper GI series
- Mention if imaging was done during a symptomatic period versus between episodes
Pain considerations: N/A - imaging review
Abdominal Physical Examination
What it measures: Assesses tenderness, guarding, organomegaly, and signs of complications on physical examination of the abdomen
What to expect: The examiner will palpate your abdomen in multiple quadrants, assess for epigastric tenderness, and note any abnormal findings. Describe any pain or discomfort during examination.
Critical thresholds
- Epigastric tenderness on palpation Objective finding supporting active symptomatic disease
- Rebound tenderness or guarding May suggest acute flare or complication
Tips
- Do not take extra pain medication before the exam that could mask your typical discomfort
- If the exam is on a relatively good day, say so explicitly
- Describe where your pain typically is located and whether it matches what the examiner finds on palpation
Pain considerations: Verbally report your pain level during palpation. Describe if the examiner's touch reproduces your typical epigastric or upper abdominal pain.
Rating criteria by percentage
100%
Chronic symptoms of pain, vomiting, hematemesis (vomiting blood) or melena (tarry stools) with substantial weight loss; or recurrent incapacitating episodes averaging 10 or more days per month requiring continuous total parenteral nutrition (TPN) for a period longer than 2 months, or continuous tube feeding for a period longer than 2 months
Key symptoms
- Recurrent hematemesis (vomiting blood)
- Melena (tarry black stools indicating GI bleeding)
- Severe, chronic abdominal pain with vomiting
- Substantial weight loss due to condition
- Requiring continuous TPN or tube feeding for more than 2 months
- Manifestations of severe anemia requiring hospitalization
- Persistent partial bowel obstruction
- Clinical evidence of recurrent obstructions requiring hospitalization
From 38 CFR: Under DC 7304 (Peptic Ulcer Disease), the 100% level requires chronic symptoms of pain, vomiting, hematemesis, or melena with substantial weight loss, or requires continuous total parenteral nutrition or tube feedings for longer than 2 months. Chronic gastritis (DC 7307) is rated as peptic ulcer disease under DC 7304.
60%
Periodic vomiting, pain uncontrolled by standard therapy, and considerable weight loss; or two or more incapacitating episodes per year of abdominal pain, nausea or vomiting lasting 1-4 weeks; or severe post-gastrectomy symptoms including dumping syndrome, alkaline gastritis with confirmed persistent diarrhea, or post-operative complications following confirmation
Key symptoms
- Periodic vomiting managed by medication
- Epigastric pain not controlled by standard therapy
- Considerable weight loss
- Two or more incapacitating episodes per year lasting 1-4 weeks
- Severe dumping syndrome (postprandial lightheadedness or syncope)
- Discomfort or pain within one hour of eating requiring ongoing treatment
- Symptoms of alkaline gastritis with confirmed persistent diarrhea
- Post-operative complications following confirmation
From 38 CFR: DC 7304 at the 60% level covers periodic vomiting, pain uncontrolled by standard therapy with considerable weight loss, or two or more incapacitating episodes per year averaging 1-4 weeks in duration. Post-gastrectomy syndrome symptoms such as dumping syndrome map to this level under DC 7305.
40%
Recurrent episodes of nausea and vomiting after meals, or typical abdominal cramping with changes in bowel habits; or one incapacitating episode per year; or symptoms managed with continuous medication and dietary modification
Key symptoms
- Recurrent nausea after meals
- Vomiting requiring medication management
- Abdominal cramping (colic)
- Diarrhea or watery bowel movements
- One incapacitating episode per year lasting 1-4 weeks
- Ongoing requirement for prescription medications
- Medically directed dietary modification
From 38 CFR: DC 7304 at 40% covers symptoms requiring continuous medication and dietary modification with recurrent symptomatic episodes. Conditions rated analogously to DC 7304 (including chronic gastritis under DC 7307) are assessed at this level when symptoms are persistent but not incapacitating multiple times per year.
20%
Two or more symptomatic episodes per year of abdominal distress, or continuous symptoms manageable with diet modification, or intermittent nausea without vomiting; history of peptic ulcer disease documented by endoscopy or radiology
Key symptoms
- Periodic abdominal distress or pain
- Intermittent nausea without vomiting
- Symptoms controlled with dietary modification only
- Documented history of peptic ulcer disease
- Oral dietary modification required
- Symptoms present but not requiring continuous medication
From 38 CFR: DC 7304 at 20% recognizes documented peptic ulcer disease with symptomatic episodes manageable with dietary adjustment. This level applies when symptoms are present and recurring but controlled without continuous pharmacologic intervention.
