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C&P Exam Prep: Small Intestine Resection
DBQ Overview
Interview + Physical- Form Name
- intestines
- Form Code
- intestines
- Page Count
- 11
- Examiner Type
- Gastroenterologist or Physician
- Estimated Duration
- 20-30 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To accurately document the current severity and functional impact of your small intestine resection for VA disability rating purposes under 38 CFR - 4.114, DC 7328. The examiner will assess your post-surgical status, any ongoing symptoms, nutritional deficiencies, need for supplementation or parenteral nutrition, and how the condition affects your daily life and work capacity.
What the examiner evaluates:
- Confirmation of small intestine resection and surgical history including type, extent, and date
- Whether short bowel syndrome is present and its severity (high vs. without high output syndrome)
- Current symptoms including diarrhea frequency, abdominal pain, bloating, nausea, and vomiting
- Nutritional status including BMI, weight loss, anemia, vitamin deficiencies, and hypocalcemia
- Need for prescribed oral dietary supplementation, enteral tube feeding, or total parenteral nutrition (TPN)
- Presence of peritoneal adhesions and any complications such as obstruction, abscess, or fistula
- Whether the condition results in an inability to work
- Frequency of emergency treatment or hospitalizations for intestinal episodes
- Presence of an ileostomy or colostomy
- All current medications used to manage the condition
- Laboratory results including CBC, hemoglobin, hematocrit, white blood cell count, and platelets
- Systemic manifestations such as weakness, fatigue, dermatitis, and lymph node enlargement
- Functional impact on daily activities and occupational capacity
The exam will be conducted by a gastroenterologist or general physician, typically at a VA facility or contract examination site. The examiner will review your medical records, conduct a focused physical examination, and interview you about your current symptoms and functional limitations. Bring all relevant records, medication lists, and surgical documentation. You have the right to request that the exam be recorded in most states.
Typical duration: 20-30 minutes
Body Mass Index (BMI)
Nutritional status and degree of undernutrition resulting from malabsorption following small intestine resection
What to expect:
The examiner will measure or record your current height and weight to calculate BMI. Values below 18 or below 16 are tied directly to specific rating thresholds.
Key thresholds:
- BMI less than 16 — Meets criteria for severe undernutrition at higher rating levels
- BMI 16 to 18 inclusive — Meets criteria for moderate undernutrition relevant to mid-tier ratings
- BMI above 18 — Does not meet BMI-based undernutrition threshold; other symptom criteria still apply
Tips:
- Weigh yourself regularly before the exam and track your lowest consistent weight
- Report any unintentional weight loss since surgery, even if your current weight has stabilized
- If you have lost significant weight on your worst days or during flare-ups, communicate this clearly
- Bring any records of historical weights from treating providers showing a downward trend
Pain considerations: N/A for BMI measurement itself, but abdominal pain and discomfort after eating may directly drive nutritional deficits; be sure to connect these symptoms to your inability to maintain adequate weight.
Complete Blood Count (CBC)
Anemia, leukocytosis, and platelet abnormalities related to malabsorption and nutritional deficiencies following small intestine resection
What to expect:
The examiner may review prior CBC results from your medical records. Values for hemoglobin, hematocrit, white blood cell count, and platelets will be noted on the DBQ. A new blood draw may or may not occur at the exam.
Key thresholds:
- Low hemoglobin / low hematocrit — Supports anemia related to malabsorption, which is a documented systemic manifestation that can influence severity rating
- Elevated white blood cell count (leukocytosis) — May indicate active inflammation or infection, potentially supporting higher-severity findings
Tips:
- Bring copies of any recent lab results, especially if obtained within the past 12 months
- Ask your treating gastroenterologist or primary care provider for updated labs prior to the exam if none are recent
- Note whether your anemia has required treatment such as iron infusions or B12 injections, as this demonstrates severity
Pain considerations: Anemia from malabsorption can cause fatigue, weakness, and reduced ability to perform daily tasks; accurately connect these symptoms to your lab findings when describing functional impact.
Nutritional and Vitamin Level Assessment
Presence of nutritional deficiencies, low vitamin levels (e.g., B12, D, A, K), and hypocalcemia resulting from malabsorption
What to expect:
The examiner will inquire about and review laboratory evidence of vitamin and mineral deficiencies. This may include B12, folate, fat-soluble vitamins, and calcium levels.
