C&P Exam for IBS: What to Expect and How to Prepare for the Big Day!

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If you’ve filed a VA claim for IBS, you’ll likely be scheduled for a C&P exam for IBS.

In this high-value blog post, you’ll learn “what” to expect and “how” to prepare for the #1 most important day in the VA claim process so you can get the VA rating and compensation you deserve.

What’s the bottom line?

Irritable Bowel Syndrome (IBS) is a big problem for military veterans.

So much so that IBS is among the Top 50 Most Common VA Disability Claims across all veteran demographics.

Pro Tip: Effective May 19, 2024, under the new name for DC 7319, Irritable Bowel Syndrome (IBS), veterans will be eligible to receive VA disability for IBS ranging from 10% to 30% with a break at 20%. The 0% non-compensable rating for IBS was recently removed. Thus, the new minimum compensable rating for IBS is now 10%.

What to Expect at Your C&P Exam for IBS

A C&P exam for IBS is designed to evaluate whether (#1) you have IBS diagnosed, and if so, (#2) The severity of your symptoms and any negative impacts on your work, life, and social functioning.

Here are six things you can expect during a VA C&P exam for IBS:

• Review of Medical History: The C&P examiner should start by reviewing your medical records, including any previous diagnoses, medical history, treatments, and evaluations related to IBS. Note: The examiner has access to the medical records and documents you submitted to the VA. You don’t need to bring records with you to the exam; however, it’s certainly acceptable to do so if you think it will help you remember important things.

• History and Onset: The examiner should ask about your military service history and any prior diagnoses of IBS. Certain factors commonly encountered in military environments, such as stress, irregular meal schedules, physical exertion, dietary factors, and exposure to environmental hazards, can contribute to the development or exacerbation of IBS. Service members deployed to combat zones may experience increased stress levels, irregular eating patterns, and exposure to environmental factors like smoke, dust, and chemicals, all of which can trigger or worsen IBS symptoms. Additionally, certain military occupations that involve heavy lifting, strenuous physical activity, or prolonged periods of sitting or standing may increase the risk of developing IBS. For example, “I was deployed to Iraq and exposed to many hazards including stress from the job, which is when my IBS symptoms began.”

• Discussion of Symptoms: The examiner should ask you about your IBS symptoms, including when you first noticed them and how often you experience them. Remember, your final VA rating for IBS depends upon the Frequency (how often), Severity (how bad), and Duration (how long) of symptoms and how those symptoms negatively affect your work, life, and social functioning. Common symptoms of IBS in veterans include: Abdominal pain or discomfort, altered bowel habits (diarrhea, constipation, or both), bloating and gas, changes in stool appearance, incomplete evacuation, abdominal distension, urgency for bowel movements, fatigue and sleep disturbances, and anxiety and depression.

• Negative Impacts on Daily Life: You’ll be asked about how IBS affects your daily activities, such as sleeping, concentrating, working, socializing, and overall quality of life. Be honest and provide specific examples of how IBS interferes with your ability to function normally.

• Physical Examination: The C&P examiner might conduct a physical exam to check for signs of complications related to IBS. The examiner may observe the patient for signs of discomfort, distress, or malnutrition. Expect the examiner to check your vital signs and perform an abdominal examination.

• Completion of VA Disability Benefits Questionnaire (DBQ) for IBS: The examiner will document their findings on the DBQ for IBS, which is then submitted to the VA Rater for further processing. Eventually, the VA Rater will either approve, deny, or defer your IBS claim.

List of Questions You Might Get Asked at a C&P Exam for IBS

Here’s a list of questions the examiner is required to document on the VA DBQ for IBS at the conclusion of your exam:

Diagnosis Confirmation:

• Does the veteran now have or has he or she ever been diagnosed with an intestinal condition such as IBS?

• Select the appropriate diagnosis for the intestinal condition with the ICD code and date of diagnosis.

History and Onset:

• Describe the history (including onset and course) of the veteran’s IBS (provide a brief summary).

• Details of any surgical interventions.

List the Veterans Symptoms of IBS:

Does the veteran have any signs or symptoms attributable to any non-surgical non-infectious intestinal conditions such as IBS? If yes, check and explain each symptom.

• Alternating diarrhea and constipation

• Abdominal distension

• Diarrhea

• Nausea

• Vomiting

• Anemia

• Other

Frequency and Severity of Symptoms:

• Explain how often the veteran experiences symptoms of IBS.

