38 CFR § 4.114 - Schedule of ratings - digestive system. (2022)

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§ 4.114 Schedule of ratings - digestive system.

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Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.

Rating
7200 Mouth, injuries of.
Rate as for disfigurement and impairment of function of mastication.
7201 Lips, injuries of.
Rate as for disfigurement of face.
7202 Tongue, loss of whole or part:
With inability to communicate by speech100
One-half or more60
With marked speech impairment30
7203 Esophagus, stricture of:
Permitting passage of liquids only, with marked impairment of general health80
Severe, permitting liquids only50
Moderate30
7204 Esophagus, spasm of (cardiospasm).
If not amenable to dilation, rate as for the degree of obstruction (stricture).
7205 Esophagus, diverticulum of, acquired.
Rate as for obstruction (stricture).
7301 Peritoneum, adhesions of:
Severe; definite partial obstruction shown by X-ray, with frequent and prolonged episodes of severe colic distension, nausea or vomiting, following severe peritonitis, ruptured appendix, perforated ulcer, or operation with drainage50
Moderately severe; partial obstruction manifested by delayed motility of barium meal and less frequent and less prolonged episodes of pain30
Moderate; pulling pain on attempting work or aggravated by movements of the body, or occasional episodes of colic pain, nausea, constipation (perhaps alternating with diarrhea) or abdominal distension10
Mild0
Note: Ratings for adhesions will be considered when there is history of operative or other traumatic or infectious (intraabdominal) process, and at least two of the following: disturbance of motility, actual partial obstruction, reflex disturbances, presence of pain.
7304 Ulcer, gastric.
7305 Ulcer, duodenal:
Severe; pain only partially relieved by standard ulcer therapy, periodic vomiting, recurrent hematemesis or melena, with manifestations of anemia and weight loss productive of definite impairment of health60
Moderately severe; less than severe but with impairment of health manifested by anemia and weight loss; or recurrent incapacitating episodes averaging 10 days or more in duration at least four or more times a year40
Moderate; recurring episodes of severe symptoms two or three times a year averaging 10 days in duration; or with continuous moderate manifestations20
Mild; with recurring symptoms once or twice yearly10
7306 Ulcer, marginal (gastrojejunal):
Pronounced; periodic or continuous pain unrelieved by standard ulcer therapy with periodic vomiting, recurring melena or hematemesis, and weight loss. Totally incapacitating100
Severe; same as pronounced with less pronounced and less continuous symptoms with definite impairment of health60
Moderately severe; intercurrent episodes of abdominal pain at least once a month partially or completely relieved by ulcer therapy, mild and transient episodes of vomiting or melena40
Moderate; with episodes of recurring symptoms several times a year20
Mild; with brief episodes of recurring symptoms once or twice yearly10
7307 Gastritis, hypertrophic (identified by gastroscope):
Chronic; with severe hemorrhages, or large ulcerated or eroded areas60
Chronic; with multiple small eroded or ulcerated areas, and symptoms30
Chronic; with small nodular lesions, and symptoms10
Gastritis, atrophic.
A complication of a number of diseases, including pernicious anemia.
Rate the underlying condition.
7308 Postgastrectomy syndromes:
Severe; associated with nausea, sweating, circulatory disturbance after meals, diarrhea, hypoglycemic symptoms, and weight loss with malnutrition and anemia60
Moderate; less frequent episodes of epigastric disorders with characteristic mild circulatory symptoms after meals but with diarrhea and weight loss40
Mild; infrequent episodes of epigastric distress with characteristic mild circulatory symptoms or continuous mild manifestations20
7309 Stomach, stenosis of.
Rate as for gastric ulcer.
7310 Stomach, injury of, residuals.
Rate as peritoneal adhesions.
7311 Residuals of injury of the liver:
Depending on the specific residuals, separately evaluate as adhesions of peritoneum (diagnostic code 7301), cirrhosis of liver (diagnostic code 7312), and chronic liver disease without cirrhosis (diagnostic code 7345).
7312 Cirrhosis of the liver, primary biliary cirrhosis, or cirrhotic phase of sclerosing cholangitis:
Generalized weakness, substantial weight loss, and persistent jaundice, or; with one of the following refractory to treatment: ascites, hepatic encephalopathy, hemorrhage from varices or portal gastropathy (erosive gastritis)100
History of two or more episodes of ascites, hepatic encephalopathy, or hemorrhage from varices or portal gastropathy (erosive gastritis), but with periods of remission between attacks70
History of one episode of ascites, hepatic encephalopathy, or hemorrhage from varices or portal gastropathy (erosive gastritis)50
Portal hypertension and splenomegaly, with weakness, anorexia, abdominal pain, malaise, and at least minor weight loss30
Symptoms such as weakness, anorexia, abdominal pain, and malaise10
Note: For evaluation under diagnostic code 7312, documentation of cirrhosis (by biopsy or imaging) and abnormal liver function tests must be present.
7314 Cholecystitis, chronic:
Severe; frequent attacks of gall bladder colic30
