Gallbladder removal, chronic cholecystitis or cholelithiasis, biliary strictures, bile duct injury, cholangitis and other biliary tract conditions are documented for VA disability claims on this 7-page questionnaire. The clinician records clinically documented right upper quadrant attacks in the past 12 months, symptoms after cholecystectomy including diarrhea frequency, injury residuals, hospitalizations in the past 24 months, and imaging and lab results.
The Veteran's treating or examining clinician completes Sections I to VIII and signs the Section IX examiner's certification. The Veteran completes no part of the form.
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Gallbladder Conditions Disability Benefits Questionnaire
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Yes. Cholecystectomy is the first diagnosis listed, and item 3C asks about symptoms afterward: none, intermittent or recurrent post-prandial or nocturnal abdominal pain, and diarrhea graded by number of watery bowel movements per day. Other gallbladder surgeries go in item 3D with dates and facility.
Item 6B lists alkaline phosphatase, bilirubin, WBC, amylase and lipase, each with date and results, plus space for other tests. The examiner then states how any abnormal result relates to the diagnosed condition.