DC 7307 · 38 CFR 4.114
Stomach and Duodenum (Ulcers / Gastritis) C&P Exam Prep
To document the current severity of your stomach and duodenal condition (chronic gastritis, peptic ulcer disease, or related disorders) so that VA can assign a disability rating under 38 CFR - 4.114, DC 7307 (rated as DC 7304 peptic ulcer disease). The examiner will evaluate the frequency, severity, and duration of your symptoms, any complications such as bleeding or obstruction, surgical history, 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 diagnosis and ICD code (e.g., chronic gastritis, H. pylori infection, drug-induced gastritis, peptic ulcer disease)
- Symptom frequency, severity, and character (abdominal pain, nausea, vomiting, diarrhea, constipation, colic)
- Presence and history of serious complications: hematemesis (vomiting blood), melena (tarry stools), GI bleeding requiring hospitalization
- History of peptic ulcer disease documented by endoscopy or radiology
- Episodes of abdominal pain, nausea, or vomiting lasting days to weeks
- Continuous abdominal pain with intermittent vomiting
- Surgical history: gastrectomy, vagotomy with pyloroplasty, gastroenterostomy, surgery for perforation or hemorrhage
- Post-gastrectomy syndrome, post-operative complications, alkaline gastritis
- Stomach stenosis, persistent partial bowel obstruction
- Nutritional support requirements: total parenteral nutrition (TPN), tube feedings
- Current medications used to treat the condition
- Dietary modifications required due to the condition
- Laboratory results: CBC, hemoglobin, hematocrit, H. pylori testing
- Imaging and procedures: upper GI radiographic studies, upper endoscopy, CT, MRI, biopsy
- Functional impact on occupation and daily activities
- Hospitalization history related to the condition
- Presence of Zollinger-Ellison syndrome, portal hypertensive gastropathy with varix-related complications
- Whether the condition is asymptomatic or symptomatic
The exam will primarily be an interview and review of medical records. A physical examination of the abdomen may be performed. You may be examined in person or via telehealth. Bring all relevant medical records, medication lists, and any private treatment records not already in your VA file. You have the right to request that the exam be recorded in most states.
Measurements and tests
Upper Endoscopy (EGD) Review
What it measures: Direct visualization of the esophagus, stomach, and duodenum to identify ulcers, gastritis, erosions, bleeding sources, stenosis, or malignancy
What to expect: The examiner will review prior endoscopy reports. They may note date performed, findings (active ulcer, scarring, H. pylori status, biopsies), and whether the condition has been confirmed by this gold-standard diagnostic method.
Critical thresholds
- Active ulcer or erosive gastritis documented Supports diagnosis; severity of symptoms and complications drive the rating percentage
- History of bleeding or perforation documented May support higher ratings (60-100%) if associated with hospitalization or anemia
Tips
- Know the date(s) of any endoscopies you have had and what was found
- Bring or ensure VA has copies of all endoscopy and pathology reports
- If H. pylori was detected, know whether you were treated and whether it was eradicated
- Note if your symptoms persisted even after H. pylori eradication or medication treatment
Pain considerations: Endoscopy results confirm the organic basis for your pain; describe how your pain and symptoms match what was found on endoscopy
H. pylori Testing
What it measures: Presence of Helicobacter pylori bacteria, a recognized cause of chronic gastritis and peptic ulcer disease included under DC 7307
What to expect: The examiner will review H. pylori test results (urea breath test, stool antigen, serology, or biopsy). They will note date of test and results.
Critical thresholds
- Positive H. pylori confirmed Establishes diagnosis under DC 7307 (H. pylori infection explicitly listed); supports service connection nexus if exposure occurred in-service
- Persistent symptoms despite successful H. pylori eradication Demonstrates ongoing disability independent of infection; important for continued rating justification
Tips
- Know whether you have ever tested positive for H. pylori
- Know the treatment you received (triple therapy, quadruple therapy) and whether a test-of-cure was performed
- If still symptomatic after eradication, emphasize ongoing symptom burden to the examiner
Pain considerations: H. pylori infection causes epigastric pain, bloating, and nausea; accurately describe these symptoms even if infection has been treated
Complete Blood Count (CBC) - Hemoglobin, Hematocrit, Platelets
What it measures: Assesses for anemia (low hemoglobin/hematocrit) resulting from GI bleeding associated with peptic ulcer disease or severe gastritis
What to expect: The examiner will review most recent CBC values including hemoglobin, hematocrit, white blood cell count, and platelets. Anemia requiring hospitalization is a specific rating criterion.
