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C&P Exam Prep: Stomach and Duodenum (Ulcers / Gastritis)
DBQ Overview
Interview + Physical- Form Name
- stomach-and-duodenum
- Form Code
- stomach-and-duodenum
- Page Count
- 8
- Examiner Type
- Gastroenterologist or Physician
- Estimated Duration
- 20-30 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To document the current severity of peptic ulcer disease (DC 7304), chronic gastritis (DC 7307, rated as DC 7304), or stomach stenosis (DC 7309) for VA disability rating purposes under 38 CFR - 4.114. The examiner will establish diagnosis, characterize symptom frequency and severity, identify complications, and assess functional impairment.
What the examiner evaluates:
- Confirmed diagnosis and type of condition (peptic ulcer disease, chronic gastritis, H. pylori infection, drug-induced gastritis, Zollinger-Ellison syndrome, portal hypertensive gastropathy)
- Current symptom profile including pain, nausea, vomiting, diarrhea, constipation, melena, and hematemesis
- Frequency and duration of symptomatic episodes
- History of hospitalizations for perforation, hemorrhage, or obstruction
- Surgical history including gastrectomy, vagotomy with pyloroplasty, gastroenterostomy, or other procedures
- Post-gastrectomy or post-surgical syndrome presence
- Current medications specifically treating the GI condition
- Dietary modifications required by the condition
- Laboratory findings including CBC, hemoglobin, hematocrit, H. pylori testing
- Endoscopic and radiographic study results
- Presence of anemia requiring hospitalization
- Functional impact on daily activities and occupational functioning
- History of total parenteral nutrition (TPN) or continuous tube feedings
- Presence of post-prandial lightheadedness or syncope (dumping syndrome indicators)
Exam will primarily involve a structured interview reviewing symptom history, medical records, and pertinent lab or endoscopy results. A brief physical examination of the abdomen may be performed. Bring all relevant records including endoscopy reports, hospitalization summaries, lab results, and current medication lists. In most states, veterans have the right to record the exam - check your state laws and notify the examiner in advance.
Typical duration: 20-30 minutes
Upper Endoscopy (EGD) Review
Direct visualization of ulceration, gastritis, mucosal damage, or stenosis in the esophagus, stomach, and duodenum
What to expect:
Examiner will review existing endoscopy reports. A new endoscopy is unlikely at the C&P exam itself. Bring copies of all prior EGD reports.
Key thresholds:
- Active ulcer or gastritis documented — Supports current diagnosis; essential for DBQ Section 1 diagnosis confirmation
- History of perforation or hemorrhage — Relevant to hospitalization history and potential 60-100% rating criteria
Tips:
- Ensure all prior endoscopy dates and results are listed in your records
- If endoscopy showed H. pylori, note whether treatment was completed and if symptoms persisted
- Mention if symptoms continue despite normal endoscopy - functional impairment still matters
Pain considerations: Document whether endoscopy was prompted by pain, bleeding, or vomiting episodes - this links symptoms to objective findings
Complete Blood Count (CBC) - Hemoglobin, Hematocrit, WBC, Platelets
Anemia related to chronic GI blood loss; signs of chronic disease or acute hemorrhage
What to expect:
Examiner will review recent lab values. The DBQ specifically captures hemoglobin, hematocrit, WBC, and platelet counts. Bring recent lab printouts.
Key thresholds:
- Low hemoglobin/hematocrit consistent with anemia — Supports higher rating if anemia required hospitalization - relevant to 60-100% criteria involving hemorrhage complications
- Normal CBC — Does not preclude a significant rating - symptom severity and functional impact remain independently ratable
Tips:
- Request recent CBC labs from your treating provider before the exam
- If you have a history of anemia requiring transfusion or hospitalization, document dates and facilities
- Iron-deficiency anemia from chronic GI blood loss is a recognized complication
Pain considerations: Fatigue and weakness associated with anemia should be reported as functional limitations at the exam
H. Pylori Testing
Presence of Helicobacter pylori infection, a recognized cause of peptic ulcer disease and chronic gastritis (included under DC 7307, rated as DC 7304)
What to expect:
Examiner will note positive H. pylori history. DBQ field 250 specifically captures H. pylori test results. Bring documentation of any positive tests and treatment history.
