VA Disability Rating for Postgastrectomy Syndromes (DC 7308)
Diagnostic Code 7308 · 38 CFR §4.114
What Is It?
DC 7308 is “Postgastrectomy syndrome,” and its rating cell in 38 CFR 4.114 is empty. The entry is one line: rate residuals as chronic complications of upper gastrointestinal surgery (DC 7303). That destination code is deliberately wide — its Note (3) says it covers operations performed on the esophagus, stomach, pancreas and small intestine, including bariatric surgery. Postgastrectomy syndrome is what follows removal of part or all of the stomach: food arrives in the small intestine too fast, and the result is cramping, diarrhoea, sweating and light-headedness after meals, sometimes with a delayed drop in blood sugar an hour or more later. Dumping syndrome is not an analogy here — DC 7303 names it inside its own 50 percent row, alongside delayed gastric emptying, as an example of a complication requiring specifically prescribed medication. Two further instructions matter: Note (1) sends resection of the small intestine to DC 7328 instead, and Note (2) directs that a vitamin or mineral deficiency caused by pancreatic surgery — B12, iron, calcium, fat-soluble vitamins — be evaluated under the appropriate deficiency code.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 7308 assigns no percentages of its own — its rating cell in 38 CFR 4.114 is empty. The entry directs: rate residuals as chronic complications of upper gastrointestinal surgery (DC 7303). DC 7303 runs 80, 50, 30, 10 and 0 percent. 80 percent requires continuous total parenteral nutrition or tube feeding for longer than 30 consecutive days in the last six months. 50 percent requires any one of daily vomiting despite oral dietary modification or medication; six or more watery bowel movements a day every day, or explosive movements that are difficult to predict or control; or post-prandial light-headedness with sweating together with medication prescribed specifically for a complication of upper gastrointestinal surgery such as dumping syndrome or delayed gastric emptying. 30 percent requires two or more of a shorter list, including vomiting two or more times a week or vomiting despite treatment, and discomfort or pain within an hour of eating requiring ongoing oral dietary modification. 10 percent is nausea or vomiting managed by ongoing medical treatment. 0 percent is post-operative status, asymptomatic. |
Evidence Needed
- The operative report for the gastrectomy, showing what was removed and how the remaining anatomy was reconstructed
- A meal-and-symptom diary recording what happens after eating, how soon, how long it lasts, and how many episodes occur in a day
- A count of watery bowel movements per day, because six or more every day is one of the three routes into the 50 percent row
- Documentation of post-prandial light-headedness with sweating, and the medication prescribed specifically for dumping syndrome or delayed gastric emptying
- Records of any total parenteral nutrition or tube feeding, with start and stop dates — the 80 percent row requires more than 30 consecutive days in the last six months
- Laboratory work for B12, iron, calcium and fat-soluble vitamins, which Note (2) routes to their own deficiency codes
- A gastric emptying study where one has been performed
C&P Exam Tips
- Describe the timing precisely: early symptoms within about 30 minutes of eating and late symptoms one to three hours after are different findings
- Count, do not estimate — daily vomiting and six or more watery bowel movements a day are counted criteria in the 50 percent row
- Say whether bowel movements are explosive and difficult to predict or control, which is the alternative wording in that same row
- Name any medication prescribed specifically for dumping syndrome or delayed gastric emptying rather than describing it generically
- Bring the dates of any tube feeding or parenteral nutrition, because the 80 percent row is measured in consecutive days
- Bring your vitamin and mineral labs; deficiencies from pancreatic surgery are evaluated under their own codes rather than absorbed here
How to File
File VA Form 21-526EZ naming postgastrectomy syndrome or dumping syndrome; the rater applies DC 7308 and takes the percentage from DC 7303. Attach the operative report, the meal-and-symptom diary, the medication list, and the dates of any tube feeding or parenteral nutrition. If the original surgery was performed for a service-connected condition, establish that link explicitly. Note (1) to DC 7303 matters where the small intestine was resected: that residual belongs to DC 7328, not here. DC 7308 and DC 7303 are both inside DC 7301 through 7329, so 38 CFR 4.114's opening paragraph bars stacking them — one evaluation under the predominant code, elevated a step where the overall severity warrants.
Common Mistakes
Expecting a percentage from DC 7308 itself. Its rating cell is empty and the entry routes residuals to DC 7303. Describing episodes instead of counting them, when daily vomiting and six or more watery bowel movements a day are counted criteria. Not naming the medication prescribed specifically for dumping syndrome or delayed gastric emptying, which the 50 percent row asks for by name. Letting vitamin and mineral deficiencies be absorbed into this rating when Note (2) directs them to their own codes.
Frequently Asked Questions
Why is there no rating table under DC 7308?
Because the code assigns no percentages. Its rating cell in 38 CFR 4.114 is empty and the entry reads “Rate residuals as chronic complications of upper gastrointestinal surgery (DC 7303).” DC 7303's rows — 80, 50, 30, 10 and 0 percent — decide the evaluation.
What is dumping syndrome, and is it rated separately?
Dumping syndrome is what happens when food passes too quickly from the stomach into the small intestine — early dumping within about 30 minutes causes cramping, nausea and diarrhoea, late dumping one to three hours later causes dizziness and sweating from a drop in blood sugar. It is not rated separately: DC 7303 names it inside its own 50 percent row as an example of a complication requiring specifically prescribed medication.
Can postgastrectomy symptoms improve over time?
Some veterans improve in the first year as the body adapts; many keep chronic symptoms that need permanent dietary management. VA rates the current level of impairment, so what matters at the exam is the last 12 months of counted episodes rather than how things were just after surgery.