What is the Gallbladder VA Rating?

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Effective May 19, 2024, under the new Diagnostic Code (DC) 7317, gallbladder injury, veterans can get a VA rating for the gallbladder between 0% and 80% with breaks at 10%, 30%, and 50%, depending on the condition, its severity and how it affects you, and the application of the appropriate DC.

There are now three DCs applicable to the gallbladder: DC 7301, DC 7314, and DC 7318.

• If you have an injury to the gallbladder that results in adhesions (bands of scar tissue) forming in the peritoneum (the membrane lining the abdominal cavity), it should be rated according to the rating criteria outlined in DC 7301 at 0%, 10%, 30%, 50%, or 80%.

• If you have chronic issues involving the gallbladder or biliary tract (the ducts that transport bile from the liver to the small intestine), it should be rated based on the rating criteria specified in DC 7314 at 0%, 10%, or 30%.

• If you have Cholecystectomy (gallbladder removal) or complications arising from a previous cholecystectomy (surgical removal of the gallbladder), such as the development of strictures (narrowing) or biliary leaks, it should be rated based on the rating criteria outlined in DC 7318 at 0%, 10%, or 30%.

Your final gallbladder VA disability rating depends on the frequency (how often), severity (how bad), and duration (how long) of symptoms and how those symptoms negatively impact your work, life, and social functioning.

➡️ These updates are part of the VA’s digestive system rating changes explained here.  

Summary of Main Points

• Gallbladder issues are rated with DC 7317 under CFR Title 38, Part 4, the Schedule for Rating Disabilities. DC 7317 instructs the VA to rate the gallbladder with DC 7301, 7314, or 7318 depending on the condition and its severity of symptoms. VA ratings for the gallbladder range from 0% to 80% with breaks at 10%, 30%, and 50%.

• (NEW!) Gallbladder removal is now rated under DC 7318 with ratings from 0% to 30% with a break at 10%.

• If you already have a VA disability rating for the gallbladder, there will be no change to your current VA rating—you are “grandfathered” in under the old rating criteria.

What is the Gallbladder?

The gallbladder is a small, pear-shaped organ located just beneath the liver on the right side of the abdomen.

Its primary function is to store and concentrate bile, a digestive fluid produced by the liver.

Bile helps in the digestion of fats in the small intestine.

When food enters the small intestine, the gallbladder contracts and releases stored bile into the small intestine through a series of ducts to aid in the digestion process.

Bile itself is composed of water, cholesterol, fats, bile salts, proteins, and bilirubin.

The bile salts break down fat so that it can be absorbed by the digestive tract.

Without the gallbladder, the liver still produces bile, but it is released directly into the small intestine in a continuous, slow trickle, which can affect the digestion of fatty foods.

Gallbladder Problems Explained

The gallbladder can be the source of several problems, such as gallstones (cholelithiasis), inflammation (cholecystitis), and cancer.

Gallstones are the most common issue, where small stones form from cholesterol and other substances in the bile.

These stones can block the flow of bile, causing pain, nausea, and potentially leading to serious complications such as infection or pancreatitis.

Gallbladder removal, or cholecystectomy, is a common surgery performed when gallbladder problems cannot be resolved through other treatments.

While people can live without their gallbladder, the absence of this organ can lead to changes in digestion and sometimes result in diarrhea or fat malabsorption.

What Gallbladder Conditions Can Get a VA Rating?

The VA rates multiple gallbladder conditions including adhesions to the peritoneum, chronic gallbladder and biliary tract disease, and gallbladder removal (cholecystectomy) as follows:

Gallbladder with Adhesions of the Peritoneum (Rate Under DC 7301)

Adhesions refer to bands of scar tissue that can form between abdominal tissues and organs. Often, these result from surgery, trauma, disease, or infection. When adhesions occur in the peritoneum, they can cause chronic abdominal pain and other complications. The rating under Diagnostic Code (DC) 7301 would depend on the severity of the symptoms and the extent to which they impair the veteran’s health.

Chronic Gallbladder Conditions and Biliary Tract Disease (Rate Under DC 7314)

This code is used to rate disabilities related to chronic diseases of the gallbladder and the biliary tract (the pathway through which bile flows from the liver to the small intestine). Conditions under this category might include chronic cholecystitis (inflammation of the gallbladder) or biliary dyskinesia (abnormal movement of bile through the biliary tract), with the rating based on the severity and frequency of symptoms such as pain, nausea, and vomiting.

