VA Disability Rating for Digestive System CHANGES (Effective May 19, 2024)

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The VA recently announced an update to the VA Schedule for Rating Disabilities (VASRD), which impacts VA disability ratings for the digestive system.

The updates impact the VA ratings and evaluation criteria for 55 digestive conditions and take effect on May 19, 2024.

The four biggest changes include the new rating criteria for Celiac Disease, Gastroesophageal Reflux Disease (GERD), Hemorrhoids, and Irritable Bowel Syndrome (IBS).

Let’s begin!

Key VA Rating Updates Effective May 19, 2024

• Under the new Diagnostic Code (DC) 7355, veterans can get a VA rating for Celiac Disease ranging from 30% to 80% with a break at 50%.

• Under the new DC 7206 for Gastroesophageal Reflux Disease (GERD), veterans are eligible for a rating of 0%, 10%, 30%, 50%, or 80%.

• Under the updated DC 7336 for Hemorrhoids, the new VA ratings are either 10% or 20%.

• Under the updated name for DC 7319, Irritable Bowel Syndrome (IBS), veterans will be eligible for a VA rating ranging from 10% to 30% with a break at 20%.

New VA Rating for Celiac Disease

The old VA ratings for Celiac Disease ranged from 0% to 30% and were rated by analogy.  

Since May 19, 2024, under the new Diagnostic Code (DC) 7355, veterans will be eligible for a VA rating for Celiac Disease ranging from 30% to 80% with a break at 50%.

New DC 7355, Celiac Disease:

• 80% VA Rating for Celiac Disease: Malabsorption syndrome with weakness which interferes with activities of daily living; and weight loss resulting in wasting and nutritional deficiencies; and with systemic manifestations including but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels; and anemia related to malabsorption; and episodes of abdominal pain and diarrhea due to lactase deficiency or pancreatic insufficiency.  

• 50% VA Rating for Celiac Disease: Malabsorption syndrome with chronic diarrhea managed by medically prescribed dietary intervention such as prescribed gluten-free diet, with nutritional deficiencies due to lactase and pancreatic insufficiency; and with systemic manifestations including, but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels, or atrophy of the inner intestinal lining shown on biopsy.

• 30% VA Rating for Celiac Disease: Malabsorption syndrome with chronic diarrhea managed by medically prescribed dietary intervention such as prescribed gluten-free diet; and without nutritional deficiencies.

Note (1): An appropriate serum antibody test or endoscopy with biopsy must confirm the diagnosis.

Note (2): For evaluation of celiac disease with the predominant disability of malabsorption, use the greater evaluation between DC 7328 or celiac disease under DC 7355.

New VA Rating for Gastroesophageal Reflux Disease (GERD)

GERD was previously rated analogous to Hiatal Hernia, DC 7346, with ratings of 10%, 30%, or 60%.

Effective May 19, 2024, veterans will now be rated under the new DC 7206 for GERD with ratings of 0%, 10%, 30%, 50%, or 80%.

New DC 7206, Gastroesophageal Reflux Disease (GERD)

• 80% VA Rating for GERD: Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction of esophageal stricture(s)  or percutaneous esophago-gastrointestinal tube (PEG tube).  

• 50% VA Rating for GERD: Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement.

• 30% VA Rating for GERD: Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year.

• 10% VA Rating for GERD: Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic.

• 0% VA Rating for GERD: Documented history without daily symptoms or requirement for daily medications.  

Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.

Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.

Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.

Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.

Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.

New VA Rating for Hemorrhoids

Hemorrhoids previously had a 0% non-compensable VA rating if symptoms were mild; however, the 0% rating is now gone.

The new minimum VA rating for Hemorrhoids under DC 7336, Hemorrhoids, external or internal, is 10%, which is the minimum compensable rating.

Beginning May 19, 2024, veterans will see new VA rating criteria for Hemorrhoids with ratings of either 10% or 20%.

Updated DC 7336, Hemorrhoids

• 20% VA Rating for Hemorrhoids: Internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis.

• 10% VA Rating for Hemorrhoids: Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis.

New VA Rating for Irritable Bowel Syndrome (IBS)

The old VA ratings for IBS ranged from 0% to 30% with a break at 10%, and were rated by analogy under DC 7319, Irritable Colon Syndrome.  

The 0% non-compensable rating for IBS was removed in this update; the new minimum compensable rating for IBS is now 10%.

Beginning May 19, 2024, under the new name for DC 7319, Irritable Bowel Syndrome, veterans will be eligible for a VA rating ranging from 10% to 30% with a break at 20%.

Updated DC 7319, Irritable Bowel Syndrome (IBS)

• 30% VA Rating for IBS: Abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.

• 20% VA Rating for IBS: Abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.

• 10% VA Rating for IBS: Abdominal pain related to defecation at least once during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.

Note: This diagnostic code may include functional digestive disorders (see § 3.317 of this chapter), such as dyspepsia, functional bloating and constipation, and diarrhea. Evaluate other symptoms of a functional digestive disorder not encompassed by this diagnostic code under the appropriate diagnostic code, to include gastrointestinal dysmotility syndrome (DC 7356), following the general principles of § 4.14 and this section.

What About My Current VA Rating?

If you already have a VA rating for one of the digestive systems conditions impacted by these updates, there will be no change to your current VA rating; you are “grandfathered” in under the old rating criteria.

A reduction in evaluation will only occur if there is improvement in a disability sufficient to warrant a reduction under the former 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.

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