The VA’s rating schedules for gastrointestinal disability ratings are surprising in two respects. First, for the gastrointestinal disabilities that are included, the VA’s gastrointestinal disability rating schedules are very detailed. Second, the VA’s gastrointestinal disability rating schedules are incomplete because they are intended to address specific types of gastrointestinal disabilities rather than providing an exhaustive list.
In This Article About GI Problems and VA Disability Benefits
- Military Disability Ratings for Gastrointestinal Problems: Frequently Asked Questions (FAQ)
- Can Veterans Obtain Abdominal Pain VA Benefits?
- What Is the VA Rating for GERD?
- What Is the VA Rating for Peptic Ulcer?
- What Is the VA Rating for Diverticulitis?
- What Is the VA Rating for Polyps?
- Is There a VA Rating for Persian Gulf War Syndrome?
- What Is the Disability Rating for Constant Bowel Pain from IBS?
- What Is Postgastrectomy Syndrome?
- How Are Liver Disorders Rated?
- What Other Gastrointestinal Disabilities Are Entitled to VA Disability Ratings?
- Gastrointestinal Disabilities Vary Widely in Symptoms and Disability Ratings
Military Disability Ratings for Gastrointestinal Problems: Frequently Asked Questions (FAQ)
The VA’s gastrointestinal disabilities and ratings for veterans cover everything within the digestive system from the mouth to the rectum. These disability ratings appear in the VA’s regulations for the digestive system 38 CFR 4.110-4.114.
The ratings schedule includes gastrointestinal disabilities arising from physical trauma such as hernias and physical injuries, infectious disease such as dysentery, chronic multi-symptom illnesses like gastrointestinal disabilities related to Gulf War Syndrome, and surgery such as bowel resection. Similarly, the rating schedule for gastrointestinal disabilities includes disability percentages based on both digestive symptoms and other symptoms, such as speech impairment, anemia, and jaundice.
Can Veterans Obtain Abdominal Pain VA Benefits?
The answer, surprisingly, is yes. Until 2018, the VA had a policy of rejecting VA disability claims that cited pain alone, without any diagnosis to explain the origin or cause of the pain, as the disability. However, in 2018, a court of appeals reversed this precedent and held that pain can be a disability if it impairs a veteran’s ability to work even if the source of the pain is undiagnosed.
Veterans can use this case to support a disability claim for abdominal pain, alone, with no diagnosis of the source of the pain. The wrinkle in this process, however, is to determine how the VA will assign a disability percentage for undiagnosed pain.
The VA’s typical process for assigning a disability rating for gastrointestinal disabilities that do not appear in its schedule is to compare it to the most similar gastrointestinal disability in its rating tables. Thus, abdominal pain will be rated based on the tables for diagnosed disorders that also produce abdominal pain.
For example, if the abdominal pain is accompanied by bowel dysfunction, the rating schedule for IBS may be used. Alternatively, if the abdominal pain is accompanied by vomiting or regurgitation, the rating schedule for hiatal hernia may be used.
What Is the VA Rating for GERD?
Even though GERD is a common gastrointestinal disability, the VA’s regulations do not include a rating schedule for GERD. Using the VA’s principle of finding an analogous condition to assign a disability percentage, the rating schedule for hiatal hernia uses symptoms of vomiting, regurgitation, and pain to distinguish different levels of severity of the condition.
Based on this analog, a severe case of GERD, like a severe case of hiatal hernia, would be assigned a disability rating of 60% if the veteran experienced vomiting, bloody vomit or stool, pain, severe weight loss, and anemia. Moderate cases of GERD, like moderate cases of hiatal hernia, would be assigned a disability rating of 30% if the veteran experienced persistent and recurring heartburn, difficulty swallowing, regurgitation, and chest pain. Mild cases that involve two or more symptoms of a moderate case, but with less severity, would be rated 10% disabling.
What Is the VA Rating for Peptic Ulcer?
This is a bit of a trick question because the VA’s regulations state that “peptic ulcer” lacks the specificity to assign a disability rating. Rather, the VA’s rating schedules are tailored based on the location of the ulcer as well as the symptoms the ulcer causes.
For example, the rating schedule for gastric and duodenal ulcer assigns a 60% disability rating for severe cases involving constant pain, periodic vomiting, bloody vomit or stool, anemia, and weight loss and a 10% disability rating for mild cases that only manifest symptoms once or twice per year. Moderate and moderately severe cases in both level and frequency of symptoms fall in between.
Alternatively, the rating schedule for marginal ulcers range from 100% for totally incapacitating ulcers with severe and constant pain to 10% for mild cases that are only symptomatic once or twice per year. Ratings of 20%, 40%, and 60% can be assigned for intermediate cases.
What Is the VA Rating for Diverticulitis?