Key thresholds:
- Documented low vitamin levels (e.g., B12 deficiency) — Supports systemic manifestations of malabsorption; contributes to higher severity documentation
- Hypocalcemia — Documents significant malabsorptive consequence; relevant to higher rating levels
Tips:
- Bring records of all vitamin supplement prescriptions, especially if prescribed by a physician rather than self-initiated
- Distinguish between prescribed oral dietary supplementation and over-the-counter vitamins you take on your own
- If you require B12 injections due to inability to absorb oral B12, this is a significant finding to communicate
Pain considerations: Nutritional deficiencies can cause neurological symptoms, bone pain, muscle cramps, and fatigue; describe how these affect your ability to function on your worst days.
Stool Output Frequency and Characteristics
Severity of diarrhea, short bowel syndrome with high output, and functional bowel disruption
What to expect:
The examiner will ask you to describe your bowel movements, including frequency, consistency, urgency, and whether you experience explosive or uncontrollable episodes. This is a clinical history assessment, not a laboratory test.
Key thresholds:
- 4 or more episodes of diarrhea per day — Meets threshold criteria for higher rating levels under post-resection symptoms
- High output syndrome (short bowel syndrome) — Distinguishes more severe short bowel syndrome and supports higher rating levels
- Watery bowel movements difficult to predict or control — Supports functional impairment documentation
Tips:
- Keep a bowel diary for 1-2 weeks before your exam to accurately document frequency on typical and worst days
- Note whether urgency prevents you from leaving the house, attending work, or sleeping through the night
- Describe whether explosive bowel movements occur with little or no warning
- Report any episodes of fecal incontinence accurately and without understatement
Pain considerations: The unpredictability and urgency of diarrhea episodes may cause significant anxiety, social isolation, and work limitations; these functional consequences are relevant to your overall disability picture.
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 100% | Under DC 7328, rated as DC 7329 (large intestine resection) if it produces a higher rating, or as celiac disease under DC 7355 if applicable. At the 100% level under analogous criteria: requiring complete dependence on total parenteral nutrition (TPN), or short bowel syndrome with high output syndrome requiring TPN, or condition resulting in an inability to work with severe malabsorption. Essentially the most severe manifestation with near-total loss of intestinal function. |
CFR: Analogous rating to DC 7329 at 100%: symptom complex so severe as to preclude any employment; complete dependence on artificial nutritional support. Alternatively, rated under DC 7355 for celiac disease at 100% if applicable and produces higher rating. |
| 60% | Severe manifestation with significant nutritional consequences and ongoing functional impairment. Short bowel syndrome without high output syndrome but with significant symptoms; or malabsorption syndrome causing weakness interfering with daily activities; or requiring enteral nutrition (tube feeding); or BMI 16-18 with significant systemic manifestations. Frequent diarrhea requiring dietary management. |
CFR: Analogous to DC 7329 at 60%: four or more loose stools daily with systemic manifestations such as weakness, anemia, or vitamin deficiency; or requiring continuous medication. Significant impact on ability to maintain nutrition through normal means. |
| 40% | Moderate manifestation with ongoing symptoms managed through dietary modification and medication. Malabsorption syndrome causing chronic diarrhea managed with dietary changes; recurrent episodes of diarrhea; abdominal pain; requiring continuous medication for management. Functional impact present but condition is manageable on outpatient basis. |
CFR: Analogous to DC 7329 at 40%: chronic diarrhea requiring dietary restrictions; episodes of abdominal pain and cramping; condition managed on outpatient basis with medications and dietary changes. Moderate impact on daily activities. |
| 20% | Mild manifestation with minimal symptoms, managed by diet and/or medication. Occasional abdominal discomfort, mild dietary restrictions, no significant nutritional deficiencies. Condition is largely controlled but still present. |
CFR: Analogous to DC 7329 at 20%: mild symptoms managed by diet and medication; occasional loose stools; no systemic manifestations; condition largely controlled. |
| 10% | Post-resection status with no or minimal current symptoms. Asymptomatic or with only occasional mild symptoms not significantly affecting quality of life. Condition exists as a matter of record but produces minimal functional impairment. |
CFR: Analogous to DC 7329 at 10%: postoperative status with no significant symptoms; asymptomatic resection with intact nutritional status. |
100% Under DC 7328, rated as DC 7329 (large intestine resection) ...
Under DC 7328, rated as DC 7329 (large intestine resection) if it produces a higher rating, or as celiac disease under DC 7355 if applicable. At the 100% level under analogous criteria: requiring complete dependence on total parenteral nutrition (TPN), or short bowel syndrome with high output syndrome requiring TPN, or condition resulting in an inability to work with severe malabsorption. Essentially the most severe manifestation with near-total loss of intestinal function.