Key thresholds:
- Positive H. pylori with persistent symptoms post-treatment — Supports ongoing disability even after eradication therapy - symptoms persisting after treatment remain ratable
- H. pylori eradicated but gastritis continues — Rate based on residual symptom severity; condition does not resolve just because H. pylori was treated
Tips:
- Note whether H. pylori was ever diagnosed and when treatment occurred
- If symptoms continued after H. pylori eradication, emphasize this to the examiner
- Bring biopsy or breath test results if available
Pain considerations: Persistent epigastric pain after H. pylori treatment is a key indicator of ongoing disability - report its frequency, character, and aggravating factors
Upper GI Radiographic Studies
Structural abnormalities of the stomach and duodenum including ulcer craters, stenosis, or motility disorders
What to expect:
Examiner will review any prior upper GI series or fluoroscopic studies. DBQ field 225 captures this. Bring radiology reports if available.
Key thresholds:
- Documented stenosis of the stomach — May support rating under DC 7309 (stomach stenosis), rated as DC 7303 or DC 7304 depending on predominant disability
Tips:
- If you had a barium swallow or upper GI series, obtain the radiology report
- Stenosis findings support higher-level ratings tied to obstruction history
Pain considerations: Report any difficulty swallowing, early satiety, or sensation of food not passing - these may correlate with structural findings
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 100% | Chronic, severe symptoms of peptic ulcer disease manifesting as recurrent hematemesis (vomiting blood) or melena (tarry stools) with manifestations of anemia requiring hospitalization AND/OR other serious complications requiring surgery, plus persistent and debilitating symptoms. This level also encompasses total gastrectomy or comparable surgical outcomes with severe post-operative complications requiring continuous nutritional support. |
CFR: Under 38 CFR - 4.114, DC 7304, the 100% rating reflects the most severe manifestations including recurrent hemorrhage requiring hospitalization, surgery for life-threatening complications, and conditions requiring total nutritional support. Chronic gastritis (DC 7307) is rated identically under DC 7304. |
| 60% | Severe peptic ulcer disease with: two or more of the symptoms for the 40% evaluation, OR shotgun surgery (two or more surgical procedures for perforation or hemorrhage), OR impairment so severe as to preclude more than light sedentary work. Chronic persistent symptoms with moderate to severe impact on daily functioning. |
CFR: The 60% rating under DC 7304 reflects a combination of severe, persistent symptoms and/or a history of major surgical interventions for complications. Veterans with two or more qualifying symptoms from the 40% level, or who have had repeated surgeries, qualify at this tier. |
| 40% | Moderate peptic ulcer disease with documented history of peptic ulcer disease by endoscopy or X-ray AND pain not controlled by standard ulcer therapy, OR recurrent episodes of stomach or duodenal symptoms with documented history of peptic ulcer, OR symptoms managed only by medications, restricted diet, or activity restrictions. |
CFR: At 40%, the key requirement under DC 7304 is a confirmed diagnosis AND pain or recurrent symptoms that are not fully controlled by standard ulcer therapy. Per M21-1, peptic ulcer disease must be documented by endoscopy or X-ray for this level. |
| 20% | Mild peptic ulcer disease with documented history of peptic ulcer by endoscopy or X-ray AND symptoms controlled by continuous medication therapy or a restricted diet, with some periodic exacerbations requiring medical attention. |
CFR: The 20% rating under DC 7304 represents a mild but chronic condition where the ulcer is confirmed but symptoms remain largely controlled by continuous medication or dietary restriction. Veterans still require ongoing treatment to maintain symptom control. |
| 0% | Post-operative asymptomatic - peptic ulcer disease with no current symptoms following surgical treatment, OR confirmed diagnosis with no current symptoms and no ongoing treatment requirements. A 0% rating preserves service connection and remains subject to future re-evaluation if symptoms recur. |
CFR: The 0% noncompensable rating under DC 7304 applies when the condition is confirmed but currently produces no disability. Per 38 CFR - 3.105(e), any future change in evaluation based on a subsequent exam is subject to that provision. |
100% Chronic, severe symptoms of peptic ulcer disease manifesting ...
