C&P Exam for Peritoneum, adhesions of, due to surgery, trauma, disease, or infection (DC 7301)

Diagnostic code: 7301Condition: Peritoneum, adhesions of, due to surgery, trauma, disease, or infectionRegulation: 38 CFR § 4.114DBQ: DBQ GI Peritoneal Adhesion

Which form the examiner uses

For peritoneum, adhesions of, due to surgery, trauma, disease, or infection (DC 7301), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQs are Department of Veterans Affairs Form 21-0960 series documents. Public DBQs are hosted on benefits.va.gov. A handful are examiner-only and are not posted publicly.

What the examiner records

The fields below are reproduced from the DBQ form the examiner completes for this diagnostic code. This is the structural map of the form, showing what the examiner is asked to measure, observe, and record. It is a factual reproduction of the public DBQ, not advice on how to answer.

This DBQ evaluates peritoneal adhesions, including their etiology, affected organs, symptomatic manifestations, bowel obstruction severity, hospitalizations, and functional impact for VA disability rating purposes.

DIAGNOSIS (Section I)
  • 1A. List the claimed condition(s) that pertain to this questionnaire:
  • 1B. Provide the diagnosis(es) that pertain to peritoneal adhesions (due to surgery, trauma, disease, or infection):
  • The Veteran does not have a current diagnosis associated with any claimed condition(s) listed above.
  • Diagnosis #1
  • Diagnosis #1 ICD code:
  • Diagnosis #1 Date of diagnosis:
  • Diagnosis #2
  • Diagnosis #2 ICD code:
  • Diagnosis #2 Date of diagnosis:
  • Diagnosis #3
  • Diagnosis #3 ICD code:
  • Diagnosis #3 Date of diagnosis:
  • 1C. If there are additional diagnoses that pertain to peritoneal adhesions, list using above format:
MEDICAL HISTORY (Section II)
  • 2A. Describe the history (including onset and course) of the Veteran's peritoneal adhesions (brief summary):
  • 2B. Provide the etiology of the Veteran's peritoneal adhesions.
  • Surgery
  • Trauma
  • Inflammatory disease process, such as chronic cholecystitis or Crohn's disease
  • Infection
  • Other
  • 2C. Indicate organ(s) affected. Check all that apply and complete the appropriate questionnaire.
  • Stomach
  • Gallbladder
  • Liver
  • Small intestines
  • Large intestines
  • Pancreas
  • Other
MANIFESTATIONS OF PERITONEAL ADHESIONS (Section III)
  • 3A. Does the Veteran have peritoneal adhesions?
  • Asymptomatic peritoneal adhesions (complete 3C).
  • Symptomatic peritoneal adhesions (complete 3B and 3C).
  • 3B. If peritoneal adhesions are symptomatic, check all that apply:
  • Diarrhea
  • Constipation
  • Colic
  • Vomiting
  • Nausea
  • Abdominal pain
  • Medically directed dietary modification other than total parenteral nutrition (TPN)
  • Persistent partial bowel obstruction
  • Is the persistent partial bowel obstruction inoperable?
  • Is the persistent partial bowel obstruction refractory to treatment?
  • Does the persistent partial bowel obstruction require (TPN) for obstructive symptoms?
  • Clinical evidence of recurrent obstructions requiring hospitalization at least once a year (as shown and documented in the Veteran's health record(s). If checked, also complete Section IV).
  • 3C. Does the Veteran's treatment plan include taking medication for the diagnosed condition?
  • If yes, list medications used.
HOSPITALIZATIONS (Section IV)
  • 4A. Has the Veteran had any hospitalizations for the treatment of, or complications resulting from peritoneal adhesions in the past 24 months?
  • Date of admission:
  • Indicate treatment facility:
  • If there are additional hospitalizations, list using above format:
OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS (Section V)
  • 5A. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the diagnosis section above?
  • If yes, describe (brief summary):
  • 5B. Does the Veteran have any scars or other disfigurement (of the skin) related to any conditions or to the treatment of any conditions listed in the diagnosis section?
DIAGNOSTIC TESTING (Section VI)
  • 6A. Are there any clinically relevant laboratory or other diagnostic studies that were reviewed in conjunction with this examination that are related to the claimed condition(s) and/or diagnosis(es)?
  • If yes, provide type of test or procedure, date and results (brief summary):
FUNCTIONAL IMPACT (Section VII)
  • 7A. Regardless of the Veteran's current employment status, do the conditions listed in the diagnosis section impact his/her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)?
  • If yes, describe the functional impact of each condition, providing one or more examples:
REMARKS (Section VIII)
  • 8A. Remarks (if any – please identify the section to which the remark pertains when appropriate).

