Intestinal Conditions (Other than Surgical or Neoplasms)

Your doctor will complete VA Form 21-0960G-4 (Intestinal Conditions (Other than Surgical or Neoplasms) DBQ) after examining you. This walkthrough helps you prepare them. The DBQ is a standardized questionnaire; your doctor's answers directly determine your VA rating. Brief them on these specific points before the exam so nothing important is missed or underdocumented.

Common mistakes

• ×Asking your doctor to just "fill out the VA form" without briefing them - an uninformed completion is often generic and leads to lower ratings.
• ×Bringing the DBQ to a provider who has never seen you before - your treating physician who knows your history will write the most credible documentation.
• ×Going to the exam and waiting for the doctor to ask questions - come prepared with specific examples of your worst days and functional limitations.

These are the key clinical questions from the Intestinal Conditions (Other than Surgical or Neoplasms) DBQ. Help your doctor understand what each question is asking and give them concrete examples for your situation. Print this section and bring it to the appointment. 1. How frequently do you experience episodes of bowel disturbance? WHY IT MATTERS: Frequency of episodes (constant, near-constant, or episodic) directly determines rating level TIPS: Track episodes daily in a symptom diary; Note alternating diarrhea and constipation patterns 2. Do you have any nutritional deficiency or weight loss? WHY IT MATTERS: Malnutrition and definite weight loss are criteria for higher ratings (30% and above) TIPS: Document weight over time with dates; Bring lab results showing nutritional deficiencies 3. Is there a need for continuous medication? WHY IT MATTERS: Continuous medication requirement supports moderate to severe rating levels TIPS: List all GI medications with dosages and frequency; Note if medications have changed due to worsening symptoms 4. How do symptoms impact your ability to work and function daily? WHY IT MATTERS: Marked interference with daily activities and employment supports higher ratings TIPS: Describe urgency and frequency of bathroom needs; Note work missed or limitations due to symptoms 5. Have you experienced any serious complications (bleeding, obstruction, fistula)? WHY IT MATTERS: Complications like hemorrhage, obstruction, or fistula indicate severe disease warranting higher ratings TIPS: Document any ER visits or hospitalizations; Bring records of any surgical interventions for complications

Common mistakes

• ×Not keeping a symptom diary to document episode frequency
• ×Describing symptoms on a good day instead of typical or worst days
• ×Failing to document weight loss with actual numbers

VA raters use the Intestinal Conditions (Other than Surgical or Neoplasms) DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Frequency and severity of bowel disturbance episodes 2. Presence of malnutrition and definite weight loss 3. Need for continuous medication or immunosuppressive therapy 4. Number of exacerbations per year (for Crohn's and ulcerative colitis) 5. Whether there is marked interference with absorption and nutrition 6. Presence of serious complications (hemorrhage, obstruction, fistula) For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Not mentioning secondary conditions like anemia or vitamin deficiencies
• ×Overlooking that IBS and inflammatory bowel disease have different rating criteria

Authority

• 38 CFR 4.1 - Functional impairment as the basis for rating.

Preparation checklist for the Intestinal Conditions (Other than Surgical or Neoplasms) DBQ exam: 1. Keep a detailed symptom diary for at least 3 months before the exam 2. Bring colonoscopy and lab results showing disease activity 3. Document weight changes and any nutritional deficiencies 4. List all medications including over-the-counter remedies 5. Describe how symptoms affect work, travel, and social activities Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

Common mistakes

• ×Describing your best days or average functioning instead of your worst - VA rates the full range of disability.
• ×Minimizing symptoms out of stoicism or pride - accurate documentation is not exaggeration; it is honesty.
• ×Not mentioning secondary symptoms, side effects, or additional conditions the doctor may not ask about.