0%
Post-operative asymptomatic; condition present and documented but currently causing no symptoms; service connection established but no ratable disability
Key symptoms
- Asymptomatic with documented history
- Post-surgical with no current symptoms
- No current dietary restrictions or medication required
- No symptomatic episodes in the past year
From 38 CFR: DC 7304 at 0% (non-compensable) applies when the condition is documented and service-connected but produces no current disability. For post-gastrectomy syndrome (DC 7305), a 0% rating may apply when the veteran is post-operative and asymptomatic.
Describing your symptoms accurately
Abdominal Pain
How to describe it: Describe the location (epigastric, upper abdomen, diffuse), character (burning, gnawing, cramping, stabbing), timing (before meals, after meals, at night, constant), severity on a 0-10 scale, and what makes it better or worse. Report your worst days, not just your average days.
Example: On my worst days, I have a severe burning pain in my upper abdomen that starts about 30 minutes after eating and lasts 2-3 hours. The pain is a 7-8 out of 10 and stops me from working, concentrating, or doing any physical activity. I have to lie down and I often can't eat at all because I know it will trigger the pain.
Examiner listens for: Specific location and radiation of pain, relationship to meals, frequency of severe episodes, interference with work and daily activities, and whether standard medications adequately control the pain.
Avoid: Do not say 'it's not that bad' or 'I just deal with it.' Do not only describe your average days - specifically address your worst days as the VA rates based on the full range of your disability, including worst-case presentations.
Nausea and Vomiting
How to describe it: Describe how often nausea occurs (daily, several times per week, after every meal), whether it leads to vomiting, how long episodes last, and whether they are managed by medication. Note any vomiting of blood (hematemesis) or coffee-ground material, which is a critical symptom.
Example: During a bad flare, I feel nauseated every time I eat and often vomit within an hour of meals. During my worst episodes, this happens daily for 1-2 weeks straight and I can barely keep food down. I have to take prescription anti-nausea medication just to function.
Examiner listens for: Frequency and severity of nausea and vomiting, whether vomiting is managed with medication, any blood in vomit, weight loss associated with vomiting, and impact on ability to maintain nutrition.
Avoid: Veterans often forget to mention blood in vomit or coffee-ground material out of embarrassment or normalize it. This is a critical symptom that can support a 100% rating - always report it if it has occurred.
Dietary Restrictions and Weight Loss
How to describe it: Describe all foods you must avoid due to your condition, whether your doctor specifically instructed dietary changes, whether you have lost weight as a result, and how dietary restrictions affect your social life, work, and family meals.
Example: I cannot eat spicy foods, fatty foods, alcohol, caffeine, or large meals without triggering severe symptoms. My doctor has directed me to eat 5-6 small meals per day. I have lost 15 pounds over the past year because eating triggers so much pain and nausea that I avoid eating when possible.
Examiner listens for: Whether dietary modification is medically directed (not just a personal preference), amount of weight loss and timeframe, whether dietary restrictions limit normal daily functioning and social activities.
Avoid: Do not minimize weight loss or dietary restrictions as 'just watching what I eat.' If your doctor prescribed specific dietary modifications, state that clearly - this is a medically directed intervention that supports higher rating levels.
Diarrhea, Bowel Changes, and Dumping Syndrome
How to describe it: Describe frequency of diarrhea or watery bowel movements, whether they are explosive or unpredictable, whether they occur postprandially (right after eating), any lightheadedness or near-fainting after meals (dumping syndrome), and how these symptoms affect your ability to work and leave the house.
Example: After my stomach surgery, I have explosive diarrhea within 30 minutes of eating almost every meal. I get lightheaded and sometimes feel like I am going to pass out after eating. I cannot go anywhere without knowing exactly where the nearest bathroom is. This has caused me to miss work and avoid social situations entirely.
Examiner listens for: Whether diarrhea is persistent and confirmed, frequency per day, whether diarrhea is explosive or unpredictable, presence of dumping syndrome (postprandial lightheadedness or syncope), and functional impact on daily life.
Avoid: Veterans with post-gastrectomy syndrome often underreport dumping symptoms because they assume it is 'normal' after surgery. These symptoms are specifically rated under DC 7305 and can support 60% or higher ratings.