Gallbladder Removal and Related Complications (Rate Under DC 7318)

A cholecystectomy, the surgical removal of the gallbladder, can sometimes lead to complications like strictures (narrowing of the bile ducts) and biliary leaks (leakage of bile due to a breach in the bile ducts). These complications can cause significant health issues, including pain, infection, and jaundice. The rating under DC 7318 would reflect the impact of these complications on the veteran’s health.

VA Disability Rating for Gallbladder

Beginning May 19, 2024, the VA rates the gallbladder with DC 7317 under CFR Title 38, Part 4, the Schedule for Rating Disabilities.

DC 7317 instructs the VA to rate gallbladder conditions with DC 7301, 7314, or 7318 depending on the condition and its severity of symptoms.

VA ratings for the gallbladder range from 0% to 80% with breaks at 10%, 30%, and 50%.

VA Rating for Gallbladder with Adhesions of the Peritoneum due to Surgery, Trauma, Disease, or Infection (DC 7301)

• Gallbladder with persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition (TPN) for obstructive symptoms rate at 80%

• Gallbladder with symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and clinical evidence of recurrent obstruction requiring hospitalization at least once a year; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 50%

• Gallbladder with symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 30%

• Gallbladder with symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider, and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 10%

• Gallbladder with history of peritoneal adhesions, currently asymptomatic (no symptoms) rate at 0%

Detailed Explanations of the Rating Criteria:

Gallbladder with Persistent Partial Bowel Obstruction (80% VA Rating):

• This condition involves a blockage in the bowel that is not completely obstructing the passage of intestinal contents but significantly impairs normal bowel function. It’s described as “inoperable and refractory to treatment” when surgical or other treatments cannot correct it or consistently fail to alleviate symptoms. “Requires total parenteral nutrition (TPN)” refers to the need for nutrients to be delivered directly into the bloodstream through an intravenous (IV) line because the digestive tract cannot process food normally. This condition is rated at an 80% disability due to its severity and the impact on daily life.

Gallbladder with Symptomatic Peritoneal Adhesions (50% VA Rating):

• Peritoneal adhesions are scar tissues that form between the abdominal lining and abdominal organs, leading to painful symptoms and complications. This condition persists or recurs after surgery, trauma, inflammatory diseases (like chronic cholecystitis or Crohn’s disease), or infection. It requires hospitalization at least once a year due to recurrent obstruction, necessitates medically-directed dietary modifications (other than TPN), and is associated with at least one symptom like abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. This complexity and the required level of care justify a 50% disability rating.

Gallbladder with Symptomatic Peritoneal Adhesions (30% VA Rating):

• Similar to the 50% rating condition, but the difference here is the absence of the requirement for annual hospitalization due to obstruction. It still involves medically-directed dietary modifications and at least one of the listed symptoms, reflecting a somewhat less severe impact on the individual’s health and daily functioning, hence a 30% rating.

Gallbladder with Symptomatic Peritoneal Adhesions (10% VA Rating):

• This describes a milder form of symptomatic peritoneal adhesions, where the presence of one of the listed symptoms (abdominal pain, nausea, vomiting, colic, constipation, or diarrhea) impacts the individual. The condition persists or recurs after interventions like surgery but is less debilitating than the scenarios warranting higher ratings. The condition’s impact on health and functionality is considered limited, justifying a 10% rating.

Gallbladder with History of Peritoneal Adhesions, Currently Asymptomatic (0% VA Rating):

• This situation applies when there’s a documented history of peritoneal adhesions related to the gallbladder, but the individual is currently free from symptoms. It signifies that while there’s a medical history of the condition, it does not currently impair the individual’s health or daily activities, warranting a 0% disability rating.

VA Rating for Gallbladder with Chronic Biliary Tract Disease (DC 7314)

• Gallbladder with three or more clinically documented attacks of right upper quadrant pain with nausea and vomiting during the past 12 months; or requiring dilatation of biliary tract strictures at least once during the past 12 months rate at 30%.

