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C&P Exam Prep: Peritoneal Adhesions
DBQ Overview
Interview + Physical- Form Name
- peritoneal-adhesions
- Form Code
- peritoneal-adhesions
- Page Count
- 4
- Examiner Type
- Gastroenterologist or Physician
- Estimated Duration
- 20-30 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To evaluate the current severity of peritoneal adhesions caused by surgery, trauma, inflammatory disease, or infection, and to determine how your symptoms impact daily functioning for VA disability rating purposes under 38 CFR 4.114, Diagnostic Code 7301.
What the examiner evaluates:
- Confirmed diagnosis of peritoneal adhesions and underlying etiology (surgery, trauma, infection, inflammatory disease)
- Presence and frequency of symptomatic episodes including abdominal pain, nausea, vomiting, colic, constipation, and diarrhea
- Whether adhesions are currently symptomatic or asymptomatic
- Presence of persistent partial bowel obstruction and whether it is inoperable or refractory to treatment
- Need for total parenteral nutrition (TPN) for obstructive symptoms
- Whether clinically-directed dietary modifications are required
- History of hospitalizations related to recurrent bowel obstruction (at least once per year is a key threshold)
- Organs involved: stomach, gallbladder, liver, small intestines, large intestines, pancreas, or other structures
- Prior surgeries and their outcomes as related to adhesions
- Current medications prescribed for symptom management
- Functional impact on occupational and daily activities
Exam may be conducted in person at a VA facility or contracted exam site, or via telehealth. You have the right to request an in-person exam if telehealth is offered but you believe your condition requires physical evaluation. Bring all relevant medical records, surgical reports, imaging results, and a list of current medications. Note your state's laws regarding recording of medical appointments if you wish to record.
Typical duration: 20-30 minutes
Abdominal Physical Examination
Palpable tenderness, guarding, distension, bowel sounds, and signs of obstruction or peritoneal irritation on physical exam of the abdomen.
What to expect:
The examiner will press on various areas of your abdomen to assess for pain, tenderness, and rigidity. They may listen with a stethoscope for bowel sounds. Inform the examiner of all areas that are tender, including areas that are only tender on deeper palpation.
Key thresholds:
- Tenderness with guarding or rebound — Supports symptomatic classification at 30%, 50%, or 80% depending on additional criteria
- No tenderness, no abnormal findings — May support 0% asymptomatic rating if consistent with history
Tips:
- Do not hold back when the examiner presses on tender areas - communicate pain immediately and clearly
- Describe where exactly the pain is located (e.g., right lower quadrant, periumbilical, diffuse)
- If your pain fluctuates, explain that the exam is a single snapshot and does not reflect your worst days
- Mention if the pain is worse after eating, physical activity, or bowel movements
Pain considerations: Peritoneal adhesion pain can be intermittent and may not be fully apparent during a single exam. Clearly state that pain levels vary and describe your worst episodes accurately. Mention if you have taken pain medications prior to the exam that may be masking your typical pain level.
Dietary Assessment and Nutritional Status Review
Whether you require medically-directed dietary modifications due to adhesion-related symptoms, or whether total parenteral nutrition (TPN) has been prescribed for obstructive symptoms.
What to expect:
The examiner will ask about your diet, any dietary restrictions prescribed by your physician, and whether you have ever required TPN. They will review your medical records for documentation of these interventions.
Key thresholds:
- Total parenteral nutrition (TPN) required for obstructive symptoms — Meets criteria for 80% rating under persistent partial bowel obstruction criteria
- Medically-directed dietary modification other than TPN documented — Required to qualify for 50% or 80% rating levels
- No dietary modification required — Maximum rating under this pathway is 30%
Tips:
- Bring written documentation from your physician prescribing dietary modifications (e.g., low-residue diet, soft diet, liquid diet orders)
- Describe specific foods you cannot eat and why
- If you self-restrict your diet due to symptoms even without formal medical instruction, clearly explain this and note that symptoms compel the restriction
- Distinguish between a general healthy diet and a medically necessary dietary modification
Pain considerations: Dietary changes are often driven by fear of pain or obstruction. Explain how eating certain foods predictably triggers abdominal pain, colic, nausea, or vomiting so the examiner understands the functional necessity of dietary restriction.
Hospitalization History Review
Whether you have been hospitalized for recurrent bowel obstruction at least once per year, which is a key threshold for the 80% rating level.