Diverticulitis is a gastrointestinal disability in which inflamed pockets of intestine develop. The pockets can lead to fever, nausea, and abdominal pain.
The VA does not provide a rating schedule for diverticulitis. Instead, the VA’s regulations direct the use of the rating schedules for IBS, ulcerative colitis, or peritoneal adhesions, depending on which includes the most analogous symptoms.
The schedule for IBS is primarily focused on bowel disturbance, abdominal distress, and incidence of diarrhea.
The schedule for ulcerative colitis accounts for the severity of abdominal and rectal pain, rectal bleeding, and diarrhea during flare-ups, frequency of flare-ups, and degree of weight loss and malnutrition. According to the VA’s regulations, substantial weight loss means more than 20% of the veteran’s baseline weight and minor weight loss means 10% to 20% of the veteran’s baseline weight. Baseline weight is calculated using a two-year average.
Peritoneum adhesions, by contrast, are rated based on the degree of obstruction, the severity of pain, and the presence of nausea and vomiting.
It is not unusual under the VA’s regulations for gastrointestinal disabilities to refer to the rating schedules for other disorders. For example, the entries for chronic enteritis, dysentery, and chronic enterocolitis all refer to the rating schedules for other gastrointestinal disabilities for assignment of VA disability percentages.
What Is the VA Rating for Polyps?
Once again, the VA’s regulations do not specifically address a gastrointestinal disability rating for colon polyps. However, a VA rating for polyps can be determined based on the symptoms that are caused by the polyps.
According to reported cases, most disability ratings for polyps use the IBS VA disability rating schedule. When polyps cause only mild disturbances to bowel function and only occasional episodes of abdominal distress, the disability rating is 0%.
If polyps cause frequent episodes of bowel disturbance and abdominal distress, the VA assigns a disability rating of 10%.
If polyps cause diarrhea or diarrhea alternating with constipation and “more or less” constant pain, a disability rating of 30% is assigned under the IBS rating table.
This mode of analysis can be broadened to any gastrointestinal disability involving veterans and diarrhea. Specifically, the rating schedules for IBS and peritoneal adhesions are the colon disabilities that specifically mention diarrhea. As a consequence, most disabilities that do not appear in the schedule but are primarily characterized by diarrhea would likely be rated under either the IBS or peritoneal adhesion rating schedules depending on whether there is also abdominal discomfort (IBS) or bowel obstruction (peritoneal adhesion).
Is There a VA Rating for Persian Gulf War Syndrome?
Gulf War Syndrome, also known as Persian Gulf War Syndrome or Desert Storm Syndrome, is associated with many seemingly unrelated symptoms including IBS and other functional gastrointestinal disabilities. The VA prefers to avoid the phrase “Gulf War Syndrome” because it has no generally accepted definition and it encompasses many possible symptoms that may or may not manifest in Gulf War veterans. Instead, the VA uses the term “chronic multi-symptom illness.”
As with veterans and diarrhea, disability ratings for veterans and Gulf War Syndrome typically rely on the IBS ratings schedule. The IBS rating schedule is the most generalized for pain and diarrhea. However, when functional gastrointestinal disabilities manifest with symptoms other than pain and diarrhea, a rating may be more appropriately found under a different rating schedule.
What Is the Disability Rating for Constant Bowel Pain from IBS?
IBS is characterized by abdominal pain, gas, constipation, diarrhea, alternating constipation and diarrhea, and mucus in the stool.
Doctors are usually unable to tie IBS to a specific physical disorder. However, the structure of the intestines is not damaged in IBS. Rather, IBS merely results from a malfunction of the intestines.
The VA’s ratings schedule for IBS also refers to some alternate names for IBS, including irritable colon syndrome, spastic colitis, and mucous colitis. IBS can result from disorders of the nerves, muscles, lining, or microflora of the intestine. However, the schedule ignores the underlying cause and lists VA disability ratings for IBS solely based on the presence or absence of diarrhea and the severity and frequency of pain.
Under the VA’s disability rating table for IBS, mild cases of IBS with occasional bowel dysfunction and abdominal pain are rated at 0%, meaning that the veteran is not entitled to any disability benefits for mild IBS.
Moderate cases of IBS are rated at 10% if they involve frequent episodes of bowel dysfunction and abdominal pain.
The highest disability rating for IBS is 30%. This rating is awarded for severe cases of IBS characterized by diarrhea, or alternating constipation and diarrhea, and constant abdominal pain.
What Is Postgastrectomy Syndrome?
If you require the removal of a part or all of your stomach (a gastrectomy), you may experience postgastrectomy syndrome. This gastrointestinal disability arises from the loss of the stomach tissue and causes hypoglycemia or symptoms that mimic hypoglycemia.
