Chronic pancreatitis, total or partial pancreatectomy, pancreas transplant and pancreatic neoplasms are documented for VA disability claims on this 8-page questionnaire. The clinician records ongoing treatment for pain or complications, hospitalizations for abdominal or mid-back pain, maldigestion requiring enzyme supplements, diabetes from pancreatic insufficiency, post-pancreatectomy symptoms such as post-prandial syncope or vomiting, and EUS, ERCP, MRCP, CT and amylase or lipase results.
The Veteran's treating or examining clinician completes the form and signs the Section IX examiner's certification. The Veteran fills in no part of the form.
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Pancreas Conditions Disability Benefits Questionnaire
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Item 3A lists the findings to check: ongoing outpatient treatment for pain or complications such as pseudocyst or ascites, yearly hospitalization for abdominal or mid-back pain or tube feeding complications, physician-managed pain, maldigestion needing enzyme supplements, diabetes from pancreatic insufficiency, and undernutrition.
Item 3B asks whether removal was total or partial and its date, then symptoms such as post-prandial light-headedness with sweating, vomiting or diarrhea by frequency and treatment, medications for dumping syndrome or delayed gastric emptying, emergency care for obstruction, and malabsorption with vitamin deficiencies.