What to expect:
The examiner will review your treatment records and ask about emergency room visits, hospitalizations, and procedures related to bowel obstruction caused by adhesions.
Key thresholds:
- Hospitalization for obstruction at least once per year — Meets one required criterion for 80% rating level
- No hospitalizations but symptomatic with dietary modification — Supports 50% rating level
- Symptomatic without hospitalizations or dietary modification — Supports 30% rating level
Tips:
- Compile a complete list of all hospitalizations, ER visits, and urgent care visits related to bowel obstruction or severe adhesion symptoms
- Include dates, facilities, and diagnoses for each hospitalization
- If hospitalizations occurred at non-VA facilities, bring copies of discharge summaries
- Do not undercount - include all admissions even if brief
Pain considerations: Hospitalizations often represent your worst episodes. Describe what each hospitalization involved - pain severity, inability to keep food or liquids down, IV fluids required, nasogastric tube placement - so the examiner understands the severity of your obstructive episodes.
Bowel Obstruction Assessment
Whether you have a persistent partial bowel obstruction that is inoperable or refractory to treatment, which drives the highest rating tier.
What to expect:
The examiner will review imaging (CT scans, X-rays), surgical records, and notes from treating physicians to determine if obstruction is persistent, inoperable, and refractory to treatment.
Key thresholds:
- Persistent partial bowel obstruction, inoperable AND refractory to treatment — Meets criteria for 80% rating
- Persistent partial bowel obstruction requiring TPN — Meets criteria for 80% rating
- Recurrent obstructive episodes without persistent obstruction — May support 50% or 80% depending on hospitalization frequency and dietary modification
Tips:
- Bring imaging reports demonstrating bowel obstruction
- Obtain a letter from your treating physician documenting that obstruction is inoperable or refractory if applicable
- Describe how obstructive episodes present: inability to pass gas or stool, severe cramping, distension, vomiting
- Document any surgeries for adhesion lysis and whether they provided lasting relief
Pain considerations: Refractory bowel obstruction episodes involve severe pain. Describe the intensity (scale of 1-10), duration of episodes, what you cannot do during an episode, and how long recovery takes after each episode.
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 80% | Persistent partial bowel obstruction that is either (a) inoperable AND refractory to treatment, OR (b) requires total parenteral nutrition (TPN) for obstructive symptoms. Alternatively: symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease, or infection; AND clinical evidence of recurrent obstruction requiring hospitalization at least once per year; AND medically-directed dietary modification other than TPN; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. |
CFR: A veteran whose adhesions from a prior appendectomy cause recurrent small bowel obstructions requiring hospitalization three times per year, is on a medically-prescribed liquid diet, and has been told by their surgeon that further surgery is not advisable would meet the 80% criteria. |
| 50% | Symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease process (such as chronic cholecystitis or Crohn's disease), or infection, as determined by a healthcare provider; AND medically-directed dietary modification other than TPN; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. |
CFR: A veteran with adhesions following abdominal surgery who experiences frequent abdominal cramping and nausea, has been placed on a low-residue diet by their gastroenterologist, but has not required hospitalization for obstruction in the past year, would meet the 50% criteria. |
| 30% | Symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease process (such as chronic cholecystitis or Crohn's disease), or infection, as determined by a healthcare provider; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. No medically-directed dietary modification required at this level. |
CFR: A veteran with post-surgical adhesions who reports intermittent abdominal cramping and alternating constipation and diarrhea confirmed by their physician, without a specific medically-directed dietary plan in place, would meet the 30% criteria. |
| 10% | History of peritoneal adhesions, currently asymptomatic. The veteran has a documented history of peritoneal adhesions but reports no current symptoms attributable to the condition. |
CFR: A veteran with a history of adhesions following service-connected abdominal surgery who currently reports no abdominal pain, nausea, vomiting, colic, constipation, or diarrhea attributable to adhesions would be rated at 10%. |
| 0% | No current peritoneal adhesions diagnosis or the condition does not meet the threshold for any compensable rating. May apply when the examiner cannot confirm a current diagnosis or the veteran has no symptoms and history is not clearly established. |
CFR: A veteran who had a suspected adhesion-related episode that resolved completely with no residual symptoms and no confirmed current diagnosis would receive a 0% non-compensable rating. |
80% Persistent partial bowel obstruction that is either (a) inop ...