Rating Levels for DC 7301

The following tiers are reproduced from 38 CFR Part 4, the VA Schedule for Rating Disabilities. Toggle between the official VA criteria and a Plain English explanation.

Plain-English summaries are AI-generated to explain the official criteria. The official 38 CFR language is the binding legal standard. When in doubt, ask a VSO.

What the Board discussed in granted decisions for DC 7301

The themes below were extracted by clustering 500 grant-factor sentences from published Board of Veterans Appeals decisions for this diagnostic code. Frequencies indicate how often each theme appeared in the sample. This is a factual aggregate of the public record, not advice or strategy for any specific claim.

  1. 32% Benefit of the doubt doctrine cited in grant or denial
    The Board noted its consideration, application, or inapplicability of the benefit of the doubt doctrine as part of its rationale for granting or denying a rating or service connection.
    162 of 500 sample sentences
  2. 19% VA or private examiner nexus opinion noted as at least as likely as not
    A VA or private medical examiner opined that a current disability was at least as likely as not caused by, related to, or aggravated by service or a service-connected condition.
    94 of 500 sample sentences
  3. 14% Preponderance of evidence found against claim; benefit of the doubt inapplicable
    The Board determined that the preponderance of evidence weighed against the claim, making the benefit of the doubt doctrine inapplicable and resulting in denial.
    70 of 500 sample sentences
  4. 14% Equipoise standard cited in rating determination
    The Board found the evidence to be at least in relative equipoise on a material issue, resulting in the claim being resolved in the Veteran's favor.
    68 of 500 sample sentences
  5. 11% Benefit of the doubt applied to assign specific disability rating
    The Board explicitly resolved benefit of the doubt in the Veteran's favor to assign or affirm a particular schedular disability rating percentage.
    55 of 500 sample sentences
  6. 8% Legal standard for benefit of the doubt rule stated
    The Board or decision recited the statutory or regulatory standard requiring VA to give the benefit of the doubt when positive and negative evidence is in approximate balance.
    42 of 500 sample sentences
  7. 6% Board responsibility to weigh evidence and determine equipoise noted
    The Board described its responsibility to determine whether the evidence supports the claim, is in relative equipoise, or preponderates against the claim.
    32 of 500 sample sentences
  8. 5% Examiner opinion requested on at-least-as-likely-as-not standard
    The Board or remand order directed a medical examiner to provide an opinion framed around the at-least-as-likely-as-not (50 percent or greater) probability standard.
    24 of 500 sample sentences
  9. 4% Benefit of the doubt applied to service connection grant
    The Board resolved the benefit of the doubt in the Veteran's favor to establish service connection for a claimed disability.
    20 of 500 sample sentences
  10. 4% Examiner opinion recorded as unfavorable or negative nexus
    A VA or private examiner opined that a disability was not at least as likely as not related to service or a service-connected condition, weighing against the claim.
    18 of 500 sample sentences
  11. 2% Abdominal adhesions or gastrointestinal secondary condition nexus recorded
    A medical examiner or the Board recorded findings that abdominal adhesions, bowel resection residuals, or related gastrointestinal conditions were at least as likely as not caused by or secondary to service-connected surgery, trauma, or disease.
    8 of 500 sample sentences
  12. 1% Insufficient evidence noted; benefit of the doubt not triggered
    The Board found that the record lacked sufficient evidence of a current disability or valid claim to invoke the benefit of the doubt doctrine at all.
    7 of 500 sample sentences
View the full DC 7301 pageSearch BVA decisions for this codeAbout DBQ forms

Disclaimer: This page reproduces public Department of Veterans Affairs forms (DBQs) and verbatim text from 38 CFR Part 4 (the VA Schedule for Rating Disabilities). It is informational only and is not legal or medical advice. For guidance on a specific claim, contact a VA-accredited representative.