Moderate; gall bladder dyspepsia, confirmed by X-ray technique, and with infrequent attacks (not over two or three a year) of gall bladder colic, with or without jaundice10
Mild0
7315 Cholelithiasis, chronic.
Rate as for chronic cholecystitis.
7316 Cholangitis, chronic.
Rate as for chronic cholecystitis.
7317 Gall bladder, injury of.
Rate as for peritoneal adhesions.
7318 Gall bladder, removal of:
With severe symptoms30
With mild symptoms10
Nonsymptomatic0
Spleen, disease or injury of.
See Hemic and Lymphatic Systems.
7319 Irritable colon syndrome (spastic colitis, mucous colitis, etc.):
Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress30
Moderate; frequent episodes of bowel disturbance with abdominal distress10
Mild; disturbances of bowel function with occasional episodes of abdominal distress0
7321 Amebiasis:
Mild gastrointestinal disturbances, lower abdominal cramps, nausea, gaseous distention, chronic constipation interrupted by diarrhea10
Asymptomatic0
Note: Amebiasis with or without liver abscess is parallel in symptomatology with ulcerative colitis and should be rated on the scale provided for the latter. Similarly, lung abscess due to amebiasis will be rated under the respiratory system schedule, diagnostic code 6809.
7322 Dysentery, bacillary.
Rate as for ulcerative colitis.
7323 Colitis, ulcerative:
Pronounced; resulting in marked malnutrition, anemia, and general debility, or with serious complication as liver abscess100
Severe; with numerous attacks a year and malnutrition, the health only fair during remissions60
Moderately severe; with frequent exacerbations30
Moderate; with infrequent exacerbations10
7324 Distomiasis, intestinal or hepatic:
Severe symptoms30
Moderate symptoms10
Mild or no symptoms0
7325 Enteritis, chronic.
Rate as for irritable colon syndrome.
7326 Enterocolitis, chronic.
Rate as for irritable colon syndrome.
7327 Diverticulitis.
Rate as for irritable colon syndrome, peritoneal adhesions, or colitis, ulcerative, depending upon the predominant disability picture.
7328 Intestine, small, resection of:
With marked interference with absorption and nutrition, manifested by severe impairment of health objectively supported by examination findings including material weight loss60
With definite interference with absorption and nutrition, manifested by impairment of health objectively supported by examination findings including definite weight loss40
Symptomatic with diarrhea, anemia and inability to gain weight20
Note: Where residual adhesions constitute the predominant disability, rate under diagnostic code 7301.
7329 Intestine, large, resection of:
With severe symptoms, objectively supported by examination findings40
With moderate symptoms20
With slight symptoms10
Note: Where residual adhesions constitute the predominant disability, rate under diagnostic code 7301.
7330 Intestine, fistula of, persistent, or after attempt at operative closure:
Copious and frequent, fecal discharge100
Constant or frequent, fecal discharge60
Slight infrequent, fecal discharge30
Healed; rate for peritoneal adhesions.
7331 Peritonitis, tuberculous, active or inactive:
Active100
Inactive: See §§ 4.88b and 4.89.
7332 Rectum and anus, impairment of sphincter control:
Complete loss of sphincter control100
Extensive leakage and fairly frequent involuntary bowel movements60
Occasional involuntary bowel movements, necessitating wearing of pad30
Constant slight, or occasional moderate leakage10
Healed or slight, without leakage0
7333 Rectum and anus, stricture of:
Requiring colostomy100
Great reduction of lumen, or extensive leakage50
Moderate reduction of lumen, or moderate constant leakage30
7334 Rectum, prolapse of:
Severe (or complete), persistent50
Moderate, persistent or frequently recurring30
Mild with constant slight or occasional moderate leakage10
7335 Ano, fistula in.
Rate as for impairment of sphincter control.
7336 Hemorrhoids, external or internal:
With persistent bleeding and with secondary anemia, or with fissures20
Large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences10
Mild or moderate0
7337 Pruritus ani.
Rate for the underlying condition.
7338 Hernia, inguinal:
Large, postoperative, recurrent, not well supported under ordinary conditions and not readily reducible, when considered inoperable60
Small, postoperative recurrent, or unoperated irremediable, not well supported by truss, or not readily reducible30
Postoperative recurrent, readily reducible and well supported by truss or belt10
Not operated, but remediable0
Small, reducible, or without true hernia protrusion0
Note: Add 10 percent for bilateral involvement, provided the second hernia is compensable. This means that the more severely disabling hernia is to be evaluated, and 10 percent, only, added for the second hernia, if the latter is of compensable degree.
7339 Hernia, ventral, postoperative:
Massive, persistent, severe diastasis of recti muscles or extensive diffuse destruction or weakening of muscular and fascial support of abdominal wall so as to be inoperable100
Large, not well supported by belt under ordinary conditions40
Small, not well supported by belt under ordinary conditions, or healed ventral hernia or post-operative wounds with weakening of abdominal wall and indication for a supporting belt20
Wounds, postoperative, healed, no disability, belt not indicated0
7340 Hernia, femoral.
Rate as for inguinal hernia.
7342 Visceroptosis, symptomatic, marked10
7343 Malignant neoplasms of the digestive system, exclusive of skin growths100