Persistent partial bowel obstruction that is either (a) inoperable AND refractory to treatment, OR (b) requires total parenteral nutrition (TPN) for obstructive symptoms. Alternatively: symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease, or infection; AND clinical evidence of recurrent obstruction requiring hospitalization at least once per year; AND medically-directed dietary modification other than TPN; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea.
Key Symptoms
- Persistent partial bowel obstruction confirmed by clinical evidence
- Inoperable obstruction OR obstruction refractory to all treatments
- Requirement for total parenteral nutrition (TPN)
- Recurrent obstruction requiring hospitalization at least once per year
- Medically-directed dietary modification (short of TPN)
- Abdominal pain, nausea, vomiting, colic, constipation, or diarrhea
CFR: A veteran whose adhesions from a prior appendectomy cause recurrent small bowel obstructions requiring hospitalization three times per year, is on a medically-prescribed liquid diet, and has been told by their surgeon that further surgery is not advisable would meet the 80% criteria.
50% Symptomatic peritoneal adhesions persisting or recurring aft ...
Symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease process (such as chronic cholecystitis or Crohn's disease), or infection, as determined by a healthcare provider; AND medically-directed dietary modification other than TPN; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea.
Key Symptoms
- Confirmed symptomatic peritoneal adhesions by healthcare provider
- Medically-directed dietary modification (other than TPN)
- Abdominal pain
- Nausea
- Vomiting
- Colic
- Constipation
- Diarrhea
CFR: A veteran with adhesions following abdominal surgery who experiences frequent abdominal cramping and nausea, has been placed on a low-residue diet by their gastroenterologist, but has not required hospitalization for obstruction in the past year, would meet the 50% criteria.
30% Symptomatic peritoneal adhesions persisting or recurring aft ...
Symptomatic peritoneal adhesions persisting or recurring after surgery, trauma, inflammatory disease process (such as chronic cholecystitis or Crohn's disease), or infection, as determined by a healthcare provider; AND at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. No medically-directed dietary modification required at this level.
Key Symptoms
- Confirmed symptomatic peritoneal adhesions by healthcare provider
- Abdominal pain
- Nausea
- Vomiting
- Colic (intestinal cramping/spasm)
- Constipation
- Diarrhea
CFR: A veteran with post-surgical adhesions who reports intermittent abdominal cramping and alternating constipation and diarrhea confirmed by their physician, without a specific medically-directed dietary plan in place, would meet the 30% criteria.
10% History of peritoneal adhesions, currently asymptomatic. The ...
History of peritoneal adhesions, currently asymptomatic. The veteran has a documented history of peritoneal adhesions but reports no current symptoms attributable to the condition.
Key Symptoms
- Documented history of peritoneal adhesions
- No current symptoms (asymptomatic at time of evaluation)
CFR: A veteran with a history of adhesions following service-connected abdominal surgery who currently reports no abdominal pain, nausea, vomiting, colic, constipation, or diarrhea attributable to adhesions would be rated at 10%.
0% No current peritoneal adhesions diagnosis or the condition d ...
No current peritoneal adhesions diagnosis or the condition does not meet the threshold for any compensable rating. May apply when the examiner cannot confirm a current diagnosis or the veteran has no symptoms and history is not clearly established.
Key Symptoms
- No confirmed current diagnosis of peritoneal adhesions
- No symptoms present
CFR: A veteran who had a suspected adhesion-related episode that resolved completely with no residual symptoms and no confirmed current diagnosis would receive a 0% non-compensable rating.
How to Describe Your Symptoms
Abdominal Pain
How to describe:
Describe the location (right lower quadrant, periumbilical, diffuse), character (cramping, sharp, dull, constant vs. intermittent), severity on a 0-10 scale, duration of episodes, and what triggers or worsens the pain (eating, physical activity, bowel movements, positional changes). Be specific about how often you experience pain per week or month.
Worst-day example:
“On my worst days, I experience severe, cramping abdominal pain rated 8-9 out of 10 that lasts several hours. The pain is so intense that I cannot stand upright and I have to lie still in bed. I cannot work, drive, or care for myself during these episodes. I have missed work multiple times because of this pain.”
