C&P Exam for Peptic ulcer disease (DC 7304)

Diagnostic code: 7304Condition: Peptic ulcer diseaseRegulation: 38 CFR § 4.114DBQ: DBQ GI Stomach and Duodenum

Which form the examiner uses

For peptic ulcer disease (DC 7304), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQ GI Stomach and Duodenum (public PDF on VA.gov)

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 stomach and duodenal conditions (excluding GERD and esophageal disorders) including peptic ulcer disease, chronic gastritis, postgastrectomy syndrome, and stomach injuries.

How DC 7304 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-III and VII-XI of this form. Section III is the condition-specific section for this code. Sections IV-VI cover unrelated conditions on this DBQ and are skipped.

DIAGNOSIS (Section I)

1A. List the claimed condition(s) that pertain to this questionnaire:
1B. Select diagnoses associated with the claimed condition(s) (check all that apply): The Veteran does not have a current diagnosis associated with any claimed condition(s) listed above.
Peptic ulcer disease — ICD Code / Date of diagnosis
Stenosis of the stomach — ICD Code / Date of diagnosis
Stomach, injury of, residuals — ICD Code / Date of diagnosis
Chronic gastritis (check all that apply, if known) — ICD Code / Date of diagnosis
Helicobacter pylori infection — ICD Code / Date of diagnosis
Drug-induced gastritis — ICD Code / Date of diagnosis
Zollinger-Ellison syndrome — ICD Code / Date of diagnosis
Portal-hypertensive gastropathy with varix-related complications — ICD Code / Date of diagnosis
Postgastrectomy syndrome — ICD Code / Date of diagnosis
Status post vagotomy with pyloroplasty — ICD Code / Date of diagnosis
Gasteroenterostomy — ICD Code / Date of diagnosis
Functional digestive disorder(s) — ICD Code / Date of diagnosis
Gastrointestinal dysmotility disorder — ICD Code / Date of diagnosis
Stomach cancer — ICD Code / Date of diagnosis
Other diagnosis #1 / #2 / #3 — ICD Code / Date of diagnosis

MEDICAL HISTORY (Section II)

2A. Describe the history (including onset and course) of the Veteran's stomach or duodenum conditions (brief summary):
2B. Does the Veteran's treatment plan include taking continuous medication for the diagnosed condition?
If yes, list only those medications used for the diagnosed condition.

PEPTIC ULCER DISEASE, CHRONIC GASTRITIS, OR OTHER STOMACH CONDITIONS (Section III)

3A. Does the Veteran have any of the following signs or symptoms due to peptic ulcer disease, chronic gastritis, or other stomach conditions?
History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies
Episodes of abdominal pain, nausea, or vomiting that last for at least three consecutive days and are managed by daily prescribed medication (select frequency)
Occurring three times or less in past 12 months
Occurring four or more times in past 12 months
Continuous abdominal pain with intermittent vomiting
Recurrent hematemesis (vomiting blood)
Melena (tarry stools)
Manifestations of anemia which require hospitalization at least once in the past 12 months — Date of admission / Indicate facility
Post-operative for perforation or hemorrhage — Date of procedure(s) / Indicate facility

STOMACH INJURY (Section IV)

4A. Does the Veteran have, or has had, a stomach injury?
Post-operative (if selected, complete Section V)
Pre-operative — Asymptomatic
Pre-operative — Diarrhea
Pre-operative — Constipation
Pre-operative — Colic
Pre-operative — Vomiting
Pre-operative — Nausea
Pre-operative — 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 — Date of admission / Indicate facility

COMPLICATIONS OF UPPER GASTROINTESTINAL SURGERY AND POSTGASTRECTOMY SYNDROME (Section V)

5A. Has the Veteran had upper gastrointestinal surgery performed on the stomach or duodenum?
Post-operative, asymptomatic
Requiring continuous total parenteral nutrition (TPN) for a period longer than 30 consecutive days in the last six months — Start date of TPN / Completion date of TPN or anticipated date of completion
Requiring continuous tube feedings for a period longer than 30 consecutive days in the last six months — Start date of tube feeding / Completion date of tube feeding or anticipated date of completion
Vomiting — Frequency: Less than 2 times a week / 2 or more times a week / Daily
Vomiting — Treatment: No treatment / Managed by ongoing medical treatment / Vomiting despite medical treatment
Vomiting despite medical treatment — Oral dietary modification / Medication / Other (specify)
Watery bowel movements — Frequency: Less than 3 per day every day / 3-5 per day every day / 6 or more per day every day
Explosive bowel movements that are difficult to predict or control
Nausea — Managed by ongoing medical treatment? Yes / No
Post-prandial (meal-induced) light-headedness (syncope) with sweating
Requirement for medications to specifically treat complications of upper GI surgery including dumping syndrome or delayed gastric emptying
Discomfort or pain within an hour of eating and requiring ongoing oral dietary modification
Other, symptom(s) specify:

VAGOTOMY WITH PYLOROPLASTY OR GASTROENTEROSTOMY (Section VI)

6A. Has the Veteran had a vagotomy with pyloroplasty or gastroenterostomy?
Complete vagotomy
Incomplete vagotomy
Symptoms and confirmed diagnosis of alkaline gastritis
With confirmed persisting diarrhea
Following confirmation of post-operative complications of stricture or continuing gastric retention
Date of procedure(s) / Indicate facility

TUMORS AND NEOPLASMS (Section VII)