• Does the veteran have occassional episodes, frequenty episodes, or more or less constant abdominal distress?

• Frequency of symptoms over the last 12 months.

• Number of episodes or attacks of bowel disturbance in the past 12 months.

• Duration of typical episodes or attacks.

• Severity and type of symptoms during episodes (e.g., pain, diarrhea, constipation, other).

Weight Loss:

• Does the veteran have weight loss attributable to an intestinal condition? If yes, explain.

Malnutrition and Complications:

• Does the veteran have malnutrition, serious complications or other general health effects attributable to IBS?

Diagnostic Testing:

• Have any lab or imaging tests been performed? If yes, explain.

Examples of diagnostic testing for IBS:

Rome IV Criteria: These criteria are widely used to diagnose IBS. They focus on abdominal pain that has lasted for at least 1 day per week in the last 3 months, associated with two or more of the following: changes in the frequency of stool, changes in the form (appearance) of stool, and improvement of symptoms after defecation.

Comprehensive physical exam: Including an abdominal examination, may be conducted to check for any abdominal pain, bloating, or other physical signs of IBS.

Blood tests: To check for signs of anemia, inflammation, or celiac disease.

Stool tests: To look for infections, inflammation, or indicators of other digestive disorders.

Colonoscopy: Allows for direct visualization of the colon and the end portion of the small intestine to exclude conditions like inflammatory bowel disease (IBD), colorectal cancer, or diverticulosis.

Gastroscopy: Examines the upper part of the digestive system, which can help exclude ulcers, gastritis, or celiac disease.

Lactose intolerance tests: Lactose breath tests can identify lactose malabsorption, a condition that may mimic or exacerbate IBS symptoms.

Blood tests for anemia and celiac disease: To exclude this as a cause of symptoms.

Food Diary or Elimination Diet: Keeping a food diary or undergoing an elimination diet under the guidance of a healthcare provider or dietitian may help identify trigger foods that exacerbate IBS symptoms.

Breath tests for bacterial overgrowth: SIBO (Small Intestinal Bacterial Overgrowth) can cause symptoms similar to IBS, and breath tests can help identify this condition.

Transit studies: These can evaluate how quickly food passes through the intestines.

Treatment and Response:

• List the types of treatments received (medications, dietary modifications, etc.).

• Effectiveness of treatment in controlling symptoms.

• Any side effects of treatment experienced.

Impact on Occupational and Social Functioning:

• Effects of the condition on daily activities and work.

• Periods of hospitalization due to the condition.

• Need for assistance in personal care or activities of daily living.

Additional Questions Related to Digestive Conditions:

• Presence and treatment of associated conditions (e.g., gastroesophageal reflux disease, peptic ulcer disease).

• History of any related infectious diseases.

• Any other pertinent information or complications related to the digestive system.

C&P Examiners Observations and Comments:

• Any discrepancies observed between the claimant’s statements and medical evidence.

• Impact of the condition on the veteran’s physical and mental well-being.

• Professional assessment of the condition’s severity in relation to the veteran’s ability to work.

Examples of Common Work, Life, and Functional Impacts of IBS

IBS can have serious impacts on veterans, affecting their work, life, and overall functioning.

Here’s a list of some common examples of how IBS can negatively impact you:

Example Work Impacts of IBS

Reduced Productivity: Flare-ups of IBS symptoms can lead to discomfort and pain, making it difficult for individuals to concentrate on their work tasks. This can result in decreased productivity and the need for frequent breaks.

Increased Absenteeism: The unpredictable nature of IBS flare-ups often requires individuals to take time off work, either due to severe symptoms or the need for medical consultations and treatments. This can lead to a higher rate of absenteeism compared to individuals without IBS.

Workplace Accommodations: Some individuals with IBS may require special accommodations at work, such as easy access to restrooms or the flexibility to work from home. Navigating these accommodations can sometimes be challenging for both the employee and the employer.

Career Limitations: The chronic nature of IBS and its impacts on daily functioning can lead some individuals to reconsider their career aspirations or job choices, opting for roles that are more accommodating of their condition.

Social and Emotional Effects: The symptoms of IBS can also have social and emotional impacts that affect work life. The stress of managing a chronic condition can contribute to feelings of anxiety and depression, which can further affect work performance and relationships with colleagues.

Impact on Professional Development: Frequent absences or the need to manage symptoms can interfere with opportunities for professional development, such as attending conferences, meetings, or training sessions, potentially affecting career advancement.

