Marginal (Anastomotic) Ulcer

DC 7306Digestive38 CFR 4.114, DC 7306

An ulcer that develops at or near the site where the stomach was surgically connected to the intestine (anastomosis), typically after gastric bypass or partial gastrectomy. The VA rates marginal ulcers based on symptom severity, complications, and the impact on nutrition and daily function.

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7306

Rating range

10% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.114, DC 7306. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have a severe marginal ulcer with pain only partially relieved by standard ulcer therapy. You experience recurrent hematemesis (vomiting blood) or melena (black tarry stool) with systemic manifestations of anemia, weight loss, and general debility.

What the VA looks for

Pain only partially relieved by maximum medical therapy
Recurrent hematemesis or melena
Anemia with hemoglobin consistently below normal
Significant weight loss and general debility
Definite impairment of health documented by physician

Common Pitfalls

⚠Not getting endoscopy to document the ulcer — a marginal ulcer must be visualized and confirmed at the anastomotic site. Without endoscopic evidence, the VA may rate under a less favorable diagnostic code.
⚠Not connecting the ulcer to the original surgery — marginal ulcers develop because of previous gastric surgery. If that surgery was service-connected (e.g., for a service-connected gastric condition), the marginal ulcer is a direct residual.
⚠Not documenting incapacitating episodes — days when you are essentially bedridden from pain, nausea, and vomiting should be logged with dates and duration. These episodes are specifically referenced in the rating criteria.
⚠Not tracking weight loss with regular weigh-ins — progressive weight loss is a key differentiator between rating levels. Regular documented weights over time are more persuasive than a single measurement.

Related DBQ Forms

DBQ Stomach and Duodenal Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Marginal (Anastomotic) Ulcer

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7306

Rating range

10% – 60%

Rating levels

Rating Levels

What the VA looks for

Pain only partially relieved by maximum medical therapy
Recurrent hematemesis or melena
Anemia with hemoglobin consistently below normal
Significant weight loss and general debility
Definite impairment of health documented by physician

Common Pitfalls

⚠Not getting endoscopy to document the ulcer — a marginal ulcer must be visualized and confirmed at the anastomotic site. Without endoscopic evidence, the VA may rate under a less favorable diagnostic code.

⚠Not connecting the ulcer to the original surgery — marginal ulcers develop because of previous gastric surgery. If that surgery was service-connected (e.g., for a service-connected gastric condition), the marginal ulcer is a direct residual.

⚠Not documenting incapacitating episodes — days when you are essentially bedridden from pain, nausea, and vomiting should be logged with dates and duration. These episodes are specifically referenced in the rating criteria.

⚠Not tracking weight loss with regular weigh-ins — progressive weight loss is a key differentiator between rating levels. Regular documented weights over time are more persuasive than a single measurement.