What is the VA Rating for Ulcers?

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VA ratings for ulcers range from 0% to 100% with breaks at 20%, 40%, and 60%.

The rating factors include the severity of episodes of abdominal pain, nausea, or vomiting as well as whether hospitalization has been required in the past.

Your final VA disability rating for ulcers depends on the frequency (how often), severity (how bad), and duration (how long) of symptoms and how those symptoms negatively impact your work, life, and social functioning.

Pro Tip: VA ratings for peptic ulcers include both gastric ulcers that occur on the inside of the stomach and duodenal ulcers that occur on the inside of the upper portion of your small intestine.

Summary of Main Points

• VA Rating for Ulcers: Effective May 19, 2024, VA disability ratings for peptic ulcers, including gastic and duodenal ulcers, range from 0% to 100%, with specific breaks at 20%, 40%, and 60%, based on the severity of symptoms and how those symptoms negatively impact your work, life, and social functioning.

• Rating Factors: The severity of episodes of abdominal pain, nausea, vomiting, and the necessity of hospitalization are key factors in determining the appropriate VA rating for ulcers.

• Presumptive Disability: Peptic, gastric, and duodenal ulcers can be considered a presumptive VA disability if diagnosed within one year of discharge from military service.

What is Peptic Ulcer Disease?

Peptic Ulcer Disease (PUD) is a condition where open sores, or ulcers, develop on the inner lining of the stomach, upper part of the small intestine (duodenum), or sometimes the esophagus.

These ulcers are caused by the erosion of the protective mucous lining of these areas by stomach acid.

What Causes Ulcers?

• Helicobacter pylori (H. pylori) Infection: A common bacterial infection that disrupts the mucous lining, making it more susceptible to damage from stomach acid.

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Long-term use of NSAIDs like aspirin, ibuprofen, and naproxen can irritate and inflame the stomach lining.

• Other Factors: Excessive alcohol consumption, smoking, severe stress, and spicy foods can aggravate symptoms but are not direct causes.

Symptoms of Ulcers

The most common peptic ulcer symptom is burning pain in the stomach.

Here’s a list of common symptoms of peptic ulcers to include gastric and duodenal ulcers:

• Burning Stomach Pain: Typically felt between meals or at night, and can be temporarily relieved by eating certain foods or taking antacids.

• Bloating and Belching

• Heartburn: A burning sensation in the chest.

• Nausea and Vomiting

• Dark, Tarry Stools: Indicating bleeding in the stomach or small intestine.

• Weight Loss: Unintentional and unexplained.

How Are Ulcers Diagnosed?

• Endoscopy: A procedure where a flexible tube with a camera is inserted through the mouth to view the stomach and duodenum.

• Barium Swallow: X-ray imaging after drinking a barium solution to highlight the digestive tract.

• Tests for H. pylori: Breath, blood, stool, or tissue tests to detect the presence of the bacteria.

Treatment Options

• Medications: Proton pump inhibitors (PPIs), H2-receptor antagonists, antacids, and antibiotics to treat H. pylori infection.

• Lifestyle Changes: Avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress.

• Surgery: In severe cases, such as perforation or obstruction, surgical intervention may be necessary.

Complications

• Internal Bleeding: Leading to anemia or severe blood loss.

• Perforation: A hole in the stomach or duodenal wall, leading to peritonitis (a serious abdominal infection).

• Gastric Outlet Obstruction: Swelling or scarring that obstructs the passage of food.

• Increased Risk of Stomach Cancer: Particularly with chronic H. pylori infection.

What are the Risk Factors for Military Veterans?

Military veterans face unique risk factors for developing Peptic Ulcer Disease (PUD) due to their specific experiences and lifestyle.

Here are the key risk factors:

1. Stress

• Combat and Deployment Stress: Exposure to high-stress environments, such as combat zones, can increase the production of stomach acid, leading to a higher risk of ulcers.

• Post-Traumatic Stress Disorder (PTSD): Veterans with PTSD may have an increased risk of gastrointestinal issues, including ulcers, due to chronic stress and its physiological effects on the body.

2. Medication Use

• NSAIDs: Veterans are often prescribed NSAIDs for pain management related to service-related injuries. Long-term use of these medications can damage the stomach lining and lead to ulcers.

