Evidence Checklist: Colostomy / Ileostomy
DC 7329
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Nexus opinion linking ostomy to service ("at least as likely as not")Critical
A medical opinion connecting ostomy creation to service-connected bowel disease, colorectal trauma sustained during service, or service-connected malignancy requiring bowel diversion.
Treating Physician
Current ostomy care records and complications documentationCritical
Records from your ostomy nurse (CWOCN) or colorectal surgeon documenting stoma complications (prolapse, retraction, hernia, stenosis, skin breakdown), appliance requirements, and care needs.
Treatment Records
Perineal wound documentation (after APR, if applicable)
Records documenting perineal wound status following abdominoperineal resection, including healing, chronic wound care, sinus tracts, and pain — relevant for separate perineal rating.
Peristomal skin complication records
Dermatology or ostomy records documenting peristomal dermatitis, skin breakdown, irritant contact dermatitis, or allergic reactions to ostomy appliances requiring ongoing treatment.
Lay Statements & Personal Documentation
Functional impact statement (employment, social, hygiene limitations)
Personal statement or physician documentation of how the ostomy affects employment options, social activities, intimate relationships, and daily hygiene routines.
Buddy statement from spouse, family, or fellow service member
A written statement from someone who can describe observable symptoms and how your condition affects daily life.
Personal statement describing symptoms and functional impact
Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Intestinal Conditions (other than Small or Large Intestine)Critical
Standardized form capturing ostomy type, permanence, complications, skin breakdown, and overall functional impact. Colostomy is rated at minimum 40%.
Service Records
Surgical records documenting ostomy creation (type, indication, date)Critical
Operative reports documenting the type of diversion (end colostomy, loop colostomy, end ileostomy, loop ileostomy), indication for surgery, and whether the ostomy is permanent or temporary.
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.