Note: A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.
7344 Benign neoplasms, exclusive of skin growths:
Evaluate under an appropriate diagnostic code, depending on the predominant disability or the specific residuals after treatment.
7345 Chronic liver disease without cirrhosis (including hepatitis B, chronic active hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced hepatitis, etc., but excluding bile duct disorders and hepatitis C):
Near-constant debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain)100
Daily fatigue, malaise, and anorexia, with substantial weight loss (or other indication of malnutrition), and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least six weeks during the past 12-month period, but not occurring constantly60
Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least four weeks, but less than six weeks, during the past 12-month period40
Daily fatigue, malaise, and anorexia (without weight loss or hepatomegaly), requiring dietary restriction or continuous medication, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least two weeks, but less than four weeks, during the past 12-month period20
Intermittent fatigue, malaise, and anorexia, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least one week, but less than two weeks, during the past 12-month period10
Nonsymptomatic0
Note (1): Evaluate sequelae, such as cirrhosis or malignancy of the liver, under an appropriate diagnostic code, but do not use the same signs and symptoms as the basis for evaluation under DC 7354 and under a diagnostic code for sequelae. (See § 4.14.).
Note (2): For purposes of evaluating conditions under diagnostic code 7345, “incapacitating episode” means a period of acute signs and symptoms severe enough to require bed rest and treatment by a physician.
Note (3): Hepatitis B infection must be confirmed by serologic testing in order to evaluate it under diagnostic code 7345.
7346 Hernia hiatal:
Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health60
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health30
With two or more of the symptoms for the 30 percent evaluation of less severity10
7347 Pancreatitis:
With frequently recurrent disabling attacks of abdominal pain with few pain free intermissions and with steatorrhea, malabsorption, diarrhea and severe malnutrition100
With frequent attacks of abdominal pain, loss of normal body weight and other findings showing continuing pancreatic insufficiency between acute attacks60
Moderately severe; with at least 4-7 typical attacks of abdominal pain per year with good remission between attacks30
With at least one recurring attack of typical severe abdominal pain in the past year10
Note 1: Abdominal pain in this condition must be confirmed as resulting from pancreatitis by appropriate laboratory and clinical studies.
Note 2: Following total or partial pancreatectomy, rate under above, symptoms, minimum rating 30 percent.
7348 Vagotomy with pyloroplasty or gastroenterostomy:
Followed by demonstrably confirmative postoperative complications of stricture or continuing gastric retention40
With symptoms and confirmed diagnosis of alkaline gastritis, or of confirmed persisting diarrhea30
Recurrent ulcer with incomplete vagotomy20
Note: Rate recurrent ulcer following complete vagotomy under diagnostic code 7305, minimum rating 20 percent; and rate dumping syndrome under diagnostic code 7308.
7351 Liver transplant:
For an indefinite period from the date of hospital admission for transplant surgery100
Minimum30
Note: A rating of 100 percent shall be assigned as of the date of hospital admission for transplant surgery and shall continue. One year following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter.
7354 Hepatitis C (or non-A, non-B hepatitis):
With serologic evidence of hepatitis C infection and the following signs and symptoms due to hepatitis C infection:
Near-constant debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain)100
Daily fatigue, malaise, and anorexia, with substantial weight loss (or other indication of malnutrition), and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least six weeks during the past 12-month period, but not occurring constantly60
Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least four weeks, but less than six weeks, during the past 12-month period40
Daily fatigue, malaise, and anorexia (without weight loss or hepatomegaly), requiring dietary restriction or continuous medication, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least two weeks, but less than four weeks, during the past 12-month period20
Intermittent fatigue, malaise, and anorexia, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least one week, but less than two weeks, during the past 12-month period10
Nonsymptomatic0
Note (1): Evaluate sequelae, such as cirrhosis or malignancy of the liver, under an appropriate diagnostic code, but do not use the same signs and symptoms as the basis for evaluation under DC 7354 and under a diagnostic code for sequelae. (See § 4.14.).
Note (2): For purposes of evaluating conditions under diagnostic code 7354, “incapacitating episode” means a period of acute signs and symptoms severe enough to require bed rest and treatment by a physician.
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[29 FR 6718, May 22, 1964, as amended at 34 FR 5063, Mar. 11, 1969; 40 FR 42540, Sept. 15, 1975; 41 FR 11301, Mar. 18, 1976; 66 FR 29488, May 31, 2001]

