If you’re one of the many veterans who suffer from diverticulitis, you know how debilitating this condition can be. As insiders, we want to make sure you get the VA rating you deserve. Let us arm you with the knowledge you need to win your VA Claim for diverticulitis!
This post will look at how to file a successful diverticulitis VA claim for disability benefits and increase your chances of winning your claim. We’ll also take a deep dive into how diverticulitis can be a strong secondary claim.
At VA Claims Insider, we help you get the claim you deserve. Let’s explore everything you need to know to win your claim for diverticulitis.
- What is Diverticulitis?
- VA Rating for Diverticulitis
- How to Increase a VA Rating for Diverticulitis?
- Is Diverticulitis a Secondary Claim to PTSD?
- Difference Between IBS & Diverticulitis
- Is Diverticulitis a Secondary Claim to IBS?
- How to Service-Connect Your Diverticulitis
- Tips for Your VA Claim for Diverticulitis
- VA Claim for Diverticulitis Compensation & Pension Exam
- Diverticulitis Frequently Asked Questions
- About the Author
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What is Diverticulitis?
Diverticulitis is an intestinal disease caused by inflamed or infected diverticula, which are small bulging pouches that form in the colon or large intestine. These pouches form in the intestines when their pressure is greater than outside.
Abdominal pain is the most common symptom of diverticulitis. Nausea, vomiting, constipation, or diarrhea often accompany this pain. If experiencing any of these symptoms, it’s important to seek medical attention.
VA Rating for Diverticulitis
Diverticulitis is rated under 38 CFR $ 4.114, the Schedule of Ratings for the Digestive System, diagnostic code 7327.
According to DC 7327, diverticulitis is either rated as irritable colon syndrome (DC 7319), peritoneal adhesions (DC 7301), or ulcerative colitis (DC 7323). The specific rating will be whichever most closely describes the veteran’s overall condition and symptoms and will depend on the veteran’s predominant disability picture.
Diverticulitis Rated as Irritable Colon Syndrome
The VA uses diagnostic code 7319 for irritable colon syndrome ( e.g., spastic colitis, mucous colitis). Under this diagnostic code, the condition can be rated at 0%, 10%, or 30%.
When determining the severity of a veteran’s chronic gastrointestinal disorder, the VA will consider symptoms’ frequency, intensity, and duration. They will also consider how the disorder has affected the veteran’s ability to work and perform other daily activities.
The ratings are as follows:
- 30 percent – Severe, with symptoms such as diarrhea, or alternating diarrhea and constipation, and constant abdominal distress.
- 10 percent – Moderate, with “frequent episodes of bowel disturbance with abdominal distress.”
- 0 percent – Mild, with “disturbances of bowel function with occasional episodes of abdominal distress.”
Remember, veterans do not have to experience these exact symptoms to qualify for a particular VA rating. The list of symptoms merely contains examples of the symptoms and levels of impairment found at that rating.
Diverticulitis rated as Adhesions of the Peritoneum / Peritoneal Adhesions
The VA uses diagnostic code 7301 for peritoneal adhesions. Under this diagnostic code, the condition can be rated at 10, 30, or 50 percent disabling.
- 50 percent –Severe peritoneal adhesions with “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 drainage.”
- 30 percent –Moderately severe peritoneal adhesions with “delayed motility of barium meal and less frequent and less prolonged episodes of pain than those contemplated by the 50 percent rating.”
- 10 percent – Moderate peritoneal adhesions with “pulling pain on attempting to work or aggravated by movements of the body, or occasional episodes of colic pain, nausea, constipation (perhaps alternating with diarrhea) or abdominal distension.”
Diverticulitis rated as Ulcerative Colitis
The VA uses DC 7323 for Ulcerative Colitis. Under this diagnostic code, the condition can be rated at 10, 30, 60, and 100.
- 100 percent – Pronounced ulcerative colitis. Symptoms can include anemia, malnutrition and general debility, and serious complications such as a liver abscess.
- 60 percent –Severe ulcerative colitis, with numerous attacks within a year or malnutrition, and health only improving to “fair” during remissions.
- 30 percent –Moderately severe ulcerative colitis with frequent exacerbations
- 10 percent – Moderate ulcerative colitis with infrequent exacerbations.
Veterans should learn more about their condition and work with their medical providers to ensure the VA properly grades their claims. Let us help guide you through this process to receive the maximum benefits to which you are entitled.