Critical thresholds
- Hemoglobin below normal requiring hospitalization or transfusion Manifestations of anemia requiring hospitalization support a 60% or higher rating
- Recurrent anemia without hospitalization requirement Supports moderate-to-severe rating; document all episodes of low blood counts
Tips
- Know your most recent hemoglobin and hematocrit values
- If you have ever been hospitalized for GI bleeding or anemia, document the dates and facilities
- Mention if you have experienced fatigue, dizziness, or shortness of breath due to low blood counts
Pain considerations: Anemia from GI bleeding causes fatigue, weakness, and reduced exercise tolerance - describe these functional impacts clearly
Upper GI Radiographic Studies / CT / MRI Review
What it measures: Imaging studies that may identify ulcers, stenosis, motility disorders, obstruction, or structural abnormalities of the stomach and duodenum
What to expect: The examiner will review any upper GI series, CT scans, or MRI results. Dates and findings will be documented on the DBQ.
Critical thresholds
- Evidence of stenosis or obstruction Persistent partial bowel obstruction or stomach stenosis may support higher rating levels
- Evidence of prior perforation or complications Post-surgical complications and residuals support higher rating levels
Tips
- Bring or ensure VA has access to imaging reports and CDs if applicable
- Know when your last imaging studies were performed
- If imaging showed narrowing, ulcer craters, or structural changes, be prepared to describe associated symptoms
Pain considerations: Imaging findings that correlate with your symptoms strengthen the connection between your structural disease and functional complaints
Rating criteria by percentage
100%
Chronic gastritis / peptic ulcer disease rated at 100% under DC 7304. Requires: recurrent hematemesis (vomiting blood) or melena (tarry stools) with manifestations of anemia requiring hospitalization; OR persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation; accompanied by hemorrhage requiring hospitalization, or continuous marked impairment of digestion and absorption of food with resultant profound weight loss.
Key symptoms
- Recurrent vomiting of blood (hematemesis)
- Tarry/black stools (melena)
- Manifestations of anemia requiring hospitalization
- Continuous abdominal pain with intermittent vomiting
- Profound weight loss from inability to absorb/digest food
- Repeated hemorrhage episodes requiring hospital admission
- Requirement for total parenteral nutrition (TPN) or continuous tube feedings
From 38 CFR: Under DC 7304 (applied via DC 7307): 100% requires recurrent hematemesis or melena with anemia requiring hospitalization, or persistent severe digestive impairment with hemorrhage and profound weight loss.
60%
Chronic gastritis / peptic ulcer disease rated at 60% under DC 7304. Requires: two or more of the following - pain not relieved by standard ulcer regimen; vomiting; symptoms of obstruction; or manifestations of anemia. Also includes: clinically documented episodes requiring hospitalization, post-gastrectomy syndrome with confirmed complication, or persistent diarrhea after surgery.
Key symptoms
- Epigastric pain not relieved by standard antacid/PPI regimen
- Recurrent vomiting
- Symptoms of gastric outlet obstruction (early satiety, bloating, regurgitation)
- Manifestations of anemia (fatigue, pallor, low hemoglobin)
- Persistent diarrhea post-surgically
- Recurrent hospitalizations for GI complications
- Post-gastrectomy syndrome with confirmed alkaline gastritis or complications
- Significant weight loss
- Discomfort or pain within one hour of eating requiring ongoing medical management
From 38 CFR: Under DC 7304 (applied via DC 7307): 60% requires two or more of: pain not relieved by standard ulcer regimen, vomiting, symptoms of obstruction, or anemia manifestations.
40%
Chronic gastritis / peptic ulcer disease rated at 40% under DC 7304. Requires: recurrent episodes of stomach pain and vomiting that occur two or more times yearly, OR history of peptic ulcer disease documented by endoscopy or X-ray, with pain not relieved by standard treatment regimen and requiring frequent medical management.
