Evidence Checklist: Crohn's Disease

Colonoscopy with ileoscopy showing transmural inflammation and skip lesionsCritical

Colonoscopy report documenting characteristic Crohn's findings — skip lesions, cobblestoning, strictures, fistulas, or perianal involvement — with extent of disease mapped.

Biopsy confirming granulomatous inflammationCritical

Pathology report from colonoscopic or surgical biopsies showing transmural granulomatous inflammation consistent with Crohn's disease.

Nexus opinion linking Crohn's disease to service ("at least as likely as not")Critical

A medical opinion connecting Crohn's to service-related factors including combat stress, PTSD, infectious gastroenteritis during deployment, NSAID use, or smoking history during service.

Inflammatory markers and nutritional labs (CRP, ESR, albumin, CBC)

Lab results documenting elevated C-reactive protein, ESR, anemia, hypoalbuminemia, or other markers of active disease and nutritional compromise.

Treatment records (biologics, immunomodulators, corticosteroids, surgery)

Records documenting the escalating treatment ladder — aminosalicylates, azathioprine, methotrexate, anti-TNF biologics (infliximab, adalimumab), and any surgical resections.

Weight loss and nutritional deficiency documentation

Serial weight measurements, BMI records, and nutritional labs documenting malabsorption, weight loss, or need for enteral/parenteral nutrition.

Documentation of incapacitating episodes and hospitalizationsCritical

Medical records or personal log tracking flares requiring bed rest, ER visits, or hospitalizations. The number of incapacitating episodes per year directly determines the VA rating.

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.

Completed DBQ Intestinal Conditions (other than Small or Large Intestine)Critical

Standardized form capturing Crohn's disease extent, stool frequency, incapacitating episodes, weight impact, and complications.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.