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 speech....................... 100
One-half or more.............................................. 60
With marked speech impairment................................. 307203 Esophagus, stricture of:
Permitting passage of liquids only, with marked impairment of 80
general health...............................................
Severe, permitting liquids only............................... 50
Moderate...................................................... 307204 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 50
frequent and prolonged episodes of severe colic distension,
nausea or vomiting, following severe peritonitis, ruptured
appendix, perforated ulcer, or operation with drainage.......
Moderately severe; partial obstruction manifested by delayed 30
motility of barium meal and less frequent and less prolonged
episodes of pain.............................................
Moderate; pulling pain on attempting work or aggravated by 10
movements of the body, or occasional episodes of colic pain,
nausea, constipation (perhaps alternating with diarrhea) or
abdominal distension.........................................
Mild.......................................................... 0
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 60
therapy, periodic vomiting, recurrent hematemesis or melena,
with manifestations of anemia and weight loss productive of
definite impairment of health................................
Moderately severe; less than severe but with impairment of 40
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 year...........................
Moderate; recurring episodes of severe symptoms two or three 20
times a year averaging 10 days in duration; or with
continuous moderate manifestations...........................
Mild; with recurring symptoms once or twice yearly............ 107306 Ulcer, marginal (gastrojejunal):
Pronounced; periodic or continuous pain unrelieved by standard 100
ulcer therapy with periodic vomiting, recurring melena or
hematemesis, and weight loss. Totally incapacitating.........
Severe; same as pronounced with less pronounced and less 60
continuous symptoms with definite impairment of health.......
Moderately severe; intercurrent episodes of abdominal pain at 40
least once a month partially or completely relieved by ulcer
therapy, mild and transient episodes of vomiting or melena...
Moderate; with episodes of recurring symptoms several times a 20
year.........................................................
Mild; with brief episodes of recurring symptoms once or twice 10
yearly.......................................................7307 Gastritis, hypertrophic (identified by gastroscope):
Chronic; with severe hemorrhages, or large ulcerated or eroded 60
areas........................................................
Chronic; with multiple small eroded or ulcerated areas, and 30
symptoms.....................................................
Chronic; with small nodular lesions, and symptoms............. 10
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 60
disturbance after meals, diarrhea, hypoglycemic symptoms, and
weight loss with malnutrition and anemia.....................
Moderate; less frequent episodes of epigastric disorders with 40
characteristic mild circulatory symptoms after meals but with
diarrhea and weight loss.....................................
Mild; infrequent episodes of epigastric distress with 20
characteristic mild circulatory symptoms or continuous mild
manifestations...............................................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 100
jaundice, or; with one of the following refractory to
treatment: ascites, hepatic encephalopathy, hemorrhage from
varices or portal gastropathy (erosive gastritis)............
History of two or more episodes of ascites, hepatic 70
encephalopathy, or hemorrhage from varices or portal
gastropathy (erosive gastritis), but with periods of
remission between attacks....................................
History of one episode of ascites, hepatic encephalopathy, or 50
hemorrhage from varices or portal gastropathy (erosive
gastritis)...................................................
Portal hypertension and splenomegaly, with weakness, anorexia, 30
abdominal pain, malaise, and at least minor weight loss......
Symptoms such as weakness, anorexia, abdominal pain, and 10
malaise......................................................
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 colic................ 30
Moderate; gall bladder dyspepsia, confirmed by X-ray 10
technique, and with infrequent attacks (not over two or three
a year) of gall bladder colic, with or without jaundice......
Mild.......................................................... 07315 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 symptoms.......................................... 30
With mild symptoms............................................ 10
Nonsymptomatic................................................ 0
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, 30
with more or less constant abdominal distress................
Moderate; frequent episodes of bowel disturbance with 10
abdominal distress...........................................
Mild; disturbances of bowel function with occasional episodes 0
of abdominal distress........................................7321 Amebiasis:
Mild gastrointestinal disturbances, lower abdominal cramps, 10
nausea, gaseous distention, chronic constipation interrupted
by diarrhea..................................................
Asymptomatic.................................................. 0
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 100
general debility, or with serious complication as liver
abscess......................................................
Severe; with numerous attacks a year and malnutrition, the 60
health only fair during remissions...........................
Moderately severe; with frequent exacerbations................ 30
Moderate; with infrequent exacerbations....................... 107324 Distomiasis, intestinal or hepatic:
Severe symptoms............................................... 30
Moderate symptoms............................................. 10
Mild or no symptoms........................................... 07325 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, 60
manifested by severe impairment of health objectively
supported by examination findings including material weight
loss.........................................................
With definite interference with absorption and nutrition, 40
manifested by impairment of health objectively supported by
examination findings including definite weight loss..........
Symptomatic with diarrhea, anemia and inability to gain weight 20
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 40
findings.....................................................