What the examiner listens for:
The examiner is documenting whether abdominal pain is present as one of the qualifying symptoms under DC 7301, and assessing its impact on functioning. They need to confirm it is adhesion-related, not from an unrelated cause.
Understatements to avoid:
Do not say 'it's not that bad' or minimize your pain to seem stoic. Do not describe only your average days - describe your typical range including your worst episodes. Do not attribute pain to something unrelated to avoid 'complaining.'
Nausea
How to describe:
Explain how frequently you experience nausea, what triggers it (eating, pain episodes, physical activity), how long episodes last, and whether it interferes with eating, working, or daily activities. Note if nausea is associated with specific foods or times of day.
Worst-day example:
“On my worst days, I feel intensely nauseated from the moment I wake up. I cannot eat a full meal without becoming severely nauseated within 30 minutes. On these days I may not be able to eat at all and have lost significant weight during prolonged flare-ups.”
What the examiner listens for:
Nausea is one of the six qualifying symptoms under DC 7301. The examiner will note its presence, frequency, and whether it leads to vomiting or significantly impairs nutrition and daily function.
Understatements to avoid:
Do not say 'just a little nausea' if it significantly disrupts your day. Quantify how many days per week or month you experience nausea and how it affects your ability to eat, work, and function.
Vomiting
How to describe:
Describe frequency (times per week or month), whether it is projectile or effortless, whether it is triggered by eating or pain, whether it contains bile or blood, and whether it has led to weight loss, dehydration, or hospitalization.
Worst-day example:
“During my worst flare-ups, I vomit multiple times a day for two to three days in a row. I cannot keep any food or liquid down, become dehydrated, and have required IV fluids in the emergency room on several occasions.”
What the examiner listens for:
Vomiting is a qualifying symptom under DC 7301. The examiner also uses this to assess severity - repeated vomiting leading to hospitalization or dehydration supports higher rating levels.
Understatements to avoid:
Do not omit ER visits for dehydration related to vomiting. These hospitalizations may count toward the annual hospitalization criterion for the 80% rating level.
Colic (Intestinal Cramping/Spasm)
How to describe:
Colic refers to severe, wave-like cramping pain typically associated with intestinal spasm or partial obstruction. Describe the intensity, wave-like nature, duration, frequency, and whether it is accompanied by bloating, distension, or inability to pass gas or stool.
Worst-day example:
“The colic episodes come in waves every few minutes and are absolutely debilitating. My abdomen visibly distends and becomes board-like hard. I cannot pass gas or have a bowel movement during these episodes, which can last for hours. I have called 911 during the worst episodes.”
What the examiner listens for:
Colic is specifically listed as one of the six qualifying symptoms under DC 7301. The examiner will document its presence and severity, and assess whether it represents signs of partial bowel obstruction.
Understatements to avoid:
Do not confuse colic with general stomach upset and downplay it. This is a specific, severe symptom. If you experience wave-like intestinal cramping, use the word 'colic' and describe it fully as it directly maps to the rating criteria.
Constipation
How to describe:
Describe how many days you go without a bowel movement, whether you strain significantly, whether you take laxatives or stool softeners (prescribed or OTC), and whether constipation alternates with diarrhea. Note if constipation has ever led to obstipation (complete inability to pass stool or gas).
Worst-day example:
“During my worst periods, I go 7-10 days without a bowel movement. I take prescription laxatives daily but they often provide little relief. The constipation causes severe abdominal bloating and cramping that prevents me from wearing fitted clothing, sitting comfortably, or working a full day.”
What the examiner listens for:
Constipation is one of the six qualifying symptoms under DC 7301. The examiner will note its frequency and severity and whether it requires prescribed treatment, which may support the medically-directed dietary modification criterion.
Understatements to avoid:
Do not omit that you take laxatives or have dietary restrictions specifically to manage constipation. These interventions support the medically-directed modification criterion needed for the 50% and 80% rating levels.
Diarrhea
How to describe:
Describe frequency of loose or watery stools per day, urgency (whether you have accidents or near-accidents), whether it is related to eating, and whether it alternates with constipation. Note any dietary triggers you avoid and whether anti-diarrheal medications are prescribed.
Worst-day example:
“On my worst days, I have 8-10 episodes of watery diarrhea. I am afraid to leave my home because I cannot predict when an episode will hit. I have had accidents on the way to the bathroom and have stopped going out socially because of the unpredictability and embarrassment.”