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FAQs

What is the VA disability rating for intestine? ›

If the symptoms are “moderate,” with frequent episodes of bowel disturbance and abdominal distress, then the VA will give a 10% rating. Finally, if the symptoms are “severe,” with more or less constant abdominal distress, AND diarrhea or alternating diarrhea and constipation, then the VA will give a 30% rating.

What is the VA disability rating for gastroenteritis? ›

The veteran's gastroenteritis is currently assigned a 30 percent disability evaluation under 38 C.F.R. § 4.114, Diagnostic Code 7399-7319, irritable colon syndrome. Irritable colon syndrome (spastic colitis, mucous colitis, etc.)

Can you get a VA rating for GERD and IBS? ›

The Veteran's service-connected IBS and GERD are manifested by other symptom combinations productive of severe impairment of health. The criteria for the assignment of an increased rating of 60 percent for the service-connected IBS and GERD are met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp.

What is avoidance of pyramiding? ›

§ 4.14 Avoidance of pyramiding.

Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided.

What is the average VA rating for IBS? ›

10 percent – VA assigns veterans a 10 percent rating if they exhibit moderate symptoms of IBS, such as “frequent episodes of bowel disturbance with abdominal distress.” Examples of bowel disturbance include episodes of diarrhea, severe gas, and bloating.

How do you prove IBS is service connected? ›

You'll need to show a nexus — a link that connects your disability to a specific in-service event, injury, or illness. Your claim should include a nexus letter from your physician(s). A nexus letter is a letter to the VA explaining how your IBS was incurred or caused during service.