Chronic, severe symptoms of peptic ulcer disease manifesting as recurrent hematemesis (vomiting blood) or melena (tarry stools) with manifestations of anemia requiring hospitalization AND/OR other serious complications requiring surgery, plus persistent and debilitating symptoms. This level also encompasses total gastrectomy or comparable surgical outcomes with severe post-operative complications requiring continuous nutritional support.
Key Symptoms
- Recurrent hematemesis (vomiting blood)
- Melena (tarry stools indicating GI bleeding)
- Anemia requiring hospitalization
- Continuous abdominal pain with recurrent vomiting
- Persistent partial bowel obstruction with clinical evidence of recurrent obstructions requiring hospitalization
- Requiring continuous TPN for more than 365 days
- Requiring continuous tube feedings for more than 365 days
- Severe post-gastrectomy syndrome
- Post-prandial meal-induced lightheadedness or syncope with severe symptoms
- Following confirmation of post-operative complications of surgery
CFR: Under 38 CFR - 4.114, DC 7304, the 100% rating reflects the most severe manifestations including recurrent hemorrhage requiring hospitalization, surgery for life-threatening complications, and conditions requiring total nutritional support. Chronic gastritis (DC 7307) is rated identically under DC 7304.
60% Severe peptic ulcer disease with: two or more of the symptom ...
Severe peptic ulcer disease with: two or more of the symptoms for the 40% evaluation, OR shotgun surgery (two or more surgical procedures for perforation or hemorrhage), OR impairment so severe as to preclude more than light sedentary work. Chronic persistent symptoms with moderate to severe impact on daily functioning.
Key Symptoms
- Two or more hospitalizations in the past year for peptic ulcer complications
- History of surgery for perforation or hemorrhage (two or more procedures)
- Continuous abdominal pain with intermittent vomiting
- Significant weight loss
- Severe dietary restrictions required
- Recurrent episodes that last for prolonged periods requiring medical management
- Symptoms limiting ability to work beyond light sedentary tasks
- Symptoms and confirmed diagnosis of alkaline gastritis
- With confirmed persisting diarrhea requiring medical management
CFR: The 60% rating under DC 7304 reflects a combination of severe, persistent symptoms and/or a history of major surgical interventions for complications. Veterans with two or more qualifying symptoms from the 40% level, or who have had repeated surgeries, qualify at this tier.
40% Moderate peptic ulcer disease with documented history of pep ...
Moderate peptic ulcer disease with documented history of peptic ulcer disease by endoscopy or X-ray AND pain not controlled by standard ulcer therapy, OR recurrent episodes of stomach or duodenal symptoms with documented history of peptic ulcer, OR symptoms managed only by medications, restricted diet, or activity restrictions.
Key Symptoms
- Documented peptic ulcer by endoscopy or radiograph
- Abdominal pain not controlled by standard therapy (antacids, PPIs, H2 blockers)
- Recurrent episodes of nausea, vomiting, or abdominal pain lasting days
- Episodes requiring medical treatment or urgent care visits
- Dietary modification required to control symptoms
- Symptoms occurring multiple times per month
- Diarrhea
- Nausea managed by medication
- Vomiting occurring regularly
CFR: At 40%, the key requirement under DC 7304 is a confirmed diagnosis AND pain or recurrent symptoms that are not fully controlled by standard ulcer therapy. Per M21-1, peptic ulcer disease must be documented by endoscopy or X-ray for this level.
20% Mild peptic ulcer disease with documented history of peptic ...