Key symptoms
- Recurrent episodes of epigastric pain occurring 2 or more times per year
- Pain not fully controlled by standard PPI/antacid regimen
- Episodes of nausea and vomiting
- Episodes lasting days to weeks requiring increased medication
- History of documented peptic ulcer disease by endoscopy or radiology
- Intermittent diarrhea or colic
- Dietary modifications required to manage symptoms
- Moderate interference with work or daily activities during episodes
From 38 CFR: Under DC 7304 (applied via DC 7307): 40% requires recurrent stomach pain and vomiting episodes at least twice yearly; or history of peptic ulcer documented by endoscopy/radiology with pain not fully controlled by standard treatment.
20%
Chronic gastritis / peptic ulcer disease rated at 20% under DC 7304. Requires: two or more of the following - epigastric distress after meals, pyrosis (heartburn), regurgitation, constipation, or other digestive symptoms occurring consistently but manageable with medication and/or dietary modification.
Key symptoms
- Epigastric discomfort after meals
- Heartburn (pyrosis)
- Regurgitation
- Belching or bloating
- Constipation
- Nausea without vomiting
- Abdominal pain managed with daily medication
- Symptoms requiring oral dietary modification
- Mild to moderate interference with daily activities
From 38 CFR: Under DC 7304 (applied via DC 7307): 20% requires two or more symptoms including epigastric distress after meals, pyrosis, regurgitation, or constipation that are consistently present but manageable.
0%
Condition is present (service-connected) but currently asymptomatic, or symptoms are so mild and infrequent that they do not meet the threshold for a compensable rating. A 0% (noncompensable) rating still establishes service connection and preserves the right to seek an increased rating in the future if the condition worsens.
Key symptoms
- Condition confirmed by prior endoscopy or lab test but currently asymptomatic
- Rare, very mild episodes not requiring medication
- No dietary modifications required
- No functional impairment
From 38 CFR: Under DC 7304 (applied via DC 7307): 0% is assigned when the diagnosis is confirmed but the veteran does not currently meet the symptom criteria for 20% or higher.
Describing your symptoms accurately
Abdominal Pain
How to describe it: Describe the location (epigastric, upper abdomen, diffuse), character (burning, gnawing, sharp, cramping), severity on a 1-10 scale, timing relative to meals (before, during, or after eating), duration of each episode, and how often it occurs per week or month. Indicate whether food, antacids, or PPIs help or worsen the pain. Report your worst episodes, not just your average days.
Example: On my worst days, I have a constant burning, gnawing pain in my upper abdomen that starts about 30 minutes after eating and lasts for 3-4 hours. The pain is a 7-8 out of 10 and prevents me from concentrating at work or sleeping through the night. Antacids provide only partial relief. This happens at least 3-4 times per week.
Examiner listens for: Frequency of pain episodes (multiple times per week vs. occasional), whether standard antacid/PPI regimen controls the pain, relationship to meals, whether the pain is disabling or merely uncomfortable, and whether the pain has led to dietary restriction or work limitations.
Avoid: Do not say 'my stomach bothers me sometimes' or 'it's not that bad.' Describe specific frequency, severity, and functional impact. Do not minimize pain because you take medication - the examiner needs to know how your condition behaves even on medication.
Nausea and Vomiting
How to describe it: Report how often nausea occurs (daily, weekly, in episodes), whether it results in vomiting, frequency of vomiting episodes, and whether vomiting is managed by medication or diet. Note if vomiting has ever contained blood (hematemesis). Report the worst episodes and describe how nausea and vomiting interfere with eating, working, and daily activities.
Example: During my worst flares, I am nauseated from the time I wake up. I vomit 2-3 times in a day, which prevents me from eating more than a few bites. This has happened multiple times this year and has caused me to miss work. Even when I take anti-nausea medication, I still feel sick most of the afternoon.
Examiner listens for: Whether vomiting is managed by medication, frequency of vomiting episodes per year, whether there has been any blood in vomit, and how vomiting affects nutritional intake and work capacity.
Avoid: Do not omit episodes of nausea that did not result in vomiting - nausea alone affects your ability to eat and function. Do not say 'I just get a little sick sometimes.' Quantify frequency and impact.
GI Bleeding (Hematemesis / Melena)
How to describe it: If you have ever vomited blood or had black, tarry stools, describe each episode: when it occurred, how much blood was present, whether you were hospitalized, what treatment was received, and whether it has recurred. This is a critical factor for 100% rating. Report accurately - do not exaggerate, but do not minimize either.