Financial Impact: The costs associated with managing IBS, including healthcare visits, treatments, and medications, not to mention potential loss of income due to missed work, can have a significant financial impact on individuals.

Example Life Impacts of IBS

Dietary Restrictions: People with IBS often have to follow strict dietary guidelines to manage their symptoms, which can limit their food choices and affect their enjoyment of meals. This might involve avoiding certain foods that trigger symptoms, leading to a more restrictive diet.

Social Isolation: The unpredictability of IBS flare-ups can make socializing difficult. Fear of experiencing symptoms while out can lead individuals to decline social invitations, impacting friendships and leading to feelings of isolation.

Mental Health Issues: Living with chronic pain and discomfort can take a toll on mental health. People with IBS are at a higher risk of developing anxiety and depression due to constant worry about their symptoms and how these affect their daily life.

Impact on Relationships: The condition can strain relationships with friends, family, and partners due to the need for understanding and adjustments in plans and activities. It can also affect intimacy, as the symptoms of IBS may affect self-esteem and sexual health.

Travel Limitations: Traveling can become a source of stress, with the need to plan around access to bathrooms and food that won’t exacerbate symptoms. This can limit the ability to travel for leisure or even for work, affecting life experiences and opportunities.

Physical Activity Limitations: Regular exercise is beneficial for managing IBS symptoms, but during flare-ups, physical activity can become difficult or uncomfortable, limiting the ability to stay active and maintain fitness.

Financial Burden: The costs associated with managing IBS, such as healthcare appointments, treatments, and dietary needs, can add up, creating financial stress.

Sleep Disruptions: Symptoms of IBS, especially abdominal pain and the need to use the bathroom frequently, can disrupt sleep patterns, leading to fatigue and affecting overall quality of life.

Self-Image and Confidence Issues: Living with a chronic condition like IBS can affect how individuals see themselves and their confidence in social or professional settings due to fear of symptom flare-ups.

Example Functional Impacts of IBS

Digestive Function Disruptions: IBS primarily affects the digestive system, leading to irregular bowel movements, which can swing between diarrhea and constipation. This irregularity can disrupt normal digestive processes and nutrient absorption.

Reduced Physical Stamina: During flare-ups, the discomfort and pain can lead to decreased physical energy and stamina, making it hard to engage in physical activities or complete tasks that require sustained effort.

Impact on Concentration and Mental Functions: The constant discomfort and stress of managing IBS symptoms can affect cognitive functions, making it harder to concentrate, remember things, or stay focused on tasks.

Daily Routine Disruptions: The unpredictability of IBS symptoms can necessitate frequent and sometimes urgent trips to the bathroom, disrupting daily routines, work, social activities, and even simple tasks like grocery shopping.

Exercise Limitations: While regular exercise can help manage IBS symptoms, during flare-ups, physical activity might exacerbate symptoms like abdominal pain or diarrhea, limiting the types of exercise that are comfortable or possible.

Social Functioning: The need to manage and sometimes urgently respond to IBS symptoms can lead to anxiety about social situations, potentially leading to avoidance of social gatherings, dining out, or other activities that involve being away from familiar and safe environments.

How to Prepare for Your IBS C&P Exam

Here are some tips to help you prepare for your IBS C&P exam when the big day arrives:

• Gather Records and Documents: Collect all relevant medical records, including diagnosis reports, treatment history, and any correspondence related to your IBS. This documentation will provide essential evidence to support your claim during the examination. Review the documents in detail and feel free to bring hard copies with you to the C&P exam for reference.

• Create a Symptoms Diary: Keep a detailed log of your IBS symptoms, noting the frequency, severity, and duration of episodes. Document any factors that exacerbate or alleviate your symptoms, such as stress, spicy foods, or certain activities. This diary will help you articulate the impact of IBS on your work, life, and social functioning during the C&P exam.

• List Functional Impacts: Make a list of specific ways in which IBS affects your ability to perform daily tasks and activities. This may include pain, sleep disturbances, social problems, increased sick leave, etc. Providing concrete examples of how IBS negatively impacts your daily functioning will strengthen your case during the exam.

• Review the VA DBQ for IBS: It’s a good idea to review the IBS VA DBQ before your exam. Be prepared to describe the onset and progression of your IBS symptoms over time, as well as any treatments you have pursued and their effectiveness (if any).

DBQ for IBS [Download]

The IBS DBQ form will be completed electronically by the C&P examiner at your exam.

We’ve made a copy available for review and download below:

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