Key Symptoms
- Complete dependence on total parenteral nutrition (TPN)
- Short bowel syndrome with high output syndrome
- Severe undernutrition with BMI less than 16
- Requiring continuous TPN for extended periods
- Inability to work due to severity of condition
- Recurrent emergency treatment for intestinal episodes
- Permanent ileostomy with complications
- Severe systemic manifestations including profound anemia, weakness, and fatigue
CFR: Analogous rating to DC 7329 at 100%: symptom complex so severe as to preclude any employment; complete dependence on artificial nutritional support. Alternatively, rated under DC 7355 for celiac disease at 100% if applicable and produces higher rating.
60% Severe manifestation with significant nutritional consequenc ...
Severe manifestation with significant nutritional consequences and ongoing functional impairment. Short bowel syndrome without high output syndrome but with significant symptoms; or malabsorption syndrome causing weakness interfering with daily activities; or requiring enteral nutrition (tube feeding); or BMI 16-18 with significant systemic manifestations. Frequent diarrhea requiring dietary management.
Key Symptoms
- Short bowel syndrome without high output syndrome
- BMI of 16 to 18 inclusive
- Requiring enteral nutrition or tube feeding
- Malabsorption syndrome causing weakness that interferes with activities
- Four or more diarrhea episodes per day
- Nutritional deficiencies including anemia, low vitamins, hypocalcemia
- Recurrent dehydration requiring intravenous fluids (more than 2 episodes)
- Requiring prescribed oral dietary supplementation
- Episodic abdominal pain and diarrhea due to lactase or pancreatic enzyme deficiency
CFR: Analogous to DC 7329 at 60%: four or more loose stools daily with systemic manifestations such as weakness, anemia, or vitamin deficiency; or requiring continuous medication. Significant impact on ability to maintain nutrition through normal means.
40% Moderate manifestation with ongoing symptoms managed through ...
Moderate manifestation with ongoing symptoms managed through dietary modification and medication. Malabsorption syndrome causing chronic diarrhea managed with dietary changes; recurrent episodes of diarrhea; abdominal pain; requiring continuous medication for management. Functional impact present but condition is manageable on outpatient basis.
Key Symptoms
- Malabsorption syndrome causing chronic diarrhea managed by dietary modifications
- Recurrent episodes of diarrhea
- Recurrent abdominal pain
- Requiring continuous medication
- Abdominal bloating and distention
- Nausea managed by medical treatment
- Change in stool frequency or form
- Weakness and fatigue without meeting higher threshold criteria
- Low vitamin levels requiring supplementation
CFR: Analogous to DC 7329 at 40%: chronic diarrhea requiring dietary restrictions; episodes of abdominal pain and cramping; condition managed on outpatient basis with medications and dietary changes. Moderate impact on daily activities.
20% Mild manifestation with minimal symptoms, managed by diet an ...
Mild manifestation with minimal symptoms, managed by diet and/or medication. Occasional abdominal discomfort, mild dietary restrictions, no significant nutritional deficiencies. Condition is largely controlled but still present.
Key Symptoms
- Mild or occasional abdominal discomfort
- Managed by diet and medication without ongoing complications
- Minimal change in stool frequency
- No significant nutritional deficiencies
- Condition requires dietary attention but does not significantly limit function
CFR: Analogous to DC 7329 at 20%: mild symptoms managed by diet and medication; occasional loose stools; no systemic manifestations; condition largely controlled.
10% Post-resection status with no or minimal current symptoms. A ...
Post-resection status with no or minimal current symptoms. Asymptomatic or with only occasional mild symptoms not significantly affecting quality of life. Condition exists as a matter of record but produces minimal functional impairment.
Key Symptoms
- Status post resection, asymptomatic
- No current nutritional deficiencies
- No requirement for dietary supplementation or medication for symptoms
- Postoperative asymptomatic status
CFR: Analogous to DC 7329 at 10%: postoperative status with no significant symptoms; asymptomatic resection with intact nutritional status.
How to Describe Your Symptoms
Diarrhea and Bowel Frequency
How to describe:
Describe diarrhea in terms of specific frequency per day (e.g., '6-8 loose bowel movements daily'), consistency (watery, liquid), presence of urgency, and whether episodes are difficult to predict or control. Distinguish between your average day and your worst days. Mention whether urgency causes accidents or prevents you from leaving the house.