Example: In [month/year], I vomited a significant amount of bright red blood and was admitted to [facility] for 3 days. I required IV fluids and my hemoglobin dropped to [value]. I was told I had a bleeding ulcer. I have also had episodes of black, tarry stools on [dates].
Examiner listens for: Number of episodes, whether hospitalizations were required, whether anemia resulted, whether the condition has been recurrent, and whether bleeding episodes are ongoing or in the past.
Avoid: Do not downplay or omit any prior bleeding episodes. If you had black stools or vomited material that looked like coffee grounds, report this - these are signs of GI bleeding that directly affect your rating.
Diarrhea, Constipation, and Bowel Changes
How to describe it: Describe frequency of loose or watery stools per day or week, urgency, whether bowel movements are explosive or unpredictable, whether constipation alternates with diarrhea, and how these symptoms affect your ability to leave home, work, or engage in social activities. Note if you have had post-surgical bowel changes (e.g., after gastrectomy or vagotomy).
Example: On bad days, I have 5-6 watery bowel movements that I cannot predict or control. I have had accidents because I could not reach the bathroom in time. This makes it impossible for me to travel, attend meetings, or leave the house without knowing where every bathroom is.
Examiner listens for: Frequency and consistency of bowel movements, urgency and predictability, whether diarrhea is a post-surgical complication, and whether symptoms are managed by medication or dietary restriction.
Avoid: Do not omit diarrhea because it seems unrelated to gastritis - post-gastritis and post-surgical diarrhea are explicitly rated under DC 7307/7304. Report urgency and accidents accurately.
Dietary and Nutritional Impact
How to describe it: Describe all dietary modifications you have made because of your condition: foods you cannot eat, meal sizes you must restrict, frequency of eating (small frequent meals), foods that trigger symptoms, and any weight loss attributable to your stomach condition. Note if a doctor has prescribed a specific diet.
Example: I have lost [X] pounds over the past [X] months because eating causes severe pain. I can only tolerate small amounts of plain food at a time. I have eliminated spicy food, caffeine, alcohol, and acidic foods entirely on my doctor's advice. I carry antacids everywhere and often skip meals to avoid the pain.
Examiner listens for: Whether dietary modification is medically directed, whether it is oral modification only or involves tube feeding or TPN, the degree of nutritional restriction, and whether weight loss is present and attributable to the GI condition.
Avoid: Do not say 'I just watch what I eat' without explaining the extent of restriction. Medically directed dietary modification is a specific DBQ field that can affect your rating. Quantify weight loss with actual numbers.
Functional and Occupational Impact
How to describe it: Describe how your condition affects your ability to work, including time missed from work, inability to perform job duties during flares, restrictions on physical activity, and impact on daily activities such as driving, socializing, sleeping, and caring for yourself or family. Connect specific symptoms to specific limitations.
Example: During flares, I miss 1-2 days of work per month because the pain and vomiting make it impossible to function. I cannot sit through a full workday without needing to lie down. I have asked to be reassigned from physical tasks because eating at work triggers pain. I wake up 2-3 nights per week from stomach pain.
Examiner listens for: How the condition limits occupational and daily functioning, whether limitations are consistent or only during flares, and whether the veteran has sought accommodations or changed jobs due to their condition.
Avoid: Do not say 'I manage okay' if your condition affects your work or daily life. The examiner must document functional impact - if you downplay it, the DBQ will not reflect the true severity of your disability.
Common mistakes to avoid
Describing only average or good days
Why: VA rates the condition based on its overall impact, including worst-day functioning. M21-1 guidance supports reporting the full range of symptom severity.
Do this instead: Explicitly describe your worst days. Say: 'On my worst days, which occur [X times per month], I experience...' and provide specific, concrete details.
Impact: All levels - particularly the difference between 20% and 40%, and 40% and 60%
Failing to mention all symptoms because some seem minor
Why: DC 7304 (applied via DC 7307) requires two or more symptoms for several rating levels. Omitting symptoms like constipation, heartburn, or nausea can prevent you from meeting multi-symptom thresholds.
Do this instead: Prepare a written list of all symptoms - abdominal pain, nausea, vomiting, diarrhea, constipation, colic, heartburn, regurgitation, bloating - and report every one that applies to you.
Impact: 20% and 40% - these ratings require two or more symptoms simultaneously
Not mentioning prior hospitalizations or ER visits
Why: Hospitalizations for GI bleeding, anemia, or obstruction are explicit criteria for 60% and 100% ratings. Failing to disclose them causes the examiner to miss critical rating criteria.