Mild peptic ulcer disease with documented history of peptic ulcer by endoscopy or X-ray AND symptoms controlled by continuous medication therapy or a restricted diet, with some periodic exacerbations requiring medical attention.
Key Symptoms
- Confirmed peptic ulcer history with symptoms controlled by medications
- Periodic flare-ups requiring temporary medication adjustments
- Mild to moderate epigastric pain occurring intermittently
- Symptoms manageable with dietary modifications
- Occasional nausea or vomiting not requiring hospitalization
- Condition stable but requiring ongoing pharmacologic management
CFR: The 20% rating under DC 7304 represents a mild but chronic condition where the ulcer is confirmed but symptoms remain largely controlled by continuous medication or dietary restriction. Veterans still require ongoing treatment to maintain symptom control.
0% Post-operative asymptomatic - peptic ulcer disease with no c ...
Post-operative asymptomatic - peptic ulcer disease with no current symptoms following surgical treatment, OR confirmed diagnosis with no current symptoms and no ongoing treatment requirements. A 0% rating preserves service connection and remains subject to future re-evaluation if symptoms recur.
Key Symptoms
- Asymptomatic following surgery
- No current pain, nausea, vomiting, or dietary restrictions
- No medications currently required for the condition
- Confirmed prior diagnosis but currently inactive
CFR: The 0% noncompensable rating under DC 7304 applies when the condition is confirmed but currently produces no disability. Per 38 CFR - 3.105(e), any future change in evaluation based on a subsequent exam is subject to that provision.
How to Describe Your Symptoms
Abdominal / Epigastric Pain
How to describe:
Describe the location (upper abdomen, below the breastbone, between meals or at night), character (burning, gnawing, sharp, cramping), frequency (daily, several times a week), duration (minutes to hours), and what makes it better or worse (food, antacids, fasting, stress). Report your worst episodes, not just average days.
Worst-day example:
“On my worst days, I wake up at 2 a.m. with a severe burning pain in my upper abdomen that rates 8 out of 10. Eating brings temporary relief but within an hour the pain returns. I cannot concentrate at work, I have to cancel plans, and I spend the day lying down or near a bathroom.”
What the examiner listens for:
Frequency of pain episodes, whether pain is continuous or episodic, whether standard therapy (PPIs, antacids) controls it, relationship to meals, whether pain has caused missed work or social withdrawal
Understatements to avoid:
Do not say 'I just have some stomach pain sometimes' - be specific about frequency, intensity, duration, and the impact on your daily activities. Vague descriptions result in lower ratings.
Nausea and Vomiting
How to describe:
Report how often nausea and vomiting occur (daily, weekly, monthly), whether they are triggered by eating, and whether they are managed by prescription anti-nausea medication. Note whether vomiting has ever contained blood (hematemesis).
Worst-day example:
“Several times a week I become so nauseated after eating that I vomit. I take prescription anti-nausea medication every day. On bad days, I cannot keep food down for hours and I have to stay in bed. I have missed meals because I know eating will trigger vomiting.”
What the examiner listens for:
Whether nausea/vomiting is managed by medication, frequency, and whether hematemesis has ever occurred - hematemesis is a key criterion for higher ratings
Understatements to avoid:
Do not minimize vomiting by saying 'it happens sometimes.' State the frequency clearly and confirm whether you require medication to control it. Medication management is a specific DBQ checkmark.
GI Bleeding (Hematemesis / Melena)
How to describe:
If you have ever vomited blood or had tarry/black stools, describe when it happened, how many episodes you have had, whether you required hospitalization, and whether you received blood transfusions. Even past episodes are highly relevant.
Worst-day example:
“I have been hospitalized twice for GI bleeding. During the worst episode I vomited blood and passed black tarry stools for two days before going to the ER, where I received a blood transfusion. I was admitted for four days.”
