Peritoneal Adhesions

Your doctor will complete VA Form 21-0960G-7 (Peritoneal Adhesions 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 Peritoneal Adhesions 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 colic pain, nausea, and vomiting? WHY IT MATTERS: The frequency and severity of these episodes directly determines rating level under DC 7301 TIPS: Track every episode with dates, duration, and severity; Note what triggers each episode 2. Have you had partial bowel obstruction episodes? WHY IT MATTERS: Frequent and prolonged episodes of partial obstruction support a 50% rating TIPS: Document any ER visits or hospitalizations for bowel obstruction; Bring imaging that shows obstruction or adhesion-related findings 3. Do you experience constipation or alternating constipation and diarrhea? WHY IT MATTERS: Bowel function disturbances from adhesions document ongoing functional impact TIPS: Describe the pattern of bowel disturbance; Note dietary modifications needed to manage symptoms 4. What is your surgical history that led to the adhesions? WHY IT MATTERS: Post-surgical origin helps establish nexus and explains the source of adhesions TIPS: Bring all operative reports from abdominal surgeries; Document each surgery with dates and reasons

Common mistakes

• ×Not documenting episode frequency and severity
• ×Failing to bring surgical records establishing the source of adhesions
• ×Not mentioning partial obstruction episodes requiring medical attention

VA raters use the Peritoneal Adhesions DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Pulling pain on attempting work or aggravated by movement 2. Frequency of episodes of colic pain, nausea, constipation, or vomiting 3. Whether episodes are occasional, fairly frequent, or frequent and prolonged 4. Presence of partial obstruction shown by X-ray 5. Whether there is definite interference with absorption and nutrition For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Overlooking dietary modifications needed due to the condition

Authority

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

Preparation checklist for the Peritoneal Adhesions DBQ exam: 1. Keep a detailed diary of colic pain episodes and bowel disturbance 2. Bring all surgical and operative reports from abdominal surgeries 3. Bring imaging showing adhesions or bowel obstruction episodes 4. Document all ER visits and hospitalizations related to adhesion symptoms 5. Describe how symptoms affect eating, work, and daily 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.