Postgastrectomy syndrome is a separately rated disability. The ratings for postgastrectomy syndrome range from 20% for mild cases to 60% for severe cases that result in weight loss, anemia, malnutrition, and hypoglycemia.
How Are Liver Disorders Rated?
There are three main categories of liver disorder in the VA’s disability ratings for gastrointestinal disabilities. Cirrhosis of the liver is rated based on the frequency of ascites (a buildup of fluid in the abdomen), brain dysfunction (called hepatic encephalopathy), jaundice, and hemorrhage from gastritis. Cirrhosis ratings vary from 10% for mild cases to 100% for severe cases.
Non-cirrhosis liver disease is rated using the severity of fatigue, nausea, anorexia, vomiting, and malaise. Ratings can vary from 0% for non-symptomatic liver disease to 100% for liver disease that produces near-constant debilitating symptoms.
Hepatitis C is rated using almost the same factors as non-cirrhosis liver disease, with ratings that vary from 0% for non-symptomatic hepatitis C to 100% for debilitating hepatitis C.
What Other Gastrointestinal Disabilities Are Entitled to VA Disability Ratings?
There are several other gastrointestinal disabilities for which VA disability benefits can be obtained. Briefly, these include:
- Gall bladder: Ratings are available for chronic cholecystitis and gall bladder removal. Disability ratings for gall bladder disabilities range from 0% to 30% depending on the severity of the symptoms.
- Tongue: Loss of part or all of the tongue can be rated from 30% to 100% depending on the impact of the loss on the veteran’s ability to speak.
- Esophagus: Damage or dysfunction of the esophagus is rated based on the amount of obstruction or constriction of the esophagus with ratings ranging from 30% to 80% depending on whether the veteran is able to consume food or is limited to liquids.
- Gastritis: Gastritis is an erosion of the stomach lining. VA disability ratings for gastritis range from 10% to 60% depending on the amount of the stomach affected and the presence of hemorrhages.
- Amebiasis: Amoebas are parasites that can infect the gastrointestinal system. The disability rating for Amebiasis is given a 10% rating if it causes gastric pain, cramps, distension, constipation, and diarrhea.
- Distomiasis: Trematodes (also called flukes) are parasites that can infect the gastrointestinal system. The disability rating for distomiasis ranges from 0% to 30% depending on the severity of the symptoms which can include fever, pain, elevated white cell count, and inflammation of bile ducts.
- Intestinal resection: When part of the intestine is removed, the VA rates the disability based on the loss of the remaining intestine’s ability to absorb nutrients. Disability ratings vary from 20% to 60%.
- Intestinal fistula: A fistula is an opening or leak in the intestine. An intestinal fistula is rated between 30% to 100% depending on the amount of fecal discharge through the fistula.
- Tuberculous peritonitis: A form of tuberculosis can infect the abdominal lining. Disability ratings for tuberculous peritonitis depend on whether the tuberculosis bacteria is active or inactive.
- Rectum and anus: Impairment of the rectum and anus is rated based on the amount of control over the sphincter, with a 100% disability rating awarded for complete loss of sphincter control. Conversely, stricture of the rectum and anus is rated based on the necessity of a colostomy which is associated with a 100% disability rating or reduction in the lumen which is associated with a disability rating ranging from 0% to 50% depending on the extent of reduction and leakage.
- Prolapsed rectum: A prolapsed rectum is awarded a disability rating between 10% and 50% based on the severity and frequency of prolapse.
- Hemorrhoids: A disability rating between 0% and 20% is assigned for hemorrhoids depending on the severity and recurrence.
- Hernia: Disability ratings for inguinal hernia vary from 0% to 50% depending on its size and whether it can be treated with surgery. Ventral hernia disability ratings range from 0% to 100% based on the same factors.
- Malignant neoplasms: These cancerous growths are rated at 100% for six months after chemotherapy or other treatment, then rated based on the residual disabilities resulting from the neoplasms.
- Pancreatitis: Pancreatitis is rated between 10% and 100% depending on the frequency and severity of pain, malabsorption, and malnutrition resulting from pancreas dysfunction.
- Vagotomy: While vagotomy can resolve some gastrointestinal disabilities like excess gastric secretion, it has side effects such as diarrhea and gastritis that can support a disability rating from 20% to 40%.
Gastrointestinal Disabilities Vary Widely in Symptoms and Disability Ratings
As you read this overview, keep in mind that it is not exhaustive. The ratings defined by the VA are representative of the types of symptoms experienced in gastrointestinal disabilities. It is entirely possible that you have a gastrointestinal disability that entitles you to VA disability benefits even if it is not specifically rated.
This is merely an overview of gastrointestinal disabilities and ratings for veterans. Contact a VA attorney, regardless of where you are currently located or whether you were deployed, for a more specific discussion of the VA benefits for your gastrointestinal disability.