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Evidence checklist

Peptic Ulcer Disease

DC 730438 CFR § 4.114Digestive

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 2 collected
Upper endoscopy (EGD) confirming ulcer location and sizeCritical

Esophagogastroduodenoscopy report documenting peptic ulcer location (gastric vs. duodenal), size, depth (superficial vs. penetrating), and presence of complications (bleeding, perforation).

Private provider · independent opinion
Nexus opinion linking PUD to service ("at least as likely as not")Critical

A medical opinion connecting peptic ulcer disease to service-related NSAID use for service-connected pain, combat stress, H. pylori acquired during deployment, or other service-related factors.

Private provider · independent opinion
02

Treatment records

0 of 4 collected
H. pylori testing results (urea breath test, stool antigen, or biopsy CLO test)Critical

Test results confirming or ruling out H. pylori infection — the primary causative agent for duodenal ulcers. Positive results support an infectious etiology and treatment course.

VA or private records · written request
Documentation of complications (hemorrhage, perforation, obstruction)

Hospital records documenting upper GI bleeding episodes (hemoglobin drops, endoscopic hemostasis), perforation surgery, or gastric outlet obstruction — each is a ratable condition in its own right.

VA or private records · written request
Treatment records (PPIs, H. pylori eradication, surgery)

Records documenting PPI therapy, H. pylori eradication triple/quadruple therapy, and any surgical procedures (vagotomy, pyloroplasty, partial gastrectomy) for refractory disease.

VA or private records · written request
Weight and nutrition documentation (supporting context)

Records showing weight loss or nutritional impact from ulcer symptoms or post-gastric surgery. Under DC 7304 weight loss is not itself a rating criterion (the rating is based on episode frequency, bleeding/anemia requiring hospitalization, and post-operative status), but it helps show severity and supports secondary claims.

VA or private records · written request
03

Lay statements

0 of 3 collected
Symptom diary: episodes lasting 3+ days and daily medication useCritical

A log of each episode of abdominal pain, nausea, or vomiting that lasts at least three consecutive days, how many you have in a 12-month period, and your daily prescribed medication — under DC 7304 this sets the 20% (up to 3 episodes a year) and 40% (4 or more a year) levels.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
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.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
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.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Stomach and Duodenal ConditionsCritical

Standardized form capturing endoscopy findings, H. pylori status, complication history, weight impact, and treatment requirements.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

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

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forC&P exam prepWhat the examiner will askBuddy statement builderGuided VA Form 21-10210

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