VIDEO: VA Ratings for Digestive System Conditions 

“According to the 2023 VBA annual report, over 1.3 million digestive system conditions have been service connected with a 7% increase from 2021 to 2022. While it is sometimes an uncomfortable subject to talk about, it’s an important topic for veterans. 

“Today, we will talk about VA claims for conditions that affect the digestive system. 

“Hopefully, after watching this video, you will have a better understanding of how the VA rates different digestive conditions. Let’s start out by discussing one of the most common digestive disorders veterans experience — irritable bowel syndrome.”

IBS VA rating 

“Does it seem like your stomach hurts all the time? If you aren’t running to the bathroom, you have so much gastric distress that you feel like you need to. You feel bloated and uncomfortable most of the time. It makes you not want to leave the house or be far from the bathroom. 

“You’re not alone. IBS affects 10% to 15% of the US population. The most common symptom of IBS is abdomen pain, which is often related to changes in bowel movements. These changes may be diarrhea, constipation, or both, depending on the type of IBS. These symptoms range in severity and are at best inconvenient and at worst debilitating. Unfortunately, many veterans experience these symptoms every day. 

“Doctors aren’t sure what causes IBS, but they believe it can be related to stress, environmental exposures to bacteria or pollutants, mental disorders such as depression, anxiety, somatic symptom disorder, and food intolerances and sensitivities. 

“As you’re probably aware, many veterans experience stress and were exposed to various toxins during their time in service. Additionally, veterans are more likely than the general population to develop mental health conditions. These are contributing factors as to why so many veterans have IBS. 

“According to the VBA Annual Benefits Report for the 2022 fiscal year, almost 200,000 veterans have a rating for IBS. That makes it the third most common digestive disorder among veterans.” 

How to service connect IBS 

“There are a couple of ways to service connect your IBS. Depending on the suspected cause, veterans can be service connected in three different ways for IBS – presumptive, direct, and secondary. We’re going to explore each one of them a little more closely.” 

Presumptive service connection for IBS 

“First is presumptive service connection, which means the VA automatically presumes that certain disabilities were caused by military service. This type of service connection is relatively easy to prove. Essentially, the VA has lists of different conditions that are clearly linked to different periods of service and service locations. 

“If a condition is very common among specific groups of veterans, the government may add it to a presumptive list of conditions. Keeping this in mind, veterans who served in the Gulf War are especially prone to IBS. One study found that up to 25% of Gulf War veterans who participated had IBS. IBS is a common symptom of Gulf War syndrome, and Gulf War Syndrome is a presumptive condition for Gulf War service. 

“Gulf War Syndrome is used to describe a range of chronic, unexplained symptoms affecting Persian Gulf War veterans. However, you don’t need to have served in the Gulf War or have Gulf War Syndrome to service connect IBS.” 

Direct service connection for IBS 

“The second avenue is direct service connection, which means that a disability or disease is directly linked to active-duty service. Unlike presumptive service connection, this avenue requires evidence that shows how an event in service resulted in an IBS diagnosis. An example may be that you received an IBS diagnosis while in service, or maybe you contracted a bacterium in service that caused excessive diarrhea, later diagnosed as IBS. 

“Another example may be that a combat injury or vehicle collision may have caused damage to the nerves that control the muscles that move food through the bowel, therefore resulting in IBS. However, sometimes IBS develops after service as a result of a mental health condition or some other service-related ailment. These cases can still be service connected, though.” 

Secondary service connection for IBS 

“The third type of service connection is secondary service connection. IBS can be connected to military service on a secondary basis, meaning it was caused by or permanently aggravated by another service-connected condition. 

“For example, if you suffer from IBS because of the medication you are taking to treat your service-connected PTSD, you may qualify for secondary service connection for IBS. 

“Those are the ways a veteran can connect IBS to service. But you may be wondering how the VA will rate IBS.” 

How the VA determines IBS VA ratings 

“The veterans disability ratings for IBS are set forth in the VA schedule of ratings for the digestive system, or CFR 38 Section 4.114. The VA rates it under diagnostic code 7319, which used to be labeled as irritable colon syndrome, spastic colitis, and mucous colitis — all alternate names for IBS.

“IBS is rated depending on the severity of symptoms. To receive a rating, a veteran must experience two or more of the following symptoms: a change in stool frequency, change in stool form, constipation or diarrhea, mucus discharge, abdominal bloating, or subjective distension.