Incapacitating Episodes
How to describe it: An incapacitating episode is a period of symptoms severe enough to require bed rest and treatment by a physician. Describe how many times per year you have such episodes, how long they last, whether they required emergency room visits or hospitalization, and what treatment was required.
Example: About three times a year I have episodes that last 10-14 days where I cannot get out of bed due to severe abdominal pain, constant vomiting, and inability to eat. I went to the ER twice last year and was hospitalized once for IV fluids and pain management. During these periods I cannot work or care for myself.
Examiner listens for: Number of incapacitating episodes per year, duration of each episode in days or weeks, whether physician treatment was required, hospitalizations, and impact on employment and daily functioning.
Avoid: Do not count only hospitalizations as 'incapacitating episodes.' Any period where you required bed rest and physician treatment qualifies, even if treated at home with prescription medications.
Medications and Treatment Burden
How to describe it: List all medications you take specifically for your stomach or duodenal condition (PPIs, H2 blockers, antacids, antibiotics for H. pylori, antiemetics, antidiarrheals, etc.), how long you have been on them, and whether they fully control your symptoms. Mention side effects that affect your functioning.
Example: I take omeprazole 40mg twice daily, famotidine at bedtime, and prescription ondansetron for nausea. Even on these medications I still have breakthrough symptoms 3-4 days per week. The medications partially help but do not fully control my pain or nausea.
Examiner listens for: Whether medications are prescribed specifically for the condition, whether symptoms persist despite medication (uncontrolled by standard therapy), duration of medication use, and whether treatment requirements are continuous.
Avoid: Do not say medications are 'working fine' if you still have symptoms. Partial control of symptoms is still evidence of severity. The VA needs to know whether standard therapy fully controls your condition or leaves residual disability.
Functional Impact on Work and Daily Life
How to describe it: Describe how your condition affects your ability to perform your job, maintain regular attendance, complete physical tasks, socialize, travel, maintain relationships, and care for yourself. Be specific about activities you can no longer do or must modify.
Example: My stomach condition has caused me to miss 2-3 days of work per month on average. I cannot eat lunch at work because it triggers symptoms during the afternoon. I have had to leave work early multiple times due to sudden severe nausea and vomiting. I avoid social events involving food because I am embarrassed by my symptoms and cannot predict when they will occur.
Examiner listens for: Specific work limitations, frequency of missed work or reduced productivity, social and recreational limitations, and whether the condition causes embarrassment or social withdrawal that further limits functioning.
Avoid: Veterans often omit impact on social and recreational activities, focusing only on paid employment. The VA evaluates all functional domains. Report impact on hobbies, family activities, travel, and social participation.
Common mistakes to avoid
Describing only average or good days during the exam
Why: VA ratings under M21-1 guidance should reflect the full range of the disability including worst presentations. Examiners are required to consider the 'worst day' scenario, but they can only do so if you describe it.
Do this instead: Proactively tell the examiner: 'On my worst days, which occur approximately X times per month...' and give specific examples of your most severe episodes. Then separately describe your typical day.
Impact: All levels - most critical at 40% vs. 60% boundary
Failing to report hematemesis (vomiting blood) or melena (tarry stools)
Why: These symptoms are explicitly listed as criteria for the 100% rating level under DC 7304. Veterans often normalize these symptoms or are embarrassed to report them. Even past occurrences are relevant.
Do this instead: Report any instance of blood in vomit or black tarry stools, including historical episodes. Bring emergency room or hospital records documenting these events if available.
Impact: 100%
Describing dietary modifications as personal choices rather than medically directed restrictions
Why: The DBQ specifically distinguishes between 'oral dietary modification' that is medically directed and personal food preferences. Only medically directed modifications count toward the rating criteria.
Do this instead: State clearly: 'My gastroenterologist specifically instructed me to avoid [foods] and to eat [specific diet].' Reference the doctor who gave the dietary instructions by name and specialty if possible.
Impact: 20% and 40%
Understating or failing to count incapacitating episodes accurately
Why: The number and duration of incapacitating episodes directly determine the rating level (0, 1, or 2+ per year at different duration thresholds). Veterans often forget episodes or fail to recognize bed-rest periods as 'incapacitating.'
Do this instead: Keep a symptom diary before your exam. Count every episode where you required bed rest and physician treatment, including ER visits, urgent care, prescription changes, and periods where you could not work or perform daily activities.