What the examiner listens for:
Diarrhea is one of the six qualifying symptoms under DC 7301. The examiner will note frequency, severity, and functional impact including social and occupational limitations.
Understatements to avoid:
Do not underreport the frequency or omit social and occupational limitations caused by diarrhea. Functional impact on employment and quality of life is directly relevant to the examiner's functional impairment documentation.
Dietary Modifications
How to describe:
Be very specific about what dietary changes you make, whether they were prescribed by a physician, and what happens when you deviate from the diet. Bring written documentation such as a physician's note, dietitian instructions, or medical records referencing dietary restrictions.
Worst-day example:
“My gastroenterologist prescribed a strict low-residue diet. When I accidentally eat a high-fiber food, I experience severe cramping and colic within hours that can progress to a full obstruction episode requiring emergency care. I carry a list of forbidden foods everywhere I go.”
What the examiner listens for:
Medically-directed dietary modification is a gating criterion that separates the 30% from the 50% and 80% rating levels. The examiner must document that dietary modification was directed by a healthcare provider, not merely self-imposed.
Understatements to avoid:
Do not say you 'watch what you eat' without specifying it is medically directed. Bring a copy of the dietary prescription or physician note. Distinguish between general healthy eating and a medical necessity diet prescribed for your adhesions.
Functional Impact on Daily Life and Work
How to describe:
Describe specific activities you cannot do or have difficulty with: work duties missed, inability to lift, bend, or perform physical tasks, inability to eat at restaurants or social events, disruption of sleep, impact on personal relationships, and any accommodations required at work.
Worst-day example:
“My adhesion flare-ups have caused me to miss an average of 3-4 days of work per month. I cannot perform any job that requires physical activity, prolonged standing, or travel because I cannot predict when a severe episode will occur. I have been written up at work for absences and fear losing my job.”
What the examiner listens for:
The examiner completes DBQ field 96 documenting functional impact of each condition. This narrative directly influences the overall disability picture and is used by raters to consider a higher evaluation under 38 CFR 4.7 (benefit of the doubt) and TDIU considerations.
Understatements to avoid:
Do not say your condition 'doesn't really affect work' if it does. This field is your opportunity to paint an accurate picture of how the condition impacts your ability to maintain gainful employment and perform daily activities.
Common Mistakes to Avoid
Saying you are 'fine' or 'doing okay' when asked how you are at the start of the exam
This social reflex can be recorded as a statement about your condition and undermine your claim. The examiner may interpret this as an indication your symptoms are well-controlled.
Instead: Greet the examiner professionally but when asked about your health or condition, respond accurately: 'I continue to have significant problems with my adhesions, including [specific symptoms].'
Impact: All levels
Describing only your average or best days instead of your full range of symptoms
Per M21-1 guidance, VA raters must consider the full range of symptoms including worst-day presentations. Describing only mild or moderate days leads to an underestimate of true disability severity.
Instead: Explicitly tell the examiner: 'On my worst days, which occur approximately [X] times per month, I experience...' and provide your worst-day description in full detail.
Impact: 30%, 50%, 80%
Failing to connect dietary restrictions to a medical prescription or physician directive
The 50% and 80% rating levels require 'medically-directed dietary modification.' If you simply say you avoid certain foods without documenting it was prescribed, the examiner cannot check that criterion.
Instead: Bring a written prescription, physician note, or dietitian order. State clearly: 'My gastroenterologist prescribed a [low-residue/soft/liquid] diet on [date] because of my adhesion symptoms.'
Impact: 50%, 80%
Omitting ER visits, urgent care visits, or short hospital stays
The 80% rating requires hospitalization for recurrent obstruction at least once per year. Every qualifying visit counts, and omitting them may prevent you from meeting this critical threshold.
Instead: Compile a complete list of all hospital admissions and ER visits related to bowel obstruction, abdominal crises, or dehydration from vomiting/diarrhea. Bring discharge summaries when possible.
Impact: 80%
Not mentioning all six qualifying symptoms (pain, nausea, vomiting, colic, constipation, diarrhea) even if some are minor
The rating criteria require at least one of these six symptoms to be present. However, the number and severity of symptoms present influences the overall picture and should be fully documented.
Instead: Go through each of the six symptoms explicitly with the examiner. Do not assume they will ask about all of them. Proactively state which symptoms you experience and their frequency and severity.
