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Evidence checklist

Small Bowel Obstruction

DC 730138 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
Imaging during obstructive episodes (X-ray or CT)Critical

Abdominal X-ray or CT scan obtained during obstructive episodes showing dilated bowel loops, air-fluid levels, or transition points.

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

A medical opinion connecting your recurrent small bowel obstruction to adhesions from in-service abdominal surgery, injury, or other service-related cause.

Private provider · independent opinion
02

Treatment records

0 of 2 collected
Surgical records showing abdominal surgery during serviceCritical

Operative reports from abdominal surgeries performed during military service that caused adhesions leading to recurrent obstruction.

VA or private records · written request
ER visit records for obstructive episodes

Emergency room records documenting presentations for small bowel obstruction including symptoms, imaging, and treatment provided.

VA or private records · written request
03

Lay statements

0 of 2 collected
Episode frequency documentation

A log or medical records documenting the frequency of obstructive episodes, hospitalizations, and days of incapacitation per year.

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 →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Intestinal ConditionsCritical

Standardized form capturing obstruction frequency, surgical history, and functional impact on nutrition and daily activities.

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 forBuddy statement builderGuided VA Form 21-10210

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