“Veterans experiencing an episode once during the previous three months are eligible for a 10% rating, those who have at least three monthly episodes for at least three months receive 20%, and those with weekly episodes receive 30%.

“The veteran always needs to address his or her symptoms on a compensation and pension (C&P) exam simply to be rated accurately. 

“It’s important to keep in mind that IBS can only receive up to a 30% rating. It is still worth it to file a claim. Sometimes, IBS can lead to other conditions, which can be connected on a secondary basis. An IBS rating may also contribute to a veteran receiving TDIU.” 

TDIU for IBS 

“TDIU is used for veterans who are unable to work due to their service-connected conditions but are not receiving a 100% rating. Having to make frequent trips to the restroom can impact the veteran’s performance at work. This, in combination with other conditions, could result in the veteran becoming unemployable.” 

GERD VA rating 

“Many people might have some heartburn or acid reflux after eating spicy food or fatty food, but GERD is a more serious form of acid reflux. It is a relatively common disorder that affects numerous veterans. 

“Let’s begin with what causes GERD. Some things that may increase your risk of GERD are physical trauma, stress or stressors, some sleep disorders, medications, and so on. There are several ways a veteran may be able to service connect GERD. 

“The first way to service connect GERD is through medications. I specifically want to focus on medications, as many veterans are on some sort of medication. An example would be if a veteran takes medication for one of his or her already service-connected conditions, and then the veteran develops GERD. That veteran may be able to get a secondary service connection. 

“Some of the main medications to focus on are medications prescribed for an overactive bladder, IBS, antidepressants, nitrates, calcium channel blockers for high blood pressure and heart disease, narcotics, progesterone sedatives, and tranquilizers like Valium. While these medicines help one issue, they may exacerbate another, like GERD. This is not an all-inclusive list, but it probably hits the medications most veterans take for different medical issues. 

“Next is some sort of physical trauma to the veteran. The esophagus may become weakened or damaged because of some physical trauma. For example, an injury sustained in combat training or a vehicle collision may be cause for direct service connection. 

“Then, the veteran may experience some sort of stress from a mental health condition like PTSD. Stress can increase the production of stomach acid. Medical evidence establishes that mental health issues can lead to the overproduction of stomach acid, leading to a secondary service connection of GERD. 

“GERD used to be rated analogously to hiatal hernias but now appears in the ratings schedule as diagnostic code 7206. The condition is rated at 0, 10, 30, 50, and 80%. The more severe the symptoms and the more often the veteran requires dilatation to widen their esophagus, the higher the rating.”

VA rating for hemorrhoids 

“Hemorrhoids are another common digestive condition veterans experience. Hemorrhoids are swollen veins in the anus and lower rectum. They may cause pain and discomfort during bowel movements or when sitting down in general. Hemorrhoids are usually temporary. However, they tend to reoccur in those who have chronic digestive problems that result in constipation or diarrhea. 

“The VA assigns a 10% rating for prolapsed internal hemorrhoids with two or fewer episodes of thrombosis per year and 20% for internal or external hemorrhoids with persistent bleeding and anemia, or for continuously prolapsed internal hemorrhoids with three or more episodes of thrombosis a year.”

VA ratings for liver conditions 

“Conditions impacting the liver tend to be severe and sometimes require intense treatment. We will review some of the liver conditions that may be service connected. First, we’re going to cover cirrhosis.” 

VA disability rating for cirrhosis of the liver 

“Cirrhosis is a medical term for severe scarring of the liver. Unfortunately, cirrhosis has no symptoms until the condition is too advanced. Some symptoms a veteran may experience with cirrhosis are fatigue, bleeding, bruising, loss of appetite, swelling in the legs, feet, and ankles, itchy skin, jaundice, or fluid collection in the abdomen. 

“This serious condition can be caused by many things, such as hepatitis or chronic alcoholism. Unfortunately, drug-induced liver injury is a common cause of liver damage as well. Nearly all classes of medication can cause some sort of limited liver damage. Cirrhosis is usually service connected because of the medications the veteran takes. 

“Drinking excessive amounts of alcohol to cope with service-connected mental disorders can cause cirrhosis. Cirrhosis can also be caused by a prior liver disease, such as hepatitis, that is related to service. Cirrhosis can be rated from 10% to 100%, depending on the severity of the symptoms. 