Worst-day example:
“On my worst days, I have 8 to 10 watery bowel movements. I cannot leave the house because I have less than 30 seconds of warning before I need a bathroom. I have had accidents at work and have had to leave social events early. I wake up 2 to 3 times per night with diarrhea, leaving me exhausted.”
What the examiner listens for:
Specific frequency counts, whether episodes are watery or formed, presence of urgency or incontinence, impact on sleep, work, and social activities, and whether symptoms are controlled or uncontrolled with current treatment.
Understatements to avoid:
Do not say 'I have loose stools sometimes' without quantifying frequency. Do not omit nighttime episodes. Do not say your diarrhea is 'managed' if you still have multiple daily episodes despite treatment.
Abdominal Pain and Cramping
How to describe:
Describe the location, character (cramping, sharp, dull, constant, intermittent), severity on a 0-10 scale, triggering factors (meals, activity), duration of episodes, and how pain limits your ability to eat, work, or perform daily activities. State whether pain is daily or episodic and how long episodes last.
Worst-day example:
“On bad days I have severe cramping that starts within 30 minutes of eating any meal. The pain is an 8 out of 10 and causes me to double over. I cannot eat a normal meal without anticipating pain, so I avoid eating in public or at work. On these days I am unable to stand for prolonged periods or concentrate on tasks.”
What the examiner listens for:
Frequency, severity, relationship to meals, duration, and how pain interferes with eating, working, and activities of daily living. The examiner is noting whether pain is intermittent or constant and whether it drives avoidance behavior.
Understatements to avoid:
Do not minimize pain by saying 'it's tolerable.' Do not forget to mention that pain leads you to skip meals, which contributes to nutritional deficiencies and weight loss.
Nutritional Deficiencies and Weight Loss
How to describe:
Report your current weight, your pre-illness weight, and any documented weight loss since surgery. Describe any prescribed dietary supplements, vitamin injections, or special formulas. Explain any doctor-prescribed dietary restrictions (e.g., low-fat, low-fiber, lactose-free). Report specific vitamin or mineral deficiencies documented in laboratory tests.
Worst-day example:
“I have lost 35 pounds since my surgery and cannot maintain weight despite eating as much as I can tolerate. My doctor has prescribed high-calorie oral supplements because I cannot absorb enough nutrition from regular food. My B12 level was critically low and I now receive monthly injections. My calcium is chronically low and I take prescription calcium supplements.”
What the examiner listens for:
Whether supplementation is prescribed (versus self-initiated), documented laboratory evidence of deficiencies, degree of weight loss, BMI, and whether the veteran has progressed to requiring tube feeding or TPN.
Understatements to avoid:
Do not describe prescribed supplements as 'just vitamins I take.' Clarify that they were prescribed by a physician due to documented deficiencies. Do not omit prescription dietary formulas or special medical foods.
Fatigue and Weakness
How to describe:
Describe fatigue in concrete functional terms: how many hours you can stand, walk, or work before becoming exhausted; whether you need to rest during the day; how fatigue affects your ability to maintain employment; and whether weakness affects your physical strength or coordination.
Worst-day example:
“On my worst days I am so fatigued that I cannot work a full day. I have to rest for 1 to 2 hours in the afternoon. I have called in sick to work multiple times per month because of exhaustion combined with uncontrolled diarrhea. I cannot perform physical tasks that require sustained effort because my stamina is severely reduced.”
What the examiner listens for:
Whether fatigue and weakness are documented as systemic manifestations of malabsorption, how they limit occupational and daily functioning, and whether they constitute an inability to work.
Understatements to avoid:
Do not say 'I get tired.' Quantify: how many hours can you function, how many days per month does fatigue prevent normal activity, and what tasks have you given up because of weakness.
Nausea and Vomiting
How to describe:
State the frequency of nausea (daily, episodic), whether it results in vomiting, whether it is managed with medication, and how it affects your ability to eat adequate nutrition. Distinguish between nausea that is constantly present versus episodes triggered by meals.
Worst-day example:
“I experience nausea every day after eating. About three times per week the nausea leads to vomiting, which means I lose whatever I have just eaten. My doctor has prescribed anti-nausea medication but it only partially controls the symptoms. On my worst days I cannot eat at all due to nausea and vomiting.”
What the examiner listens for:
Whether nausea and vomiting are recurrent, whether they require medical management, and how they contribute to nutritional deficits and weight loss.
Understatements to avoid:
Do not omit the connection between nausea, vomiting, and your inability to maintain adequate nutrition. Do not fail to mention that your anti-nausea medications were prescribed specifically for this condition.