With moderate symptoms........................................ 20
With slight symptoms.......................................... 10
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 discharge......................... 100
Constant or frequent, fecal discharge......................... 60
Slight infrequent, fecal discharge............................ 30
Healed; rate for peritoneal adhesions.7331 Peritonitis, tuberculous, active or inactive:
Active........................................................ 100
Inactive: See Sec. Sec. 4.88b and 4.89.7332 Rectum and anus, impairment of sphincter control:
Complete loss of sphincter control............................ 100
Extensive leakage and fairly frequent involuntary bowel 60
movements....................................................
Occasional involuntary bowel movements, necessitating wearing 30
of pad.......................................................
Constant slight, or occasional moderate leakage............... 10
Healed or slight, without leakage............................. 07333 Rectum and anus, stricture of:
Requiring colostomy........................................... 100
Great reduction of lumen, or extensive leakage................ 50
Moderate reduction of lumen, or moderate constant leakage..... 307334 Rectum, prolapse of:
Severe (or complete), persistent.............................. 50
Moderate, persistent or frequently recurring.................. 30
Mild with constant slight or occasional moderate leakage...... 107335 Ano, fistula in.
Rate as for impairment of sphincter control.7336 Hemorrhoids, external or internal:
With persistent bleeding and with secondary anemia, or with 20
fissures.....................................................
Large or thrombotic, irreducible, with excessive redundant 10
tissue, evidencing frequent recurrences......................
Mild or moderate.............................................. 07337 Pruritus ani.
Rate for the underlying condition.7338 Hernia, inguinal:
Large, postoperative, recurrent, not well supported under 60
ordinary conditions and not readily reducible, when
considered inoperable........................................
Small, postoperative recurrent, or unoperated irremediable, 30
not well supported by truss, or not readily reducible........
Postoperative recurrent, readily reducible and well supported 10
by truss or belt.............................................
Not operated, but remediable.................................. 0
Small, reducible, or without true hernia protrusion........... 0
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 100
extensive diffuse destruction or weakening of muscular and
fascial support of abdominal wall so as to be inoperable.....
Large, not well supported by belt under ordinary conditions... 40
Small, not well supported by belt under ordinary conditions, 20
or healed ventral hernia or post-operative wounds with
weakening of abdominal wall and indication for a supporting
belt.........................................................
Wounds, postoperative, healed, no disability, belt not 0
indicated....................................................7340 Hernia, femoral.
Rate as for inguinal hernia.7342 Visceroptosis, symptomatic, marked......................... 107343 Malignant neoplasms of the digestive system, exclusive of 100
skin growths...................................................
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 Sec.
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, 100
nausea, vomiting, anorexia, arthralgia, and right upper
quadrant pain)...............................................
Daily fatigue, malaise, and anorexia, with substantial weight 60
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
constantly...................................................
Daily fatigue, malaise, and anorexia, with minor weight loss 40
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 period..............................
Daily fatigue, malaise, and anorexia (without weight loss or 20
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 period.................................................
Intermittent fatigue, malaise, and anorexia, or; 10
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
period.......................................................
Nonsymptomatic................................................ 0
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 Sec. 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 60
hematemesis or melena with moderate anemia; or other symptom
combinations productive of severe impairment of health.......
Persistently recurrent epigastric distress with dysphagia, 30
pyrosis, and regurgitation, accompanied by substernal or arm
or shoulder pain, productive of considerable impairment of
health.......................................................
With two or more of the symptoms for the 30 percent evaluation 10
of less severity.............................................7347 Pancreatitis:
With frequently recurrent disabling attacks of abdominal pain 100
with few pain free intermissions and with steatorrhea,
malabsorption, diarrhea and severe malnutrition..............
With frequent attacks of abdominal pain, loss of normal body 60
weight and other findings showing continuing pancreatic
insufficiency between acute attacks..........................
Moderately severe; with at least 4-7 typical attacks of 30
abdominal pain per year with good remission between attacks..
With at least one recurring attack of typical severe abdominal 10
pain in the past year........................................
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 40
complications of stricture or continuing gastric retention...
With symptoms and confirmed diagnosis of alkaline gastritis, 30
or of confirmed persisting diarrhea..........................
Recurrent ulcer with incomplete vagotomy...................... 20
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 100
for transplant surgery.......................................
Minimum....................................................... 30
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
Sec. 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, 100
malaise, nausea, vomiting, anorexia, arthralgia, and right
upper quadrant pain).........................................
Daily fatigue, malaise, and anorexia, with substantial weight 60
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
constantly...................................................
Daily fatigue, malaise, and anorexia, with minor weight loss 40
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 period..............................
Daily fatigue, malaise, and anorexia (without weight loss or 20
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 period.................................................
Intermittent fatigue, malaise, and anorexia, or; 10
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
period.......................................................
Nonsymptomatic................................................ 0
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 Sec. 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.------------------------------------------------------------------------ (Authority: 38 U.S.C. 1155) [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]
The Genitourinary System