“The VA rates cirrhosis under diagnostic code 7312. The VA now uses MELD scores to rate cirrhosis. MELD stands for Model for End-Stage Liver Disease. Doctors typically consult these scores when deciding who to prioritize for liver transplants. The VA will use the score to determine how advanced a veteran’s cirrhosis is and ultimately assign a rating. In the absence of a MELD score, the VA will assign a rating based on the severity of symptoms.”

Hepatitis VA ratings 

“While all three viruses affect the liver, they have different routes of transmission and different effects. Additionally, they are rated differently by the VA. Service connecting hepatitis may be difficult because the VA does not regularly test for it, and many cases of hepatitis are asymptomatic. Veterans may not even know they have hepatitis until years after service during the Vietnam era. If hepatitis was even tested for, the test would not have revealed the specific type. Therefore, it may cause issues trying to prove what type of hepatitis the veteran had in service. Let’s discuss each type in more detail.” 

Hep A VA rating

“Hepatitis A is a virus that is easily transmitted from person to person and almost always clears up without treatment. This is not a ratable virus, but it can be service connected. This is important because it can lead to other conditions such as gastroparesis, which could be ratable as a secondary service connection condition.” 

Hep B VA rating

“Unlike hepatitis A, hepatitis B is an incurable virus that causes chronic illness if service connected. It can be rated from 0% to 100%, depending on the severity and frequency of the symptoms.” 

Hep C VA rating

“Symptoms of hepatitis C are rated similarly to hepatitis B, but hepatitis C is curable. However, chronic hepatitis C can result in liver damage, liver failure, cirrhosis, liver cancer, thyroid cancer, and even death. Hepatitis C is more common in Vietnam veterans because of the wounds and blood transfusions. Blood was not screened the way it is now, so the virus was more widely spread. 

“Unfortunately, infected military personnel infected other military members. That is one possible avenue for service connection. Additionally, hepatitis C could be spread through intravenous drug use or sexual activity. It’s important to note that conditions contracted through sexual activity or drug use during service are still eligible for service connection. However, blood-borne illnesses can be spread from any blood cross-contamination. For example, if a veteran with hepatitis shared a razor with a fellow soldier, they might have unknowingly spread the virus.” 

Digestive system cancers 

“Service-connected cancers will receive a 100% rating during treatment and six months post-treatment. Usually, after this time the VA will reevaluate the veteran for a new rating based on the veteran’s cancer residuals. Residuals are symptoms of the lasting impact of the cancer or treatment has had on your health.” 

Liver cancer VA rating

“Hepatocellular carcinoma accounts for about 90% of all primary liver cancers. So, what can cause this common form of liver cancer? There are many causes such as chronic infection with hepatitis B and C, cirrhosis, diabetes, nonalcoholic fatty liver disease (also called NASH), or exposure to Aflatoxins, which are molds that can grow on crops. Because some of the causes could be linked to service, so could have a particular cellular cancer.” 

Bile duct cancer VA rating

“Bile duct cancer is a rare disease in which malignant or cancer cells form in the bile ducts. Bile ducts are tubes that connect the liver, gallbladder, and small intestine. Bile is a fluid that breaks down fats during digestion in the liver. 

“Causes of bile duct cancer include cirrhosis, chronic liver disease, a liver parasite, and diabetes. While rare, some Vietnam veterans may be at a higher risk for developing this cancer than the general population. This is because veterans who consumed raw fish while serving in Southeast Asia were susceptible to contracting a liver parasite. If an infection results in the development of bile duct cancer, then the cancer can be connected to service.” 

Esophageal cancer VA rating

“Esophageal cancer is a disease in which malignant cells form in the tissues of the esophagus. The esophagus is a hollow, muscular tube that moves food and liquid from the throat to the stomach.  

“Causes of esophageal cancer include tobacco use, heavy alcohol use, and Barrett’s esophagus. Barrett’s esophagus is a condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to cancer of the esophagus.

“Veterans who have Barrett’s Esophagus with esophageal strictures are rated from 0% to 80% under diagnostic code 7203. Without strictures, they are rated under diagnostic code 7207 and receive ratings of 10 or 30%.

“Gastric reflux, or GERD, is the most common cause of Barrett’s esophagus. So, if a veteran’s service-connected GERD resulted in Barrett’s esophagus and eventually cancer, that cancer may also be connected to service.” 

How Woods & Woods can help 

“If you have more questions about VA benefits in general, I encourage you to watch some of the other videos on our YouTube channel. If you are wondering if you qualify for an increased rating or TDIU, contact Woods and Woods for a free consultation.”