Can you go on disability for digestive problems? ›

If you have not received treatment, you may not be able to show an impairment that meets the criteria of one of the digestive system listings, but your digestive impairment may medically equal a listing or be disabling based on consideration of your residual functional capacity, age, education, and work experience.

How does VA rating gastritis? ›

Gastritis: Gastritis is an erosion of the stomach lining. VA disability ratings for gastritis range from 10% to 60% depending on the amount of the stomach affected and the presence of hemorrhages.

What are gastrointestinal issues? ›

What are gastrointestinal diseases? Gastrointestinal diseases affect the gastrointestinal (GI) tract from the mouth to the anus. There are two types: functional and structural. Some examples include nausea/vomiting, food poisoning, lactose intolerance and diarrhea.

What conditions are secondary to GERD? ›

If GERD causes extensive injuries to the esophagus, erosive esophagitis may occur. Erosive esophagitis usually involves damage to the lining of the esophagus, which can inhibit its function. Barrett's esophagus is an even more serious complication of GERD, developing at an advanced stage of erosive esophagus.

What is the highest VA rating for IBS? ›

Veterans can receive a 0 percent, 10 percent, or 30 percent rating for IBS depending on the severity of the condition.
  • 0%: Your IBS is considered to be mild. ...
  • 10%: Moderate IBS with more frequent bowel disturbances or abdominal distress.
  • 30%: Severe IBS.

Is GERD secondary to sleep apnea? ›

Studies show that there is a link between sleep apnea and GERD. This connection is bidirectional, meaning, while GERD can induce and worsen the effect of sleep apnea, sleep apnea can also induce and worsen the effect of GERD.

Can you have two VA claims at the same time? ›

You can file a secondary claim to get more disability benefits for a new disability that's linked to a service-connected disability you already have. For example, you might file a secondary claim if you: Develop arthritis that's caused by a service-connected knee injury you got while on active duty, or.

What does the VA consider functional loss? ›

Functional Loss - Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal exertion, strength, speed, coordination, and endurance.

Should I file multiple VA claims at once? ›

Each condition a veteran has must be claimed individually. However, it is often advantageous to file all of your claims together, particularly when they involve related issues.

What is the VA rating for constipation? ›

A 10 percent disability rating is assigned for moderate symptoms manifested by frequent episodes of bowel disturbance with abdominal distress. A 30 percent disability rating is assigned for severe symptoms manifested by diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress.

What is the VA disability rating for acid reflux? ›

30 percent – VA recognizes 30% for GERD when it leads to “persistently recurrent epigastric discomfort with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm and shoulder pain that is very severe.”

Is PTSD linked to IBS? ›

Random-effects meta-analysis found PTSD to be a significant risk factor for IBS (pooled odds ratio 2.80, 95% confidence interval: 2.06 to 3.54, P < 0.001). Conclusions: Overall, PTSD is associated with an increased likelihood of IBS.

Can you go on disability for digestive problems? ›

If you have not received treatment, you may not be able to show an impairment that meets the criteria of one of the digestive system listings, but your digestive impairment may medically equal a listing or be disabling based on consideration of your residual functional capacity, age, education, and work experience.

What are the top 10 VA disability claims? ›

Table of Contents
  • List of the Top 50 VA Disability Claims:
  • What are Some Common VA Disability Claims?
  • #1. Tinnitus.
  • #2. Hearing Loss.
  • #3. Limitation of Flexion, Knee.
  • #4. Post-Traumatic Stress Disorder (PTSD)
  • #5. Lumbosacral or Cervical Strain.
  • #6. Scars, General.
27 Feb 2022

What is the VA rating for gastritis? ›

Pursuant to Diagnostic Code 7307, a 10 percent disability rating is warranted for chronic gastritis with small nodular lesions and symptoms; a 30 percent disability rating is warranted for chronic gastritis with multiple small eroded or ulcerated areas and symptoms; and a maximum 60 percent disability rating is ...

What is the average VA rating for ulcerative colitis? ›

Under Diagnostic Code 7323, a 10 percent disability rating when there is moderate ulcerative colitis with infrequent exacerbations. A 30 percent disability rating is warranted for moderately severe ulcerative colitis with frequent exacerbations.

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