Do this instead: Before your exam, compile a list of all hospitalizations, ER visits, and urgent care visits related to your stomach condition, including dates and facilities.
Impact: 60% and 100%
Saying symptoms are 'controlled' by medication without explaining breakthrough symptoms
Why: Medication use is not disqualifying for higher ratings. The fact that you require daily medications to manage your condition is itself evidence of severity. Breakthrough symptoms matter.
Do this instead: Explain both that you take medication AND that you still have symptoms despite medication. Describe what happens when medication wears off or during flares.
Impact: 40% and 60%
Failing to connect current symptoms to in-service events or exposure
Why: The examiner completes the nexus opinion for service connection, but you need to provide the history. If you don't mention the in-service onset, the examiner cannot document it.
Do this instead: Clearly describe when your stomach symptoms first began in relation to your military service, any in-service treatment you received (sick call, gastroscopy, medications), and the continuous nature of symptoms since service.
Impact: Service connection - affects all rating levels
Not mentioning dietary restrictions as medically directed
Why: Oral dietary modification is a specific DBQ checkbox. If you say 'I just avoid spicy food' without noting this was directed by a doctor, the examiner may not check the medically directed box.
Do this instead: State clearly: 'My doctor told me to avoid [specific foods] and eat [specific way] to manage my condition.' Reference specific physician instructions or dietitian consultations.
Impact: 20% and 40%
Omitting weight loss or minimizing its significance
Why: Significant weight loss from inability to absorb or digest food is a criterion for higher ratings. Failing to report it or attribute it to your stomach condition can result in underrating.
Do this instead: Report your current weight, your weight before your condition worsened, and the timeframe of weight loss. Explicitly state that your doctor attributes the weight loss to your GI condition.
Impact: 60% and 100%
Not bringing documentation of all prior GI procedures and endoscopies
Why: History of peptic ulcer disease documented by endoscopy or radiology is a specific criterion for 40% rating. Without these records, the examiner cannot confirm the documented history.
Do this instead: Request copies of all endoscopy reports, upper GI series results, and pathology reports from all treating facilities, including non-VA providers, and bring them to the exam.
Impact: 40% - specifically requires endoscopic or radiologic documentation
Prep checklist
- critical
Compile a complete list of all GI symptoms
Write down every stomach and digestive symptom you experience: abdominal/epigastric pain, nausea, vomiting, diarrhea, constipation, heartburn, regurgitation, colic, bloating, blood in vomit or stool, black/tarry stools, loss of appetite, early satiety, and any weight loss. Note frequency, severity (1-10 scale), and duration for each.
before exam
- critical
Gather all endoscopy, upper GI, and imaging reports
Collect all prior upper endoscopy (EGD) reports, upper GI series results, CT scans, MRI reports, and biopsy pathology reports from VA and non-VA providers. Ensure your VA file contains these records or bring copies. Confirmed endoscopic or radiologic documentation of ulcer disease is a specific 40% rating criterion.
before exam
- critical
Document all hospitalizations and ER visits for GI conditions
List every hospitalization, ER visit, or urgent care visit related to your stomach condition: date, facility, reason (GI bleeding, ulcer flare, vomiting, obstruction, anemia), and treatment received. This information is critical for 60% and 100% rating criteria.
before exam
- critical
Compile a current medication list with dosages
List all medications you take for your GI condition: proton pump inhibitors (PPIs), H2 blockers, antacids, sucralfate, antibiotics (for H. pylori), anti-nausea medications, motility agents, and any other related medications. Include dosage and frequency. The examiner will document these on the DBQ.
before exam
- critical
Document in-service GI treatment and history
Review your service treatment records for any documentation of stomach pain, gastritis, ulcers, or GI complaints during service. Note dates of sick call visits, any in-service endoscopy or imaging, and any medications prescribed during service for GI conditions. This supports the nexus for service connection.
before exam
- critical
Record H. pylori test results and treatment history
Know whether you have ever tested positive for H. pylori, what treatment you received, whether eradication was confirmed, and whether symptoms persisted afterward. H. pylori infection is explicitly listed under DC 7307.