What the examiner listens for:
Number of bleeding episodes, hospitalizations required, transfusions, whether the condition recurs - these directly map to the 60% and 100% rating criteria under DC 7304
Understatements to avoid:
Never minimize or omit past bleeding episodes - even if they occurred years ago, a history of recurrent hematemesis or melena is directly tied to higher rating criteria.
Dietary Restrictions and Nutritional Impact
How to describe:
Describe which foods or beverages you must avoid due to your condition (spicy foods, caffeine, alcohol, large meals, fatty foods), whether a doctor has formally prescribed a special diet, and whether you have experienced significant weight loss.
Worst-day example:
“My gastroenterologist put me on a strict bland diet two years ago. I cannot eat most restaurants' food, I cannot drink alcohol or coffee, and I eat small meals six times a day. Despite this, I still have pain after eating. I have lost 15 pounds in the past year because eating causes pain.”
What the examiner listens for:
Whether dietary modification is medically directed, how restrictive it is, and whether it successfully controls symptoms - medically directed dietary modification is a specific DBQ checkmark
Understatements to avoid:
Do not say 'I just watch what I eat' - if a doctor told you to avoid certain foods or eat differently, that is a medically directed dietary modification that should be explicitly stated.
Diarrhea, Explosive Bowel Movements, and Watery Stools
How to describe:
Report frequency of diarrhea (times per day, days per week), whether stools are watery, whether bowel movements are explosive or unpredictable, and whether this has caused social or occupational embarrassment or restrictions.
Worst-day example:
“On bad days I have five to seven watery bowel movements. They come on suddenly and I cannot predict or control them. I have had accidents at work and I now plan all activities around access to a bathroom. I carry extra clothing when I leave the house.”
What the examiner listens for:
Frequency, whether bowel movements are explosive or unpredictable, whether diarrhea is a persistent confirmed post-surgical or post-gastritis complication - confirmed persisting diarrhea is a 60% criterion
Understatements to avoid:
Do not just say 'I have diarrhea sometimes.' State how many times per day, how unpredictable it is, and the impact on your social and work life. Explosive/unpredictable bowel movements are a separate DBQ item.
Post-Prandial Symptoms and Dumping Syndrome
How to describe:
If you experience lightheadedness, dizziness, sweating, rapid heartbeat, or near-fainting after eating, describe when during the meal these occur (early dumping: within 15-30 minutes; late dumping: 1-3 hours), frequency, and whether they have caused falls or required you to lie down after meals.
Worst-day example:
“Within 30 minutes of eating even a small meal, I become dizzy and lightheaded to the point where I have to lie down immediately. I have nearly passed out twice. I now eat lying down or in a recliner and I cannot eat in public because of this.”
What the examiner listens for:
Post-prandial lightheadedness or syncope - this is a specific DBQ checkbox item (field 165) and maps to higher-level rating criteria for post-surgical complications
Understatements to avoid:
Do not attribute post-meal dizziness to other causes without mentioning it to the GI examiner - post-prandial syncope or near-syncope is a discrete, ratable finding.
Hospitalizations and Surgical History
How to describe:
List every hospitalization related to your stomach or duodenal condition: date, facility, reason (bleeding, perforation, obstruction, surgery), duration of stay, and procedures performed. Include any surgeries such as vagotomy, pyloroplasty, gastrectomy, or gastroenterostomy.
Worst-day example:
“I was hospitalized in March 2019 at VA Medical Center for a perforated ulcer and underwent emergency surgery. I was hospitalized again in November 2021 for GI bleeding requiring a transfusion of two units of packed red blood cells. I stayed six days that admission.”
What the examiner listens for:
Number of hospitalizations, surgical procedures, reason for hospitalization (perforation, hemorrhage, obstruction), post-operative complications - hospitalizations for perforation or hemorrhage directly support 40%-100% ratings
Understatements to avoid:
Do not omit any hospitalization, even if it occurred many years ago or at a non-VA facility. Bring discharge summaries if available. Each hospitalization is a documented data point the examiner will record.