Impact: 40% vs. 60% vs. 100%
Not mentioning post-gastrectomy syndrome symptoms if you have had stomach surgery
Why: Post-gastrectomy syndrome (DC 7305) includes dumping syndrome, alkaline gastritis, and persistent diarrhea - symptoms that are rated separately and can reach 100% if severe enough. Veterans often attribute these symptoms to 'normal' post-surgery effects.
Do this instead: Specifically describe any postprandial lightheadedness, near-syncope, explosive diarrhea, or persistent abdominal pain after eating that developed following stomach surgery. These are ratable symptoms under DC 7305.
Impact: All levels for DC 7305; particularly 60% and above
Failing to list all medications taken for the condition
Why: Continuous medication requirement is a rating criterion. If you take medications but don't list them, the examiner may not recognize the treatment burden.
Do this instead: Bring all medications in original bottles. Verbally list every medication taken for the stomach condition and how long you have been taking it. Include over-the-counter medications if your doctor recommended them specifically for the condition.
Impact: 20% through 60%
Not bringing objective medical evidence (endoscopy reports, lab results, imaging)
Why: The DBQ requires the examiner to document test results. If you don't bring records, the examiner may only have VA records on file which may be incomplete or outdated.
Do this instead: Bring copies of all endoscopy reports, upper GI series results, H. pylori test results, CBC results, and any hospitalization records related to your stomach condition. Organize them chronologically.
Impact: All levels - objective evidence supports the claimed diagnosis and severity
Failing to describe functional impact on employment and daily activities
Why: The DBQ includes a specific section on functional impact. The VA is required to consider how the condition affects your ability to work and perform daily functions. Without this information, the nexus between symptoms and disability is incomplete.
Do this instead: Prepare specific examples of how your condition has affected your job performance, attendance, ability to travel, social activities, and family responsibilities. Quantify where possible (e.g., 'I miss 2-3 days of work per month').
Impact: All levels - critical for overall rating determination
Prep checklist
- critical
Gather all medical records related to your stomach/duodenal condition
Collect all endoscopy (EGD) reports, upper GI radiographic study reports, CT/MRI results, biopsy results, H. pylori test results, CBC lab results, and any hospitalization records. Organize these chronologically. Include both VA and private provider records.
before exam
- critical
Create a written symptom diary documenting the past 12 months
Record each symptomatic episode with dates, duration, symptoms experienced, severity (0-10), treatment required, and impact on work/daily activities. Count the number of incapacitating episodes (bed rest required) and their duration in days. Bring this written record to the exam.
before exam
- critical
Compile a complete medication list with dosages and duration
List every medication taken for your stomach/duodenal condition including prescription PPIs (omeprazole, pantoprazole, esomeprazole), H2 blockers (famotidine, ranitidine), sucralfate, antibiotics (for H. pylori), antiemetics, antidiarrheals, and any other GI-specific medications. Note how long you have been on each and whether they fully control symptoms.
before exam
- critical
Document all dietary modifications and who directed them
Write down every food restriction your doctor has directed, the name of the provider who gave the dietary instruction, and how the dietary modification has affected your daily life, social activities, and nutrition. Distinguish between medically directed modifications and personal preferences.
before exam
- critical
Write a concise narrative of your condition history from onset to present
Document when symptoms first began, whether they started during or shortly after service, what events may have triggered or worsened the condition (medications, stress, infections), hospitalizations, surgeries, and how the condition has progressed. Include any periods of improvement and subsequent worsening.
before exam
- recommended
Research your right to record the examination in your state
Many states allow veterans to record their C&P examination. Check your state's recording consent laws. If allowed, bring a recording device or use your smartphone. Notify the examiner at the start of the exam. A recording can protect you if the DBQ inaccurately reflects what you reported.
before exam
- recommended
Review the rating criteria under 38 CFR - 4.114 (DC 7304/7305/7307)
Understand what symptoms correspond to each rating level (0%, 20%, 40%, 60%, 100%) so you can ensure you communicate all relevant symptoms. Pay particular attention to the incapacitating episode criteria (number per year, duration per episode) and the specific symptoms required for each level.
before exam
- recommended
Prepare a written list of functional limitations for work and daily life
List specific ways your condition has affected your job (missed days, reduced duties, inability to eat at work, having to leave early), social life (avoiding restaurants, travel limitations, social withdrawal), and family life (inability to share meals, cook, or participate in family activities). Quantify whenever possible.
before exam
- recommended
Contact your treating gastroenterologist about a supporting nexus letter
Ask your treating gastroenterologist or primary care provider to write a nexus letter connecting your stomach/duodenal condition to your military service, or a letter documenting current severity if service connection is already established. A buddy statement from a family member or coworker who witnesses your symptoms can also be valuable.