before exam
- recommended
Document dietary modifications and weight changes
Write down all foods/beverages you have eliminated or restricted due to your condition. Note whether these changes were medically directed by a physician or dietitian. Record your current weight, prior weight, and the timeframe/amount of any weight loss attributable to your GI condition.
before exam
- recommended
Identify all surgical procedures related to your stomach/duodenum
If you have had any surgeries - gastrectomy (partial or total), vagotomy with pyloroplasty, gastroenterostomy, surgery for perforation, or any other GI surgery - document the dates, type of procedure, facility, and any post-surgical complications or residual symptoms.
before exam
- recommended
Prepare a written worst-day symptom statement
Write a brief paragraph describing your worst day with your stomach condition: what symptoms occur, how severe they are, how long they last, and how they prevent you from working or performing daily activities. Bring this to read or reference if needed during the exam.
before exam
- optional
Research your state's exam recording laws
Most states allow veterans to record their C&P exam. Check your state's one-party vs. two-party consent laws. If recording is allowed, bring a recording device and notify the examiner at the start of the exam.
before exam
- critical
Attend the exam even if feeling better than usual
C&P exams often fall on a day when symptoms are mild. Do not cancel because you are having a good day. Inform the examiner that today may not represent your typical condition, and focus your descriptions on the full range of your symptoms, including your worst days.
day of
- recommended
Do not eat a heavy meal before the exam
Your stomach condition may cause symptoms after eating. While you should not fast if it is unsafe, being aware that eating before the exam may exacerbate or suppress symptoms is important. Discuss any pre-exam dietary changes with your doctor.
day of
- critical
Bring all documentation to the exam
Bring your symptom list, medication list, surgical history, endoscopy reports, hospitalization records, H. pylori test results, and any private medical records not in your VA file. Organize them for easy reference.
day of
- recommended
Arrive early and review your symptom notes
Arrive 10-15 minutes early. Review your written symptom list and worst-day statement before entering so the information is fresh. The exam is typically 20-30 minutes, so be prepared to communicate efficiently.
day of
- critical
Describe your worst days, not your best or average days
When the examiner asks about your symptoms, describe the full spectrum including your worst episodes. Say explicitly: 'On my worst days, which happen [X times per month], I experience [specific symptoms at specific severity].' This is consistent with M21-1 guidance on reporting.
during exam
- critical
Report ALL symptoms - do not self-edit
Report every symptom on your list, even if it seems minor. DC 7304 (applied via DC 7307) uses a multi-symptom threshold at the 20% and 40% levels. Omitting any symptom can prevent you from meeting the threshold for a higher rating.
during exam
- critical
Describe functional and occupational impact specifically
Tell the examiner exactly how your condition affects your ability to work, including time missed, restrictions, and accommodations. Describe impact on daily activities: sleeping, eating, driving, socializing, caring for yourself or family. The DBQ has a functional impact field that directly influences the rating.
during exam
- recommended
Confirm the examiner reviews all submitted records
Ask the examiner to confirm they have reviewed your service treatment records, VA medical records, and any private records you submitted. If they have not, politely note this for the record.
during exam
- critical
Clarify if you are a former prisoner of war (FPOW)
If you are a former POW, peptic ulcer disease is subject to special rating provisions under M21-1, Part VIII, Subpart iv, 2.D.5.d. Ensure you identify your FPOW status to the examiner so it is noted in the DBQ.
during exam
- recommended
Document what occurred during the exam
Immediately after the exam, write down what questions were asked, what you reported, what the examiner said or observed, how long the exam lasted, and whether the examiner reviewed your records. This documentation can be important if you need to appeal the exam results.
after exam
- recommended
Request a copy of the completed DBQ
You have the right to request a copy of the completed DBQ. File a request through the VA or your VSO. Review it for accuracy once received - if the examiner's findings do not accurately reflect what you reported, this can be grounds for a supplemental claim or appeal.
after exam
- recommended
Consider a nexus letter from your treating physician
If service connection has not been established, ask your treating gastroenterologist or primary care physician to write a nexus letter explaining the medical opinion that your stomach condition is related to your military service. This is especially important if your in-service records are limited.
after exam
- recommended
Continue medical treatment and document ongoing symptoms
Continue all scheduled GI appointments and ensure all symptoms are documented in your medical records. If your condition worsens after the exam, file for an increased rating with updated medical evidence.
after exam
Your rights during a C&P exam
- You have the right to record your C&P examination in most states under applicable one-party or two-party consent laws. Research your state's law before the exam and notify the examiner if you choose to record.