Medication Burden and Treatment Requirements
How to describe:
List all medications you take specifically for your stomach or duodenal condition: name, dose, frequency, and how long you have been on them. Note whether symptoms persist despite medication compliance. Also note any side effects from medications that affect your daily functioning.
Worst-day example:
“I take omeprazole 40mg twice daily, famotidine at bedtime, and sucralfate before meals every day. Even on this regimen, I have breakthrough pain several times a week. Without medication I cannot function at all. I have been on PPIs continuously for over five years.”
What the examiner listens for:
Whether symptoms require continuous medication management, whether symptoms persist despite medication - continuous medication requirement is a core criterion distinguishing 20% from higher ratings
Understatements to avoid:
Do not say 'I just take some stomach medicine.' List every medication by name and state clearly whether symptoms are controlled or persist despite treatment.
Common Mistakes to Avoid
Only describing symptoms on the day of the exam
The C&P exam captures a snapshot, but your rating should reflect the full range of your condition. If exam day happens to be a good day, the examiner may underestimate severity.
Instead: Per M21-1 guidance, report your worst-day experiences and your average functioning over the past 12 months. Explicitly state: 'Today is a relatively good day; on my worst days, which occur approximately [X] times per month, I experience [describe worst symptoms].'
Impact: 40% vs 60%
Failing to document hospitalizations for GI bleeding or perforation
Hospitalizations for hemorrhage or perforation are key criteria separating the 20-40% range from the 60-100% range. Unreported hospitalizations result in significantly lower ratings.
Instead: Before the exam, gather all hospital discharge summaries, ER records, and surgical operative reports. List every hospitalization chronologically and bring copies to the exam.
Impact: 60% and 100%
Not mentioning that symptoms persist despite taking medications
If the examiner only records that you take a PPI and does not document that symptoms continue despite treatment, the DBQ may appear to show a well-controlled condition - which lowers the rating.
Instead: Explicitly state: 'I take [medication name and dose] every day but I still have [describe symptoms] [frequency] times per week.' Breakthrough symptoms on therapy are critical for ratings above 20%.
Impact: 20% vs 40%
Omitting dietary restrictions and the reason for them
Medically directed dietary modification is a specific DBQ checkbox (field 153). If you do not mention it, the examiner will not check that box, and a key symptom indicator for higher ratings will be missed.
Instead: Tell the examiner: 'My doctor placed me on a [specific] diet restriction because of my condition. I am required to avoid [foods] and eat [modification]. This is a medically directed requirement, not a personal preference.'
Impact: 40% vs 60%
Failing to report post-prandial dizziness or near-syncope
Post-prandial meal-induced lightheadedness or syncope (field 165) is a specific higher-rating criterion. Veterans with post-surgical or severe gastritis conditions often develop this but do not connect it to their GI condition.
Instead: If you experience dizziness, sweating, heart racing, or near-fainting after meals, tell the examiner explicitly and connect it to your stomach condition. Ask whether this could be dumping syndrome.
Impact: 60% and 100%
Minimizing explosive or unpredictable diarrhea
Explosive bowel movements that are difficult to predict (field 161) and watery bowel movements (field 157) are discrete DBQ items. Understating diarrhea as 'loose stools sometimes' fails to trigger these checkboxes.
Instead: Describe diarrhea in specific operational terms: 'I have explosive, watery bowel movements [X] times per day on bad days. They come on suddenly with little warning. I have had accidents and I plan all activities around bathroom access.'
Impact: 40% vs 60%
Not listing all GI-specific medications by name and dose
The DBQ specifically asks for medications used for the diagnosed condition (field 94). A vague response like 'stomach medicine' does not convey the burden of ongoing pharmacologic management.
Instead: Write out your complete medication list for GI conditions before the exam and hand a copy to the examiner. Include drug name, dose, frequency, and duration of use.
Impact: 20% vs 40%
Assuming H. pylori eradication means the condition is resolved
Chronic gastritis (DC 7307) can persist after H. pylori treatment. The condition is rated based on current symptoms and functional impairment, not solely on whether the infection was treated.