• Other Medications: Some medications used to treat PTSD, depression, or anxiety can also affect the gastrointestinal system and increase ulcer risk.

3. Lifestyle Factors

• Smoking: The prevalence of smoking is higher among veterans, and smoking increases stomach acid production and reduces the stomach’s ability to protect itself against acid.

• Alcohol Consumption: Higher rates of alcohol use among some veterans can contribute to the development of ulcers by eroding the stomach lining.

4. Helicobacter pylori Infection

• Increased Exposure: Veterans, especially those deployed in regions with poor sanitation, may have an increased risk of H. pylori infection, a primary cause of PUD.

5. Diet and Nutrition

• Irregular Eating Habits: The nature of military service often leads to irregular meal patterns and reliance on less nutritious food options, which can contribute to gastrointestinal issues.

• Poor Nutrition: Limited access to fresh, healthy foods during service can affect overall gastrointestinal health.

6. Age and Service-Related Health Conditions

• Aging Veterans: Older veterans are more likely to develop PUD, especially if they have other health conditions that require medication affecting the stomach lining.

• Service-Related Health Issues: Conditions like diabetes, liver disease, and other chronic illnesses common among veterans can increase the risk of PUD.

7. Mental Health Conditions

• Depression and Anxiety: These conditions can lead to increased stomach acid production and gastrointestinal distress, contributing to ulcer development.

What is the VA Disability Rating for Ulcers?

As of May 19, 2024, the VA rates ulcers, including peptic, gastric, and duodenal, under 38 CFR § 4.114, Diagnostic Code (DC) 7304, with ratings from 0% to 100% with breaks at 20%, 40%, and 60% based on severity of symptoms.

Click here to read the new law for digestive system VA rating changes.

DC 7304, Peptic Ulcer Disease

Here’s the new VA rating criteria for ulcers:

• Post-operative for perforation or hemorrhage, for three months rate at 100%

• Continuous abdominal pain with intermittent vomiting, recurrent hematemesis (vomiting blood) or melena (tarry stools); and manifestations of anemia which require hospitalization at least once in the past 12 months rate at 60%

• Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur four or more times in the past 12 months; and are managed by daily prescribed medication rate at 40%

• Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur three times or less in the past 12 months; and are managed by daily prescribed medication rate at 20%

• History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies rate at 0%

Note: After three months at the 100% evaluation, rate on residuals as determined by mandatory VA medical examination. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.

Explanation of Key Terms:

Peptic Ulcer Disease: A condition characterized by open sores (ulcers) that develop on the inner lining of the stomach, upper small intestine, or esophagus, often caused by infection with Helicobacter pylori bacteria or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Post-Operative for Perforation or Hemorrhage: Refers to the period following surgery to repair a peptic ulcer that has perforated (developed a hole) or hemorrhaged (bleeding).

Continuous Abdominal Pain with Intermittent Vomiting: Persistent pain in the abdomen accompanied by occasional episodes of vomiting.

Recurrent Hematemesis: Repeated episodes of vomiting blood, indicating ongoing bleeding from the ulcer.

Melena: Passage of dark, tarry stools due to the presence of digested blood in the stool.

Manifestations of Anemia: Symptoms related to low red blood cell count, such as fatigue, weakness, and pallor.

Hospitalization: Requires admission to the hospital for treatment and management of symptoms.

Episodes of Abdominal Pain, Nausea, or Vomiting: Periods of discomfort or gastrointestinal symptoms.

Last for at Least Three Consecutive Days: Symptoms persist for a minimum of three days in a row.

Occur Four or More Times in the Past 12 Months: Repeated occurrences of symptoms within a one-year period.

Managed by Daily Prescribed Medication: Requires ongoing treatment with medications to alleviate symptoms.

Can Ulcers Be a Presumptive Disability?

Yes, peptic, gastric, and duodenal ulcers can be considered a presumptive VA disability under certain conditions.

Ulcers fall under the presumptive category of Chronic Debilitating Diseases that were diagnosed within the first year of leaving military service.

If ulcers were diagnosed within 365 days of discharge from active duty, then they are “presumed” to be caused by military service, and therefore, are eligible for VA disability benefits.

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