Impact: 30%, 50%, 80%
Failing to bring documentation of the service-connected etiology (surgery, trauma, infection, inflammatory disease) that caused the adhesions
DC 7301 requires that adhesions be 'due to surgery, trauma, disease, or infection.' If the etiology is not clearly established in records reviewed, the examiner may leave the nexus question incomplete.
Instead: Bring service treatment records, operative reports, or post-service medical records documenting the qualifying event that caused your adhesions. Be prepared to describe when and how adhesions developed.
Impact: All levels
Accepting a telehealth exam without objection when a physical exam of the abdomen would be more appropriate
Peritoneal adhesions may benefit from physical examination including palpation for tenderness and assessment of bowel sounds. A telehealth exam cannot replicate physical findings.
Instead: If offered a telehealth exam, you may request an in-person examination. State that your condition involves abdominal symptoms that require physical examination for accurate assessment.
Impact: All levels
Not mentioning the functional impact on your ability to work or maintain employment
DBQ field 96 specifically asks for functional impact. If this field is left blank or minimized, it fails to capture data relevant to TDIU consideration and overall disability picture.
Instead: Proactively describe how your condition affects your employment, attendance, ability to perform job duties, and any accommodations you require. Quantify missed work days if possible.
Impact: All levels, TDIU
Prep Checklist
Before Your Exam
Day Of
During the Exam
After the Exam
Your Rights During a C&P Exam
- You have the right to a thorough, adequate C&P examination. An inadequate exam (one that does not address all relevant rating criteria) can be challenged under Barr v. Nicholson, 21 Vet. App. 303 (2007).
- You have the right to submit your own independent medical opinion (IMO) or nexus letter from a private physician to supplement or counter the C&P examiner's findings.
- You have the right to request an in-person examination if a telehealth exam is scheduled and you believe your condition requires physical evaluation.
- You have the right to have your claim decided under the benefit-of-the-doubt standard (38 CFR 3.102): when evidence is in approximate balance, the decision must favor the veteran.
- You have the right to request a copy of the completed DBQ form and all examination records through a records request to the VA.
- You have the right to record your C&P examination in most states under one-party consent laws. Check your specific state's recording consent laws before the exam.
- You have the right to bring a personal representative, VSO representative, or support person to your exam. Notify the exam facility in advance.
- You have the right to submit buddy statements (lay statements from witnesses) as evidence of your symptoms and their impact on your daily functioning.
- You have the right to appeal a rating decision you believe is incorrect, including requesting a Higher-Level Review, Board of Veterans' Appeals hearing, or supplemental claim with new and relevant evidence.
- Under 38 CFR 4.7, when your symptoms are equally consistent with two different rating levels, you are entitled to the higher rating.
- Your VA claim file (C-file) is available to you upon request and contains all evidence used in your rating decision. Reviewing it before an exam can help you identify gaps in your records.
Related Conditions
- Crohn's Disease Inflammatory disease process explicitly listed in DC 7301 as a qualifying cause of peritoneal adhesions. May be rated separately or as a cause of adhesions depending on service connection.
- Chronic Cholecystitis Inflammatory disease process explicitly listed in DC 7301 as a qualifying cause of peritoneal adhesions. Service connected cholecystitis may serve as the etiology for adhesions.
- Stomach Injury Residuals DC 7310 (stomach injury residuals) instructs pre operative evaluation under DC 7301 (peritoneal adhesions). These conditions share rating pathways under 38 CFR 4.114.
- Irritable Bowel Syndrome (IBS) IBS symptoms (diarrhea, constipation, abdominal pain) may overlap with peritoneal adhesion symptoms. If IBS is secondary to adhesions or a service connected condition, it may be separately ratable.
- Small Bowel Obstruction A direct complication of peritoneal adhesions and the primary driver of hospitalizations counted toward the 80% rating threshold. Recurrent small bowel obstruction is evaluated under DC 7301.
- Abdominal Hernia May co occur with peritoneal adhesions following abdominal surgery. Separately ratable under 38 CFR 4.114 if service connected.
- Total Parenteral Nutrition (TPN) Dependence Requirement for TPN is a direct criterion for the 80% rating under DC 7301. TPN dependence for obstructive symptoms from peritoneal adhesions supports the highest disability rating.
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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.