How to Increase a VA Rating for Diverticulitis?
If you are seeking a higher VA rating for diverticulitis, there are a few things you can do to improve your chances:
- First, it is crucial to keep all your medical appointments and follow your doctor’s instructions. It will show that you take your condition seriously and commit to managing it.
- Secondly, keep a detailed record of your symptoms, including their frequency, duration, and severity. It will give the VA a clear picture of how your condition impacts your life.
- Finally, consider getting a second opinion from another medical practitioner. It can provide more evidence in support of your case.
Taking these steps will increase your chances of getting the highest VA rating possible.
Is Diverticulitis a Secondary Claim to PTSD?
Many veterans suffer from diverticulitis which could be a secondary condition to PTSD. However, even if a veteran has a diagnosis of diverticulitis, diverticulosis, or irritable bowel syndrome, and PTSD, there is no competent evidence indicating that this condition was caused or aggravated by the veteran’s service-connected PTSD.
For more information, read: Is PTSD a Disability.
Difference Between IBS & Diverticulitis
There are many similarities between irritable bowel syndrome (IBS) and diverticulitis, including abdominal pain, bloating, and constipation, but some significant differences exist between the two conditions.
IBS is a chronic condition that occurs before the age of 35 in about half of the cases. The rate of diverticulitis increases with age. It occurs in 10% of people over age 40 and 50% of people over age 60. On the other hand, IBS occurs in 5% to 20% of children.
The cause of IBS is not known, while diverticulitis is caused by the inflammation or infection of pouches in the large intestine.
Diverticulitis is also a more serious condition than IBS, as it can lead to severe infections and even death.
Is Diverticulitis a Secondary Claim to IBS?
While the two conditions may share some common symptoms, they are distinct diseases. However, there are cases where diverticulitis can be secondary to IBS.
IBS is a common secondary VA disability claim, especially IBS secondary to PTSD or any other mental health condition due to the side effects of medication taken to help manage symptoms.
A veteran’s final VA disability rating for IBS depends upon the frequency, severity, and duration of their IBS symptoms – the more severe your symptoms, the higher the VA rating for IBS.
How to Service-Connect Your Diverticulitis
To receive benefits, you will need to service-connect your condition. Service connection means that the VA has recognized a connection between your military service or other service-connected disability and your medical condition.
To service-connect your diverticulitis, you will need to provide medical evidence of your diagnosis to the VA :
- The first step is to get a diagnosis from a doctor.
- Once you have a diagnosis, you will need to provide an Independent Medical Opinion/Medical Nexus Letter to link your condition to your service or service-connected disability.
- Once you have gathered this evidence, you will need to file a claim with the VA. You can do this online, by mail, or at your local VA office.
Once your claim is received, a claims processor will review your case and decide eligibility.
If your claim is approved, you will be eligible for various benefits. It includes monthly payments and coverage of medical expenses related to your condition.
Tips for Your VA Claim for Diverticulitis
- We recommend writing a personal statement—also known as a “Statement in Support of a Claim”—to provide key supporting evidence. Start with a clear and concise statement of the issue. The more specific you can be, the better. To learn more about these statements, see: Is a Buddy Letter Important?
- Gather all relevant medical records, including diagnostic tests and treatment records.
- Make sure your records establish a connection between your current condition and your service or service-connected disability.
- Get a comprehensive evaluation from a qualified medical provider if you have not already done so.
- Be prepared to discuss your symptoms in detail, including frequency, severity, and any effect on your quality of life.
- Be honest about your health history and any other factors affecting your condition.
- Keep copies of everything you submit to the VA, including any correspondence with VA staff.
- Stay organized and keep track of deadlines throughout the claims process.
- Seek help from a qualified Veterans Service Officer if you need help with your claim.
VA Claim for Diverticulitis Compensation & Pension Exam
Once a veteran has filed their claim for diverticulitis, VA may request a compensation and pension (C&P) exam. A VA examiner or VA-contracted physician usually performs the exam.
VA may use a C&P exam to get more information about your condition before deciding on your claim for diverticulitis.
The examiner will ask the veteran questions about their medical history and current symptoms to complete an accurate evaluation. The examiner will also perform a physical examination. Afterward, the examiner will prepare a report detailing their findings.
The C&P exam is part of the claims process, but it can ensure that veterans receive their deserved benefits. Veterans must attend their C&P exam, as failure to do so could result in a VA claim denial. Veterans who cannot take the exam should inform the VA as soon as possible.
