Digestive system · 38 CFR 4.114
Digestive Conditions and VA Disability
The digestive system covers the stomach, the intestines, and the organs that help you digest. GERD, irritable bowel syndrome, ulcers, and hernias are the claims we see most. The VA rates these under 38 CFR 4.114, and one rule matters a lot here: it usually will not stack two overlapping gut conditions, so the rater picks the one that fits best.
Patriot Path handles the medical side of these claims. Our physicians write the nexus letters and independent medical opinions that connect a digestive condition to your service, or to another condition the VA already covers. The fee is a flat $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the digestive conditions veterans claim most. GERD has a full guide now. The rest are on the way.
- GERD
Acid reflux that keeps coming back. As of 2024 it has its own diagnostic code. Often secondary to other conditions and their medications.
DC 7206
- Irritable bowel syndrome
Cramping, diarrhea, and constipation. A Gulf War presumptive, rated on how often symptoms hit.
DC 7319
- Peptic ulcer diseaseGuide in progress
Ulcers in the stomach or upper intestine. Rated on pain, bleeding, and how often they flare.
DC 7304
- Hiatal herniaGuide in progress
Part of the stomach pushes up through the diaphragm. Since 2024 it is rated as an esophageal stricture under DC 7203, on swallowing problems.
DC 7346
- HemorrhoidsGuide in progress
Swollen veins in the rectum. Rated on bleeding, anemia, and prolapse.
DC 7336
- Crohn's disease and colitisGuide in progress
Inflammatory bowel disease. Rated on severity, flares, and treatment.
DC 7323
How the VA rates digestive conditions
Digestive conditions are rated on how often your symptoms hit, how severe they are, and how much they wear you down, including weight loss. The more your condition disrupts eating, digestion, and daily life, the higher the rating.
One rule shapes many gut claims, and it is narrower than it is usually described. 38 CFR 4.114 bars combining ratings only among the codes it lists, 7301 through 7329, plus 7331, 7342, 7345 through 7350, 7352 and 7355 through 7357. Where two of those overlap, the rater assigns one evaluation under the code that reflects the predominant disability picture, raised a level if your case is severe. Reflux disease sits outside that range at DC 7206, so a reflux rating is not barred from combining with a stomach code such as gastritis or an ulcer. 38 CFR 4.14 still bars rating the same symptoms twice under any codes. So the goal is the right codes, correctly separated, not a pile of codes and not a single one by default.
A few conditions changed recently. As of 2024, GERD has its own diagnostic code, 7206, instead of being rated like a hiatal hernia. Knowing the current code matters, because the criteria moved with it.
Connecting a digestive condition to service
There are a few ways to tie a digestive condition to your service:
- Direct. The condition began in service, or an in-service cause led to it. Records of treatment for stomach or bowel trouble while you served help.
- Presumptive (Gulf War). Functional digestive disorders like irritable bowel syndrome are presumptive for Gulf War veterans (38 CFR 3.317). The VA accepts the link, so you do not have to prove the cause.
- Secondary. Another service-connected condition or its medication caused or worsened it (38 CFR 3.310). A common example is GERD from the anti-inflammatory drugs taken for a service-connected joint condition.
For a direct or secondary claim, the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50 percent or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate GERD?
As of 2024, GERD has its own code, Diagnostic Code 7206. It is rated on whether reflux has scarred or narrowed the esophagus, how much trouble you have swallowing, and how often you need procedures to open it up. Many GERD claims are filed as secondary to another condition or its medication.
Is IBS presumptive for Gulf War veterans?
Yes. Irritable bowel syndrome is a functional digestive disorder, and it is presumptive for Gulf War and Southwest Asia veterans under 38 CFR 3.317. If you qualify, the VA accepts the link to service without proof of cause. It is rated under Diagnostic Code 7319 on how often symptoms hit.
Can the VA combine two stomach conditions?
It depends which codes. 38 CFR 4.114 bars combining ratings under DC 7301 through 7329 with each other, so chronic gastritis (DC 7307) and peptic ulcer disease (DC 7304) get one evaluation under the predominant picture, raised a level if your case is severe. Reflux disease sits outside that range at DC 7206, and VA's manual says combining a 7200-series code with a 7300-series code is not categorically prohibited. Either way 38 CFR 4.14 still bars rating the same symptoms twice.
Can I claim GERD as secondary to another condition?
Yes, and it is common (38 CFR 3.310). A nexus letter ties the condition to the service-connected cause, or to the medication prescribed for it. See our GERD page for the rating rules, and our guide to GERD secondary to NSAIDs for the medication route.
Do I need a nexus letter for a digestive claim?
For a direct or secondary claim, usually yes. The VA needs a current diagnosis, an in-service cause, and a medical opinion linking them. If your condition is a Gulf War presumptive, you may not need one. A nexus letter is that linking opinion.
A digestive condition from service?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.114, Schedule of ratings, digestive system (eCFR) https://www.ecfr.gov/current/title-38/section-4.114
- 38 CFR 4.113, Coexisting abdominal conditions (eCFR) https://www.ecfr.gov/current/title-38/section-4.113
- 38 CFR 3.317, Persian Gulf veterans presumptive (eCFR) https://www.ecfr.gov/current/title-38/section-3.317
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- Gulf War illness and Southwest Asia (VA.gov) https://www.va.gov/disability/eligibility/hazardous-materials-exposure/gulf-war-illness-southwest-asia/