Duodenal Ulcer — VA Disability Rating (DC 7304)
Diagnostic Code 7304 · 38 CFR §4.114
What Is It?
DC 7305 no longer exists. VA rewrote the digestive schedule effective May 19, 2024 (89 FR 19743). That rewrite removed DC 7305 (duodenal ulcer) and DC 7306 (marginal ulcer) and folded both into DC 7304, retitled "Peptic ulcer disease," so gastric, duodenal and marginal ulcers now share one code and one table. VA said so itself in the rulemaking, code by code: the removal "would not, in and of itself, alter existing evaluations or grants of service connection. Rather, VA would modify the individual’s record to reflect the grant of service connection under" the current code. 38 CFR § 3.951(a) says the same thing as a rule of general application — a readjustment to the rating schedule is not grounds for reducing an evaluation already in effect unless medical evidence establishes that the disability has actually improved. The old code still appears in this page’s web address because the address has not changed; the code the page teaches has. A duodenal ulcer is an open sore in the lining of the duodenum, the first segment of small intestine past the stomach. The two main causes are Helicobacter pylori infection and long-term NSAID use — ibuprofen, naproxen, aspirin — and veterans tend to accumulate both risks. Symptoms are burning upper abdominal pain that wakes you at night or arrives two to three hours after eating, nausea, bloating, and in more severe disease vomiting, dark or bloody stools, and weight loss.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Post-operative for perforation or hemorrhage, for three months. A mandatory VA examination follows the three months and the evaluation is then set on residuals, with any change subject to 38 CFR § 3.105(e). |
| 60% | 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. |
| 40% | Episodes of abdominal pain, nausea, or vomiting that last at least three consecutive days, occur four or more times in the past 12 months, and are managed by daily prescribed medication. |
| 20% | Episodes of abdominal pain, nausea, or vomiting that last at least three consecutive days, occur three times or less in the past 12 months, and are managed by daily prescribed medication. |
| 0% | History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies. |
Evidence Needed
An upper endoscopy (EGD) with biopsy is the strongest objective evidence — it confirms the ulcer, characterizes its severity, and rules out malignancy. An H. pylori test (breath, stool antigen, or biopsy-based) documents the underlying cause. Lab work showing iron-deficiency anemia, low hemoglobin, or positive fecal occult blood supports the higher rating tiers. A symptom log covering several months captures flare frequency and duration, which directly drives the rating. Medication records — proton pump inhibitors, H2 blockers, antibiotic eradication regimens — show the chronic management burden. Service treatment records or buddy statements documenting in-service onset, in-service NSAID use, or treatment of upper-abdominal symptoms during active duty establish the nexus.
C&P Exam Tips
Bring the endoscopy report and any pathology. Bring your symptom diary — DC 7304’s 40 and 20 percent rows are built around episode frequency and duration, and they differ only in how many episodes occurred in the past 12 months. Describe each episode the way the criteria count it: the date it began, how many consecutive days it ran, and whether daily prescribed medication was managing you at the time. Three consecutive days is the threshold both rows use. Bed rest and days missed from work are not criteria anywhere in DC 7304 — counted episodes, hematemesis, melena and hospitalized anemia are. Honest reporting of nighttime pain, the relief pattern of food and antacids, and any episodes of vomiting blood or passing dark stools matters more than general statements about discomfort.
How to File
File VA Form 21-526EZ for duodenal ulcer or peptic ulcer disease — name the condition, not the code; the rater assigns DC 7304. Attach the endoscopy report, H. pylori results, hemoglobin trend, and a symptom log. The 2024 criteria turn on counted episodes: how many in the past 12 months, whether each lasted three consecutive days, and whether daily prescribed medication manages them. A log that records those three things is worth more than a general description of discomfort. If the ulcer is driven by NSAID use prescribed for a service-connected joint or back condition, file it as secondary to that condition.
Common Mistakes
Filing under DC 7305, which no longer exists — name the condition and let the rater code it. Describing symptoms generally instead of counting episodes: the 20, 40 and 60 percent rows all turn on episode counts, duration in consecutive days, and daily prescribed medication. Filing without an endoscopy or imaging report, which is what the 0 percent row itself requires. Missing the secondary pathway when the ulcer follows NSAID use for a service-connected musculoskeletal condition.
Frequently Asked Questions
My rating decision says DC 7305. Is my rating in danger?
No, not because of the code change. VA said in the rulemaking that removing DC 7305 "would not, in and of itself, alter existing evaluations or grants of service connection" — the record is simply updated to show service connection under DC 7304. 38 CFR § 3.951(a) is the general rule: a readjustment to the rating schedule is not grounds for a reduction unless medical evidence establishes the disability has actually improved. If your evaluation has been continuously at or above its level for 20 years, § 3.951(b) protects it absent fraud.
Is duodenal ulcer the same as a stomach ulcer now?
For rating purposes, yes — since May 19, 2024 both are peptic ulcer disease under DC 7304 and share one table. Anatomically they are still different: a gastric ulcer sits in the stomach, a duodenal ulcer in the small intestine just past it, and duodenal ulcer pain classically improves with eating while gastric ulcer pain often worsens.
The old criteria had a 10 percent level. Where did it go?
DC 7304 has no 10 percent step. Its rows are 100, 60, 40, 20 and 0. A veteran holding 10 percent under the old DC 7305 keeps that evaluation — the schedule change is not grounds to touch it — but a claim decided today lands on one of DC 7304’s five rows.