Evidence Checklist: Celiac Disease
DC 7319
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Small bowel biopsy confirming villous atrophy (Marsh grade)Critical
Duodenal biopsy from upper endoscopy showing villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes (Marsh grade IIIa–IIIc) — the gold standard for celiac diagnosis.
Nexus opinion linking celiac disease to service ("at least as likely as not")Critical
A medical opinion connecting celiac disease onset or exacerbation to service-related stress, infections, or gluten exposure patterns during deployment.
Treating Physician
Tissue transglutaminase IgA (tTG-IgA) and total IgA serologyCritical
Lab results showing elevated tTG-IgA antibodies (or anti-endomysial antibodies in IgA-sufficient patients) — the primary screening test for celiac disease. Total IgA must be measured to rule out IgA deficiency.
Dietary compliance records and dietitian documentation
Records from a registered dietitian or treating gastroenterologist documenting strict gluten-free diet requirement and the impact of dietary restriction on daily living.
Treatment Records
Malabsorption lab panel (iron, B12, folate, vitamin D, calcium, ferritin)
Lab results documenting nutritional deficiencies resulting from intestinal malabsorption — anemia, osteopenia, vitamin D deficiency, and hypoalbuminemia support a higher severity rating.
Lay Statements & Personal Documentation
Documentation of incapacitating GI episodes from gluten exposure
Personal log or medical records documenting episodes of severe diarrhea, abdominal pain, and incapacitation following accidental gluten ingestion.
Buddy statement from spouse, family, or fellow service member
A written statement from someone who can describe observable symptoms and how your condition affects daily life.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Intestinal Conditions (other than Small or Large Intestine)Critical
Standardized form capturing celiac diagnosis confirmation, symptom frequency, nutritional deficiency status, and incapacitating episode count.
Service Records
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.