VA Disability Rating for Stomach Stenosis (DC 7309)

Diagnostic Code 7309 · 38 CFR §4.114

What Is It?

DC 7309 is “Stomach, stenosis of,” and its rating cell in 38 CFR 4.114 is empty. The entry is one line, and it names two destinations: rate as chronic complications of upper gastrointestinal surgery (DC 7303) or peptic ulcer disease (DC 7304), depending on the predominant disability. Stenosis is a narrowing of the stomach outlet, so food will not pass into the small intestine at a normal rate. Veterans reach it from scarring left by chronic ulcer disease, from injury, or as a complication of stomach surgery, and the effect is vomiting of undigested food, early fullness and weight loss because too little food gets through. Which destination code applies is the whole question, and it usually follows the cause: a stenosis that is a complication of prior upper gastrointestinal surgery points at DC 7303, while one that is the scarred end-state of peptic ulcer disease points at DC 7304. The two ladders are not interchangeable — DC 7303 tops out at 80 percent and is keyed to feeding support, daily vomiting and bowel-movement counts; DC 7304 tops out at 100 percent and is keyed to counted episodes, hematemesis, melena and hospitalized anemia.

Rating Criteria

Rating	Criteria
See pathways	DC 7309 assigns no percentages of its own — its rating cell in 38 CFR 4.114 is empty. The entry directs: rate as chronic complications of upper gastrointestinal surgery (DC 7303) or peptic ulcer disease (DC 7304), depending on the predominant disability. 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. DC 7304 runs 100, 60, 40, 20 and 0 percent — there is no 10 percent step. 100 percent is post-operative for perforation or hemorrhage, for three months, after which a Note requires a mandatory VA examination and the evaluation is set on residuals, with 38 CFR 3.105(e) governing any change. 60 percent is continuous abdominal pain with intermittent vomiting, recurrent hematemesis or melena, and manifestations of anemia requiring hospitalization at least once in the past 12 months. 40 percent is episodes of abdominal pain, nausea or vomiting lasting at least three consecutive days, occurring four or more times in the past 12 months, and managed by daily prescribed medication. 20 percent is the same episodes occurring three times or less in the past 12 months. 0 percent is a history of peptic ulcer disease documented by endoscopy or diagnostic imaging.

Rating

Criteria

See pathways

DC 7309 assigns no percentages of its own — its rating cell in 38 CFR 4.114 is empty. The entry directs: rate as chronic complications of upper gastrointestinal surgery (DC 7303) or peptic ulcer disease (DC 7304), depending on the predominant disability. 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. DC 7304 runs 100, 60, 40, 20 and 0 percent — there is no 10 percent step. 100 percent is post-operative for perforation or hemorrhage, for three months, after which a Note requires a mandatory VA examination and the evaluation is set on residuals, with 38 CFR 3.105(e) governing any change. 60 percent is continuous abdominal pain with intermittent vomiting, recurrent hematemesis or melena, and manifestations of anemia requiring hospitalization at least once in the past 12 months. 40 percent is episodes of abdominal pain, nausea or vomiting lasting at least three consecutive days, occurring four or more times in the past 12 months, and managed by daily prescribed medication. 20 percent is the same episodes occurring three times or less in the past 12 months. 0 percent is a history of peptic ulcer disease documented by endoscopy or diagnostic imaging.

Evidence Needed

Upper GI series, CT, or endoscopy documenting the narrowing and, where possible, its cause
The operative report for any prior stomach surgery, which is what points the claim at DC 7303 rather than DC 7304
A record of ulcer disease where that is the cause, including the endoscopy that documented it
A counted episode log — for DC 7304, how many episodes of abdominal pain, nausea or vomiting occurred in the past 12 months and how many consecutive days each lasted
A daily count of vomiting and of watery bowel movements, which is what DC 7303's rows are written on
Dates of any total parenteral nutrition or tube feeding, for DC 7303's 80 percent row
The medication record, since both destination codes ask whether daily or ongoing prescribed treatment manages the symptoms
Records of any dilatation or surgical revision performed to open the outlet

C&P Exam Tips

Say what caused the stenosis — prior surgery or ulcer scarring — because that is what decides which destination code applies
Describe how much food you can take at one sitting and what happens when you exceed it
Count vomiting episodes per day and per week rather than describing them, and say whether undigested food is visible
Count watery bowel movements per day if you have them; six or more every day is a criterion in DC 7303's 50 percent row
For the DC 7304 pathway, bring an episode log with start and end dates: three consecutive days is the threshold both its middle rows use
Bring the dates of any dilatation or revision surgery, and of any period on tube feeding or parenteral nutrition

How to File

File VA Form 21-526EZ naming the stenosis — pyloric stenosis, gastric outlet obstruction, or whatever the record calls it — and say in the claim which destination fits: DC 7303 where the narrowing is a complication of prior upper gastrointestinal surgery, DC 7304 where it is the residue of ulcer disease. The ceilings differ, so naming the predominant disability picture is worth doing rather than leaving it to be inferred. Attach the imaging, the operative or endoscopy report, and the counted logs both ladders are built on. DC 7309, DC 7303 and DC 7304 all sit inside DC 7301 through 7329, which 38 CFR 4.114's opening paragraph bars from being combined with each other.

Common Mistakes

Expecting a percentage from DC 7309 itself. Its rating cell is empty and the entry routes to DC 7303 or DC 7304. Letting the destination be chosen by default. The two ladders top out at 80 and 100 percent respectively and are keyed to different findings, so the predominant disability picture is worth arguing. Relying on symptoms without imaging that documents the narrowing. Describing symptoms generally when both destination codes count them — episodes per 12 months and consecutive days for DC 7304, vomiting and bowel movements per day for DC 7303.

Frequently Asked Questions

Why is there no rating table under DC 7309?

Because the code assigns no percentages. Its rating cell in 38 CFR 4.114 is empty and the entry directs rating as chronic complications of upper gastrointestinal surgery (DC 7303) or peptic ulcer disease (DC 7304), depending on the predominant disability. DC 7303 runs 80 / 50 / 30 / 10 / 0; DC 7304 runs 100 / 60 / 40 / 20 / 0.

How is stomach stenosis different from a stomach ulcer?

An ulcer is an open sore in the lining; stenosis is a narrowing of the stomach outlet. They are often related, because chronic ulcers scar and scarring narrows. That relationship is also why one of DC 7309's two destinations is the peptic ulcer code itself.

Can I be rated for both the stenosis and the ulcer that caused it?

Not as two ratings. DC 7309 and DC 7304 both sit inside DC 7301 through 7329, and 38 CFR 4.114's opening paragraph bars combining ratings in that range with each other. VA assigns one evaluation under the code that reflects the predominant disability picture and elevates it to the next higher evaluation if the overall severity warrants.

Can stomach stenosis be fixed?

Endoscopic dilatation or surgical revision helps in some cases. If treatment improves the picture VA may re-evaluate, and 38 CFR 3.105(e) governs any reduction. Where symptoms persist after treatment, the rating follows the current level of impairment on whichever destination ladder applies.