Functional Impact on Work and Daily Life
How to describe:
Describe specific job tasks you cannot perform, how many days per month you miss work, whether you have lost employment or been unable to maintain employment, and what daily activities (grocery shopping, cooking, socializing, travel) are limited by your condition.
Worst-day example:
“My condition has prevented me from maintaining full-time employment. I cannot work in environments without immediate bathroom access. I have missed more than 10 days of work in the past six months due to diarrhea, pain, and fatigue. I cannot travel by car for more than 20 minutes without planning bathroom access. I no longer attend family gatherings because of unpredictable bowel urgency.”
What the examiner listens for:
Specific functional limitations tied directly to the gastrointestinal condition, occupational impact, and whether the condition results in an inability to work or maintain gainful employment.
Understatements to avoid:
Do not say 'I manage okay at work' if you have accommodations, have reduced your hours, or have changed jobs because of this condition. Report the accommodations and limitations accurately.
Hospitalization and Emergency Treatment
How to describe:
List all hospitalizations related to your intestinal condition in the past 12 months, including dates, locations, and reasons (dehydration, obstruction, infection). Report any emergency department visits for intestinal episodes. Quantify: how many times, for how long, and for what reason.
Worst-day example:
“In the past year I have been hospitalized twice for severe dehydration requiring intravenous fluids. I have gone to the emergency room three additional times for severe abdominal cramping and uncontrolled diarrhea. Each hospitalization lasted 2 to 3 days.”
What the examiner listens for:
Whether hospitalizations occur at least once per year, whether emergency treatment is recurrent, and whether dehydration requiring IV fluids has occurred more than twice - all of which are documented thresholds on the DBQ.
Understatements to avoid:
Do not omit emergency department visits that did not result in admission. Do not approximate - bring specific dates and hospital names if possible.
Common Mistakes to Avoid
Reporting only average symptoms instead of worst-day symptoms
VA rating is based on the full picture of disability, including how the condition affects you at its worst. Reporting only your best or average days leads to an underestimate of severity.
Instead: Describe your condition on its worst days clearly and accurately. Per M21-1 guidance, the examiner should document the range of your condition including peak severity. Say: 'On my worst days, which occur approximately [X] times per month, I experience...'
Impact: All levels - particularly the difference between 20% and 60%
Failing to quantify diarrhea frequency with a specific number
The DBQ has specific checkboxes for '4 or more episodes of diarrhea per day' which is a threshold criterion for higher ratings. Vague statements like 'frequent diarrhea' will not trigger these fields.
Instead: State a specific number: 'I have 5 to 7 loose bowel movements per day on average, and 8 to 10 on bad days.' Keep a bowel diary before the exam.
Impact: 40% vs. 60% threshold
Not distinguishing between prescribed dietary supplementation and over-the-counter vitamins
The DBQ specifically asks whether the veteran requires 'prescribed oral dietary supplementation.' Self-initiated vitamins do not meet this threshold. Failure to clarify this distinction can result in the examiner not checking the correct field.
Instead: Bring your prescription records and clearly state: 'These supplements were prescribed by my doctor because of documented malabsorption and deficiency - they are not over-the-counter vitamins I chose to take on my own.'
Impact: 40% vs. 60%
Minimizing or omitting the need for TPN or enteral tube feeding
Requirement for TPN or tube feeding is associated with the highest rating levels. Veterans who have required TPN even temporarily may not volunteer this information, significantly underrepresenting severity.
Instead: Report all periods of TPN or tube feeding, including temporary courses ordered during acute episodes. Bring records with start and end dates.
Impact: 60% vs. 100%
Omitting hospitalizations and emergency visits
The DBQ has specific fields for recurrent emergency treatment and hospitalization at least once per year. These are rating-determinative and will not be captured if you do not report them.
Instead: Compile a list of all hospital admissions and ED visits related to your intestinal condition in the past 12 months. Include dates, facilities, and reason for visit.
Impact: 40% vs. 60% and higher
Not mentioning the inability to work or specific occupational limitations
The DBQ has a specific field asking whether the condition results in an inability to work, and requires the examiner to describe how the condition prevents employment. If you do not raise this, the examiner may not address it.
Instead: Clearly and specifically describe how your condition limits your ability to maintain employment, including missed workdays, need for bathroom proximity, dietary restrictions at work, and fatigue affecting productivity.
Impact: Higher rating levels and TDIU eligibility
Failing to report post-resection complications such as peritoneal adhesions or fistulous disease
These complications have separate DBQ fields and can support additional ratings or secondary conditions. Veterans may not know to report adhesion-related obstructions as a distinct complication.