before exam
- critical
Do not take extra pain medication or antacids that could artificially suppress your symptoms
Take only your prescribed maintenance medications as directed. Do not take additional doses of antacids, pain relievers, or anti-nausea medications beyond your normal regimen before the exam. The examiner needs to assess your condition as it typically presents.
day of
- critical
Bring all medications in their original prescription bottles
Having the actual bottles allows the examiner to accurately document all medications, dosages, and prescribing providers. This provides objective evidence of the treatment burden and that medications are prescribed for your specific condition.
day of
- critical
Bring printed copies of all medical records organized chronologically
Do not rely on the VA to have pulled all relevant records. Bring a complete organized packet. Having documents on hand ensures they are reviewed and referenced in the DBQ. Consider using a binder with tabs for each category (endoscopy, labs, hospitalizations, medications).
day of
- recommended
Arrive early and review your symptom notes before entering the exam room
Review your written symptom diary and key points you want to communicate. Anxiety about the exam can cause you to forget important symptoms. Having notes in front of you is entirely appropriate - you can refer to them during the exam.
day of
- critical
If asked 'how are you doing today?' clarify this is not a typical day
Examiners sometimes open with this casual question. If today is not representative of your worst days, say so immediately: 'Today is a relatively better day for me. My condition is much worse on bad days, which happen approximately X times per month.' Then describe your worst days.
day of
- critical
Volunteer all symptoms from the DBQ checklist, do not wait to be asked
If the examiner does not ask about specific symptoms (hematemesis, melena, explosive diarrhea, dumping syndrome, dietary modification, incapacitating episodes), volunteer this information. Say: 'I also want to make sure you are aware that I experience [symptom].'
during exam
- critical
Describe your worst-day symptoms explicitly and distinguish from average days
Use language such as: 'On my worst days, which happen about [X] times per month, I experience [specific symptoms] for approximately [duration]. On an average day, I experience [milder symptoms].' This ensures the full range of your disability is documented.
during exam
- critical
Report any history of hematemesis (blood in vomit) or melena (black tarry stools)
These symptoms are specific rating criteria for the 100% level. Even if these occurred in the past and not recently, report them with dates if known. Say: 'I have had episodes of vomiting blood on [dates] and sought treatment at [facility].' Bring any ER or hospital records documenting these events.
during exam
- critical
Quantify incapacitating episodes with specific numbers and durations
Tell the examiner the exact number of incapacitating episodes in the past year and how many days each lasted. Example: 'I had three incapacitating episodes this year lasting 10 days, 14 days, and 7 days respectively, during which I required bed rest and contacted my physician for treatment adjustments.'
during exam
- recommended
Report functional impact on employment with specific examples
Tell the examiner how many days of work you have missed due to your condition, any job duties you cannot perform, and whether you have had to change jobs or reduce hours due to your stomach condition. If unemployed, state that your condition contributes to your inability to maintain employment.
during exam
- recommended
If you have had surgery, specifically describe all post-gastrectomy symptoms
Describe any dumping syndrome (lightheadedness, faintness, rapid heart rate after eating), explosive diarrhea, alkaline reflux symptoms, or persistent abdominal pain following stomach surgery. These symptoms are specifically ratable under DC 7305 and may be overlooked if you do not proactively report them.
during exam
- recommended
Write detailed notes about the exam immediately after leaving
Document what questions were asked, what symptoms were and were not discussed, whether the examiner seemed to have sufficient time to complete a thorough evaluation, and your overall impression. Note if the examiner rushed the exam, dismissed symptoms, or failed to ask about key DBQ areas. This record is valuable for any future appeals.
after exam
- recommended
Request a copy of the completed DBQ from the VA
Once your exam is complete and your rating decision is made, request a copy of the completed DBQ through your VSO, accredited claims agent, or directly from the VA. Review it carefully to ensure all symptoms you reported are accurately documented. Inaccuracies or omissions can be the basis for a supplemental claim or appeal.
after exam
- optional
If the exam was inadequate, consider requesting a new examination
If the exam lasted less than 10 minutes, the examiner did not review your records, key symptoms were not addressed, or the DBQ is factually inaccurate, you have the right to challenge the adequacy of the exam. Contact your VSO or accredited attorney/claims agent to evaluate whether to request a new C&P examination.
after exam
Your rights during a C&P exam
- You have the right to have a VSO, accredited claims agent, or accredited attorney present during your C&P examination as an observer.