• Gallbladder with one or two clinically documented attacks of right upper quadrant pain with nausea and vomiting in the past 12 months rate at 10%.

• Gallbladder issues with no symptoms (asymptomatic) without history of a clinically documented attack of right upper quadrant pain with nausea and vomiting in the past 12 months rate at 0%

Detailed Explanations of the Rating Criteria:

Gallbladder with Three or More Clinically Documented Attacks (30% VA Rating):

• This condition involves having three or more episodes of severe pain in the right upper quadrant of the abdomen, accompanied by nausea and vomiting, over the past year. It could also include the need for a medical procedure to widen (dilate) biliary tract strictures (narrowings of the bile ducts) at least once in the same timeframe. The rating of 30% reflects a significant, but not constant, impact on the individual’s well-being and daily functioning.

Gallbladder with One or Two Clinically Documented Attacks (10% VA Rating):

• Here, the individual has experienced one or two episodes of significant right upper quadrant abdominal pain with nausea and vomiting in the past 12 months. This level of symptom frequency suggests a less severe impact on health and daily life than more frequent attacks, warranting a 10% rating. It indicates occasional but not persistent or severe impairment.

Gallbladder Issues with No Symptoms (0% VA Rating):

• This category is for individuals who currently do not exhibit any symptoms of gallbladder disease, such as pain, nausea, or vomiting, and have no clinically documented attacks of right upper quadrant pain in the past year. A rating of 0% is assigned because, despite the presence of a gallbladder condition, it does not impair the individual’s health or daily activities at the moment.

VA Rating for Gallbladder Removal (DC 7318)

• Gallbladder removal with recurrent abdominal pain (post-prandial or nocturnal); and chronic diarrhea characterized by three or more watery bowel movements per day rate at 30%

• Gallbladder removal with intermittent abdominal pain; and diarrhea characterized by one to two watery bowel movements per day rate at 10%

• Gallbladder removal with no symptoms (asymptomatic) rate at 0%

Detailed Explanations of the Rating Criteria:

Gallbladder Removal with Recurrent Abdominal Pain and Chronic Diarrhea (30% VA Rating):

• Recurrent Abdominal Pain (Post-prandial or Nocturnal): This refers to ongoing or repeating abdominal pain that occurs after eating (post-prandial) or during the night (nocturnal). Such pain is not uncommon after gallbladder removal and can significantly affect quality of life.

• Chronic Diarrhea Characterized by Three or More Watery Bowel Movements Per Day: Chronic diarrhea post-cholecystectomy is sometimes part of a condition known as bile acid malabsorption (BAM) or postcholecystectomy syndrome. The rating of 30% is given due to the frequency and severity of symptoms, indicating a moderate level of impairment and impact on daily activities.

Gallbladder Removal with Intermittent Abdominal Pain and Diarrhea (10% VA Rating):

• Intermittent Abdominal Pain: This indicates less frequent abdominal pain that comes and goes, which is less severe than constant or recurrent pain but still related to the gallbladder removal.

• Diarrhea Characterized by One to Two Watery Bowel Movements Per Day: This level of diarrhea, while still inconvenient, suggests a milder form of digestive disturbance than more frequent bowel movements. A rating of 10% reflects a lower level of daily life and health impairment.

Gallbladder Removal with No Symptoms (0% VA Rating):

• This describes individuals who have undergone gallbladder removal but do not experience any adverse symptoms following the surgery, such as abdominal pain or diarrhea. A 0% rating indicates no impairment or disability related to the condition, meaning the surgery has not negatively impacted the individual’s health in a way that would impair daily functions.

What If I Already Have VA Disability for the Gallbladder?

If you already have VA disability for the Gallbladder, there will be no change to your current VA disability rating; you are “grandfathered” in under the old rating criteria.

A reduction in your rating will only occur if there is improvement in a disability sufficient to warrant a reduction under the old criteria.

All VA claims related to these digestive systems that were submitted and in “pending” status as of May 19, 2024, will be considered under both the old and new rating criteria, and whichever criteria is more favorable to the veteran will be applied.

In summary, get your VA disability claim submitted ASAP!

Why?

Because the VA rater must consider both the old and new criteria and select the rating that’s most favorable to you.

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