Veterans describe ulcer flares as the stomach acting up a lot, and the rating shows it. The 2024 rewrite of DC 7304 made the criteria a counting exercise: episodes lasting three or more consecutive days, three or fewer versus four or more per year, managed by daily prescribed medication. A dated symptom log speaks the criteria's language, and antacids bought over the counter do not count as prescribed.
The 2024 rewrite of DC 7304 turned ulcer ratings into a counting exercise: episodes lasting three or more consecutive days, three or fewer versus four or more per year, managed by daily prescribed medication. A dated symptom log speaks the criteria's language. Over-the-counter antacids do not count as prescribed medication.
How VA rates ulcers
Peptic ulcer disease, covering both gastric and duodenal ulcers, is rated under diagnostic code 7304 (38 CFR 4.114). The criteria were rebuilt in the May 19, 2024 digestive system revision. The old "mild, moderate, severe" judgment calls are gone, replaced by countable episodes. Chronic gastritis (DC 7307), including Helicobacter pylori infection and drug-induced gastritis, is rated under the same DC 7304 criteria.
The percentage levels
- 0 percent: history of peptic ulcer disease documented by endoscopy or diagnostic imaging.
- 20 percent: episodes of abdominal pain, nausea, or vomiting that last at least three consecutive days, occur three times or fewer in the past 12 months, and are managed by daily prescribed medication.
- 40 percent: the same episodes occurring four or more times in the past 12 months, managed by daily prescribed medication.
- 60 percent: continuous abdominal pain with intermittent vomiting, recurrent hematemesis (vomiting blood) or melena (tarry stools), and manifestations of anemia requiring hospitalization at least once in the past 12 months.
- 100 percent: post-operative for perforation or hemorrhage, for three months. After those three months, VA rates the residuals following a mandatory examination, and any reduction must follow the procedures of 38 CFR 3.105(e).
The criteria are a counting exercise
Three numbers decide an ulcer rating: how many days each episode lasts (three or more consecutive days is the threshold), how many episodes occur per year (three or fewer versus four or more separates 20 from 40 percent), and whether daily prescribed medication manages the condition. A dated symptom log turns "my stomach acts up a lot" into criteria language. Over-the-counter antacids you buy yourself are not "daily prescribed medication." A prescription is.
The 0 percent level still matters
A documented history by endoscopy or imaging rates 0 percent, which pays nothing but establishes service connection. Ulcer disease relapses. A veteran already service connected files a straightforward increase claim when episodes return, with the effective date tied to that claim.
The NSAID connection
Years of prescribed NSAIDs for service-connected orthopedic conditions are a well-recognized cause of gastric ulcers and gastritis. Ulcers caused or aggravated by medication taken for a service-connected disability are themselves service connectable as secondary conditions under 38 CFR 3.310. The prescription history is the evidence. Make sure it is in the file alongside a medical opinion linking it to the ulcer.
Common rating details veterans overlook
- Get the endoscopy report into the claims file. The 0 percent baseline and every level above it assume documented disease.
- Track episodes by date and duration. "At least three consecutive days" and "four or more times per year" are the literal rating criteria.
- Pending claims filed before May 19, 2024 are evaluated under both the old and new criteria, whichever is more favorable.
- Hospitalization for bleeding or anemia is 60 percent territory. ER and admission records carry that level.