- You have the right to request that the C&P examination be recorded in most states - research your state's one-party or two-party consent laws before the exam.
- You have the right to submit a personal statement (VA Form 21-4138) or lay statement describing your symptoms and functional limitations before or after the exam.
- You have the right to submit buddy statements from family members, coworkers, or fellow veterans who have personally observed your symptoms and their impact on your daily functioning.
- You have the right to submit private medical evidence, including an independent medical opinion or nexus letter from your own treating provider, which the VA must consider.
- You have the right to request a copy of the completed DBQ after your rating decision is issued and to challenge factual inaccuracies in the examination report.
- You have the right to challenge the adequacy of a C&P examination if it was not thorough, if the examiner did not review available records, or if the DBQ does not accurately reflect what you reported.
- You have the right to a Supplemental Claim if new and relevant evidence is obtained after a denial, including new medical records, a new nexus letter, or new lay evidence.
- Under the PACT Act and prior regulations, veterans who served in specific locations or were exposed to certain substances may have presumptive service connection eligibility - consult your VSO about whether any presumptives apply to your GI condition.
- You have the right to a Higher-Level Review if you believe the VA made an error in applying the law or facts of your case without submitting new evidence.
- You are not required to prove your condition is 100% caused by service - only that service is at least as likely as not (50% or greater probability) a contributing factor.
- Under 38 CFR - 3.102 (benefit of the doubt), when evidence is in approximate balance, the VA must resolve all reasonable doubt in favor of the veteran.
Related conditions
- Chronic Gastritis (H. pylori, Drug-Induced, Zollinger-Ellison) DC 7307 (Chronic Gastritis) is rated analogously to DC 7304 (Peptic Ulcer Disease). H. pylori infection, drug-induced gastritis, Zollinger-Ellison syndrome, and portal-hypertensive gastropathy are all included under DC 7307. The same symptom criteria and rating percentages apply.
- Post-Gastrectomy Syndrome DC 7305 covers complications following stomach surgery including dumping syndrome, alkaline gastritis, and persistent diarrhea. Veterans who have had gastrectomy, vagotomy, or pyloroplasty for peptic ulcer disease may have both a primary ulcer rating (DC 7304) and a post-gastrectomy syndrome rating (DC 7305) if distinct symptoms are present.
- Chronic Complications of Upper GI Surgery (DC 7303) DC 7303 covers chronic complications following upper gastrointestinal surgery. Stenosis of the stomach (DC 7309) may be rated analogously to DC 7303. If your stomach condition required surgery with resulting chronic complications, this diagnostic code may apply.
- Stenosis of the Stomach (DC 7309) DC 7309 (Stomach Stenosis) is rated analogously to DC 7303 or DC 7304, depending on which produces the predominant disability. Gastric outlet obstruction from peptic ulcer scarring is a common cause. The examiner will document any persistent partial bowel obstruction or recurrent obstructions requiring hospitalization.
- Gastroesophageal Reflux Disease (GERD) GERD frequently coexists with peptic ulcer disease and gastritis and is rated under esophageal diagnostic codes (DC 7203). If you have both upper GI and esophageal symptoms, separate diagnostic codes may apply and separate claims should be considered.
- Iron Deficiency Anemia secondary to GI bleeding Chronic GI blood loss from peptic ulcer disease or gastritis can cause iron deficiency anemia, which may be separately ratable as a condition secondary to your stomach condition. If your CBC shows low hemoglobin and hematocrit and you have a history of GI bleeding, discuss this relationship with your VSO.
- Functional Digestive Disorders / GI Dysmotility Functional digestive disorders (DC 7319) and GI dysmotility disorders may be associated with or secondary to peptic ulcer disease or chronic gastritis. If you have been diagnosed with these conditions by your treating provider, they may require separate DBQ sections and diagnostic codes.
- PTSD / Mental Health Conditions Psychological stress from PTSD and other mental health conditions is a recognized aggravating factor for peptic ulcer disease and gastritis. If you have a service-connected mental health condition, document the relationship between stress and GI flare-ups, as this may support both the nexus argument and claims for secondary service connection.
Get a personalized prep packet
This guide covers what to expect for any veteran with this condition. If you have already uploaded your medical records, sign in to generate a packet that maps your specific symptoms to the DBQ fields your examiner will fill out.
This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.