Instead: Report any history of bowel obstruction, abdominal adhesions, or fistulous tracts that developed after your resection. Bring surgical and imaging records documenting these findings.
Impact: All levels; may support separate ratings
Saying you are 'doing okay' when asked how you are doing at the start of the exam
Social politeness can undermine your claim. An examiner may document this as evidence of minimal symptoms if not corrected.
Instead: When greeted with 'how are you?' reply with a brief accurate statement: 'I'm managing today, but my condition significantly affects my daily life and I want to make sure I accurately describe that during the exam.'
Impact: All levels
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 request that your C&P examination be recorded in most states. Inform the examiner at the start of the appointment if you intend to record.
- You have the right to have a representative (VSO, accredited attorney, or claims agent) assist you in preparing for and navigating your C&P examination.
- You have the right to submit a personal statement, buddy statements, and additional medical evidence at any time before a rating decision is issued.
- You have the right to a copy of your completed DBQ and all examination reports. These are part of your VA claims file (eFolder) and can be requested via FOIA or through your VSO.
- You have the right to request a new or additional examination if you believe the original C&P exam was inadequate, did not address all claimed conditions, or did not accurately capture your symptoms.
- You have the right to challenge a C&P examination that you believe was flawed, cursory, or relied on an inaccurate history. You may submit a buddy statement, personal statement, or a private medical nexus opinion to rebut an unfavorable exam.
- You have the right to have your condition rated based on your worst-day symptoms and the full range of your disability, not only your presentation on the day of the exam.
- You have the right to bring a support person with you to the C&P examination, though that person typically may not speak on your behalf during the clinical interview.
- You have the right to be examined by a qualified examiner with appropriate expertise. If you believe the examiner lacked sufficient knowledge of your condition, you may raise this concern in a statement to VA.
- You have the right to an Increased Rating or Supplemental Claim if your condition worsens after an initial rating, allowing you to seek a higher disability percentage based on new or increased evidence.
Related Conditions
- Short Bowel Syndrome Short bowel syndrome is a direct complication of small intestine resection, particularly when a significant portion of the small intestine is removed. It is rated under DC 7328 and is a primary driver of rating level, especially the distinction between high output syndrome and without high output syndrome.
- Peritoneal Adhesions Peritoneal adhesions frequently develop as a post surgical complication of small intestine resection and can cause bowel obstruction, chronic abdominal pain, and additional surgeries. They are rated separately under DC 7301 and may warrant a secondary service connection claim.
- Celiac Disease DC 7328 directs that small intestine resection may alternatively be rated as celiac disease under DC 7355 if that produces a higher evaluation. Veterans with confirmed celiac disease should ensure both rating schedules are considered by the VA rater.
- Large Intestine Resection DC 7328 for small intestine resection cross references DC 7329 (large intestine resection) as an analogous code if it would produce a higher rating. Veterans who have had resections of both intestinal segments should ensure both are claimed and the most favorable rating schedule is applied.
- Malabsorption Syndrome Malabsorption is the central mechanism by which small intestine resection causes disability. It drives nutritional deficiencies, weight loss, anemia, vitamin deficiencies, and hypocalcemia, all of which are captured in the DBQ and influence the disability rating.
- Anemia Anemia resulting from malabsorption following small intestine resection may be ratable as a secondary condition. Iron deficiency anemia, B12 deficiency anemia, and folate deficiency anemia are all documented systemic manifestations of malabsorptive conditions.
- External Intestinal Fistulous Disease Fistulas can develop as a complication of small intestine surgery. External intestinal fistulous disease is rated separately under DC 7340 and should be claimed as a secondary condition if it arose after your resection.
- Mesenteric Ischemia / Thrombosis Mesenteric ischemia or thrombosis is a common underlying cause requiring small intestine resection. If this condition was caused by a service connected event or exposure, it may provide the basis for service connection of the resection itself.
- GERD / Gastrointestinal Dysmotility Syndrome Gastrointestinal dysmotility can occur as a secondary consequence of small intestine resection due to alteration of intestinal anatomy and transit time. If diagnosed, this condition may be ratable separately as secondary to the resection.
- Depression and Anxiety (Secondary to Chronic GI Condition) Chronic gastrointestinal conditions including small intestine resection with ongoing diarrhea, pain, and social limitations are well documented causes of secondary depression and anxiety. Veterans should consider claiming these mental health conditions as secondary to their rated digestive condition.
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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.