Crohn's Disease (Inflammatory Bowel Disease)
Crohn's disease and undifferentiated inflammatory bowel disease are rated under DC 7326. Ulcerative colitis (DC 7323) is also rated using this same schedule. Ratings are based on symptom severity, the type of medications required, and whether hospitalization is needed. The condition must be diagnosed by endoscopy or radiologic studies. Following a colectomy or colostomy with persistent symptoms, the condition is rated under this schedule or the large intestine removal schedule, whichever gives the higher rating.
VA Rating Levels
Minimal to mild disease managed with oral or topical agents (not immunosuppressants or biologics), with recurrent abdominal pain and three or fewer daily episodes of diarrhea, and no signs of systemic toxicity.
Mild to moderate disease managed with oral and topical agents (not immunosuppressants or biologics), with recurrent abdominal pain, three or fewer daily episodes of diarrhea, and minimal signs of toxicity such as fever, rapid heart rate, or anemia.
Moderate disease managed on an outpatient basis with immunosuppressants or biologic agents, with recurrent abdominal pain, four to five daily episodes of diarrhea, and intermittent signs of toxicity.
Severe disease unresponsive to treatment, requiring hospitalization at least once per year, with inability to work or recurrent abdominal pain with at least two of the following: six or more daily diarrhea episodes, six or more daily rectal bleeding episodes, recurrent rectal incontinence, or recurrent abdominal distension.
Exam Tips & Key Evidence
- →The type of medication you need is a major factor. If you are on immunosuppressants or biologics like Humira or Remicade, that supports at least a 60% rating.
- →Ulcerative colitis is rated using this same Crohn's disease schedule. If you have UC, these are the criteria that apply to your claim.
- →The condition must be confirmed by endoscopy or imaging. Make sure your colonoscopy and any other diagnostic results are in your medical records.
- →If your IBD has led to surgery (colectomy, colostomy, or ostomy), you may alternatively be rated under the large intestine removal code if it gives a higher result.
- →Document every hospitalization, ER visit, and flare-up. The frequency and severity of these episodes directly impacts your rating level.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.114, DC 7326