7A. Does the Veteran currently have, or has had, a benign or malignant neoplasm or metastases related to any condition in the diagnosis section?
7B. Is the neoplasm: Benign / Malignant
If malignant: Active / In remission
If malignant: Primary / Secondary (metastatic) — indicate the primary site, if known
7C. Has the Veteran completed treatment or is the Veteran currently undergoing treatment for a benign or malignant neoplasm or metastases?
Treatment completed
Surgery — describe / Date(s) of surgery
Radiation therapy — Date of most recent treatment / Date of completion of treatment or anticipated date of completion
Antineoplastic chemotherapy — Date of most recent treatment / Date of completion of treatment or anticipated date of completion
Other therapeutic procedure — describe procedure / Date of most recent procedure
Other therapeutic treatment — describe treatment / Date of completion of treatment or anticipated date of completion
7D. Does the Veteran currently have any residuals or complications due to the neoplasm (including metastases) or its treatment, other than those already documented in the report above?
If yes, list residuals or complications (brief summary)

OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS AND/OR SYMPTOMS (Section VIII)

8A. 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)
8B. 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 IX)

9A. Have clinically relevant diagnostic imaging studies or other diagnostic procedures been performed or reviewed in conjunction with this examination?
Upper endoscopy — Date / Results
Upper GI radiographic studies — Date / Results
MRI — Date / Results
CT — Date / Results
Biopsy, specify site — Date / Results
Other, specify — Date / Results
9B. Has clinically relevant laboratory testing been performed or reviewed in conjunction with this examination?
CBC — Date of test / Hemoglobin / Hematocrit / White blood cell count / Platelets
Helicobacter pylori — Date of test / Results
Other, specify — Date of test / Results
9C. Are there any other clinically relevant diagnostic test findings or results related to the claimed condition(s) and/or diagnosis(es), that were reviewed in conjunction with this examination?
If yes, provide type of test or procedure, date and results (brief summary):
9D. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions:

FUNCTIONAL IMPACT (Section X)

10A. 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 XI)

11A. Remarks (if any - please identify the section to which the remark pertains when appropriate).

Rating Levels for DC 7304

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.

Evidence cited in published BVA decisions for DC 7304

The counts below are aggregated from published Board of Veterans Appeals decisions for this diagnostic code. Each row reports how often a given evidence type was discussed in the decision text, broken down by outcome. This is a factual aggregate of the public record, not a prediction or recommendation about any specific claim.

VA examination: appeared in 4 granted decisions (5 denied, 10 remanded; 19 total)
Service treatment records: appeared in 2 granted decisions (0 denied, 2 remanded; 4 total)
Buddy / lay statements: appeared in 1 granted decision (0 denied, 1 remanded; 2 total)
Private medical opinion: appeared in 1 granted decision (2 denied, 2 remanded; 5 total)
Medical literature: appeared in 1 granted decision (0 denied, 0 remanded; 1 total)
Nexus letter: appeared in 0 granted decisions (0 denied, 3 remanded; 3 total)

What the Board discussed in granted decisions for DC 7304

The themes below were extracted by clustering 386 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.

23% Benefit of the doubt doctrine cited as legal standard
The Board or decision cited the statutory or regulatory requirement that benefit of the doubt be given to the claimant when positive and negative evidence is in approximate balance.
87 of 386 sample sentences
16% Evidence found in equipoise, claim granted
The Board found the evidence at least in relative equipoise regarding a peptic ulcer or related gastrointestinal condition and resolved the benefit of the doubt in the Veteran's favor to grant the claim.
61 of 386 sample sentences
13% Preponderance against claim, benefit of doubt not applied
The Board determined that the preponderance of evidence weighed against the claim, making the benefit of the doubt doctrine inapplicable and resulting in denial.
52 of 386 sample sentences
13% Medical nexus opinion noted as at least as likely as not
A VA or private examiner opined that a peptic ulcer, gastric ulcer, duodenal ulcer, GERD, or related condition was at least as likely as not incurred in, caused by, or aggravated by service or a service-connected disability.
51 of 386 sample sentences
7% Service connection for ulcer granted resolving reasonable doubt
The Board concluded, resolving benefit of the doubt in the Veteran's favor, that a duodenal ulcer, gastric ulcer, peptic ulcer disease, or related condition was incurred in or related to active military service.
27 of 386 sample sentences
5% Increased rating granted applying benefit of the doubt
The Board applied the benefit of the doubt to assign or restore a specific disability rating percentage for a peptic ulcer or related gastrointestinal disability.
19 of 386 sample sentences
3% Secondary service connection noted via NSAID or medication use
An examiner or the Board noted that a gastric or peptic ulcer was at least as likely as not caused or aggravated by NSAID or other medication use related to a service-connected disability.
10 of 386 sample sentences
3% Remand ordered for additional nexus opinion
The Board remanded the claim to obtain an additional or addendum VA medical opinion on whether a gastrointestinal or related condition was at least as likely as not related to service or a service-connected disability.
10 of 386 sample sentences
1% Veteran's credible lay statements supported equipoise finding
The Board cited the Veteran's credible account of in-service or continuous symptoms as contributing to a finding that the evidence was at least in equipoise regarding service connection for a peptic ulcer condition.
5 of 386 sample sentences
1% Destroyed or lost records noted, heightened duty applied
The Board noted that service medical records were presumed destroyed or lost, triggering a heightened duty to consider the benefit of the doubt and assist in claim development.
4 of 386 sample sentences

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.