- You have the right to request a copy of the completed DBQ form after the examination is finalized.
- You have the right to submit a written statement (lay statement/buddy statement) describing your symptoms, their impact on your daily life, and their history, which VA must consider as evidence.
- You have the right to submit private medical opinions and nexus letters from your treating physicians, which carry evidentiary weight in your claim.
- You have the right to request a new C&P examination if you believe the original exam was inadequate - for example, if the examiner did not review your records, the exam was too brief to capture your full symptom burden, or the DBQ contains factual errors.
- You have the right to appeal any rating decision you disagree with through the Supplemental Claim, Higher-Level Review, or Board of Veterans' Appeals pathways under the Appeals Modernization Act (AMA).
- VA has a duty to assist you in obtaining relevant medical records, including service treatment records, VA medical records, and private records you authorize VA to request.
- You have the right to have a Veterans Service Organization (VSO) representative, accredited claims agent, or accredited attorney assist you with your claim at no charge (for VSO representatives).
- Under the benefit of the doubt standard (38 CFR - 3.102), when there is an approximate balance of positive and negative evidence regarding any issue material to your claim, VA must resolve the question in your favor.
- If you are a former prisoner of war (FPOW), peptic ulcer disease is subject to special presumptive and rating provisions. Ensure your FPOW status is clearly documented in your claim file and communicated to the examiner.
- You have the right to submit a Fully Developed Claim (FDC) with all relevant evidence to potentially receive a faster decision.
- You may request that the examiner document your in-service nexus opinion in the DBQ remarks section if they believe your condition is related to your military service.
Related conditions
- Peptic Ulcer Disease DC 7307 (Chronic Gastritis) is rated as DC 7304 (Peptic Ulcer Disease). The rating criteria, symptom thresholds, and percentage levels are identical. Understanding DC 7304 criteria is essential for DC 7307 claims.
- Helicobacter Pylori Infection H. pylori infection is explicitly listed as a condition included under DC 7307. If your chronic gastritis was caused or complicated by H. pylori, this is rated under the same diagnostic code.
- Stomach Stenosis DC 7309 (Stenosis of the Stomach) is rated as DC 7303 or DC 7304 depending on the predominant disability. Veterans with gastric outlet obstruction or post-ulcer stenosis may have this condition separately evaluated.
- Post-Gastrectomy Syndrome Veterans who have undergone gastrectomy for ulcer disease or gastritis complications may develop post-gastrectomy syndrome, including dumping syndrome, alkaline reflux gastritis, and nutritional deficiencies. These are evaluated as part of the DC 7307/7304 rating.
- Zollinger-Ellison Syndrome Zollinger-Ellison syndrome (gastrin-secreting tumor causing hypersecretion of stomach acid and recurrent ulcers) is explicitly included under DC 7307. If diagnosed, complete the relevant DBQ sections and ensure the ICD code is documented.
- Drug-Induced Gastritis Gastritis caused by NSAIDs, aspirin, steroids, or other medications (often service-related) is explicitly included under DC 7307. If your gastritis was caused or worsened by medications prescribed for a service-connected condition, secondary service connection may apply.
- Irritable Bowel Syndrome / Functional Digestive Disorders Veterans with chronic gastritis often have comorbid functional digestive disorders. DC 7307 covers functional digestive disorders as a separate checkbox condition on the DBQ. These may be independently ratable or evaluated as part of the overall GI disability picture.
- GI Dysmotility Disorders Gastrointestinal dysmotility disorders (including gastroparesis) may co-exist with or result from chronic gastritis or peptic ulcer disease. A separate DBQ section covers this condition. If gastroparesis is present, ensure it is evaluated independently or as a secondary condition.
- Anemia Secondary to GI Bleeding Iron deficiency or other anemia caused by recurrent GI bleeding from ulcers or gastritis may be separately ratable as a secondary service-connected condition. Manifestations of anemia requiring hospitalization are also a direct criterion for 100% rating under DC 7304.
- PTSD / Mental Health Conditions Psychological stress is a known exacerbating factor for peptic ulcer disease and gastritis. Veterans with PTSD or other mental health conditions may find GI symptoms worsen with psychological stress flares. While rated separately, the connection between mental health and GI symptoms is clinically relevant.
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.