Instead: If symptoms continue after H. pylori treatment, state clearly: 'My H. pylori was treated but my gastritis symptoms - specifically [describe] - have continued. I still require [medications/diet] to manage the condition.'
Impact: 0% vs 20-40%
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 and contemporaneous C&P examination that considers your full symptom history, not just your presentation on the day of the exam.
- You have the right to request a copy of the completed DBQ through your claims file or via FOIA request.
- In most states, you have the right to record your C&P examination. Check your state's recording consent laws before the exam and notify the examiner if you plan to record.
- You have the right to submit a personal statement or buddy statements to supplement the examiner's findings if you believe the exam was inadequate or did not capture your symptoms accurately.
- You have the right to challenge an inadequate C&P examination - if the exam did not address all relevant symptoms, was too brief, or contained factual errors, you can request a new examination through your VSO.
- You have the right to have a VSO representative, accredited claims agent, or attorney assist you with your claim at no cost through accredited organizations.
- You have the right to bring a support person (family member, VSO, advocate) to the exam at most facilities - contact the exam facility in advance to confirm.
- Under 38 CFR - 3.105(e), any reduction in your rating based on a C&P exam must follow specific procedural protections, including advance notice and an opportunity to respond before the reduction takes effect.
- The benefit of the doubt rule under 38 USC - 5107(b) requires the VA to resolve all reasonable doubt in your favor when the evidence is in approximate balance.
- You have the right to submit a private nexus opinion or independent medical opinion (IMO) from a treating physician to counter an unfavorable C&P exam finding.
Related Conditions
- Chronic Gastritis (H. Pylori, Drug-Induced, Zollinger-Ellison, Portal Hypertensive Gastropathy) Rated identically to peptic ulcer disease under DC 7307, which instructs raters to apply DC 7304 criteria. All subtypes (H. pylori, drug induced, Zollinger Ellison syndrome, portal hypertensive gastropathy with varix complications) fall under this code.
- Stomach Stenosis Rated under DC 7309 by reference to either DC 7303 (chronic complications of upper GI surgery) or DC 7304 (peptic ulcer disease), depending on the predominant disability. A complication or sequela of peptic ulcer disease or gastritis.
- Post-Gastrectomy Syndrome (Dumping Syndrome) Arises as a post surgical complication following gastrectomy performed for peptic ulcer disease or gastric cancer. Rated under DC 7308 and may be separately ratable in addition to the underlying stomach condition under 38 CFR 4.114.
- Chronic Complications of Upper GI Surgery Veterans who have had vagotomy, pyloroplasty, gastrectomy, or gastroenterostomy for peptic ulcer disease may develop chronic post operative complications rated under DC 7303, which may be considered in combination with or instead of DC 7304 depending on the predominant disability.
- GI Dysmotility Disorder / Functional Digestive Disorders May co exist with or result from peptic ulcer disease or gastritis. The DBQ includes checkboxes for functional digestive disorders and GI dysmotility disorders, which may be separately evaluated and claimed.
- Anemia (Secondary to GI Bleeding) Iron deficiency or hemorrhagic anemia secondary to peptic ulcer disease or gastritis may be separately ratable as a secondary condition under 38 CFR 3.310 if it is not already captured in the primary ulcer/gastritis rating. A history of anemia requiring hospitalization is a specific criterion for higher ulcer ratings.
- PTSD / Mental Health Conditions Chronic stress from PTSD and other mental health conditions is a recognized aggravating factor for peptic ulcer disease and gastritis. Veterans with both PTSD and GI conditions should consider whether a secondary service connection claim is warranted.
- Duodenal Ulcer Disease Duodenal ulcer disease is encompassed within peptic ulcer disease under DC 7304 and the GI Stomach and Duodenum DBQ. Specific documentation of duodenal versus gastric ulcer location may affect ICD coding but both are evaluated under the same rating criteria.
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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.