The examiner will review the veteran’s c-file before the exam. The c-file contains any documentation that has been previously submitted to VA and the veteran’s medical and military service records.
The C&P examiner typically asks the veteran questions about how their condition affects them daily.
Veterans need to be honest and upfront with their C&P examiner about their diverticulitis symptoms and how they impact their lives.
By providing accurate information, veterans can ensure that they receive an accurate evaluation of their condition and benefits.
You might also be interested in our comprehensive list of Digestive VA claims.
Diverticulitis Frequently Asked Questions
What Is the Difference Between Diverticulosis and Diverticulitis?
Diverticulosis and diverticulitis are both conditions that can affect the digestive tract.
Diverticulosis occurs when small, bulging pouches (diverticula) develop in the walls of the intestines. These pouches can become inflamed or infected, and when this happens, the condition is called diverticulitis.
There are different ways to treat diverticulosis and diverticulitis. Both conditions can cause abdominal pain, cramping, and bloating. Diverticulitis can lead to fever, nausea, and vomiting in severe cases. Treatment for diverticulosis may include changes in diet and lifestyle. Treatment for diverticulitis may also need antibiotics or surgery.
Is Diverticulosis a Disability?
For some people, diverticulitis can be a disabling condition.
While most people can control their symptoms with diet and medication, a small minority experience severe pain, bleeding, and other complications. Diverticulitis can be a serious impediment to working and leading a normal life for these individuals.
In some cases, surgery may be necessary to remove infected or damaged tissue. Even after successful treatment, many people with diverticulitis continue to experience periodic flare-ups that make it difficult to maintain full-time employment.
What Is the VA Disability Rating for Diverticulosis?
The Veterans Affairs (VA) disability rating for diverticulosis is dependent on the severity of the condition. The VA rates diverticulitis as irritable colon syndrome (DC 7319), peritoneal adhesions (DC 7301), or ulcerative colitis (DC 7323). Veterans whose claims are rated at 0 percent within these diagnostic codes have mild symptoms that do not impact their daily lives.
Those rated at 10 percent have moderate symptoms that may cause discomfort or interference with daily activities. Those rated at 30 percent or higher have severe symptoms that significantly impact their daily lives. The exact rating a person receives will be determined by their medical records and the severity of their symptoms.
Does PTSD Cause Diverticulitis?
The current evidence does not suggest that diverticulitis is caused or aggravated by a veteran’s service-connected PTSD. The condition is more likely due to other factors, such as the veteran’s age or diet.
With proper care, a veteran can reduce the impact of both PTSD and diverticulitis on their life. But, the fact that a veteran has PTSD may make it difficult for them to manage their condition. For this reason, a veteran with PTSD and diverticulitis needs to receive treatment for both conditions.
Is Diverticulitis Stress-Related?
Several factors have been linked to developing diverticulosis and diverticulitis. While stress is not one of them, it is still important to be aware of these other factors.
These include advancing age, obesity, a low-fiber diet, smoking, and certain medications.
What Is the Main Cause of Diverticulitis?
Diverticulitis is usually caused by a high-fat, low-fiber diet, leading to constipation and hard stools. When these stools become stuck in the diverticula, they can cause an infection.
Treatment for diverticulitis typically includes antibiotics to clear the infection, pain relief, and a high-fiber diet to prevent constipation and further inflammation. Surgery may be necessary in severe cases. Genetics may also play a role in developing diverticulitis and low physical activity levels.
What Is Diverticulitis Pain Like?
Diverticulitis pain can be a sharp cramp-like pain on the left side of the lower abdomen. Some people may experience other symptoms such as fever and chills, nausea, vomiting, constipation, or diarrhea.
The severity of the pain can vary from person to person. Some people may only experience mild discomfort. Others may have severe pain that requires hospitalization. If you think you may be experiencing diverticulitis pain, it is important to see a doctor. Diverticulitis is a serious condition. It can lead to complications if left untreated. It is important to get prompt medical treatment if you think you may have it.
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Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC)—so you can increase your rating fast!
If you’ve filed your VA disability claim and have been denied or have received a low rating—or you’re unsure how to get started—reach out to us! Take advantage of a FREE VA Claim Discovery Call. Learn what you’ve been missing—so you can FINALLY get the disability rating and compensation you deserve!
We’ve supported more than 15,000 veterans to win their claims and increase their ratings. NOW IT’S YOUR TURN.
About the Author
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).