Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional VA disability rating & claim guide

Yes. The VA rates Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional under VASRD diagnostic code 7338 (Digestive System). A hernia is a bulge that forms where the abdominal wall gives way and tissue pushes through. DC 7338 is a single code for hernias "including femoral, inguinal, umbilical, ventral, incisional, and other (but not including hiatal)" — hiatal and paraesophageal hernia is DC 7346. Every compensable evaluation here starts from the same footing: an irreparable hernia, new or recurrent, present for 12 months or more. From there the percentage is set by the hernia's size in one dimension and by how many named activities — bending over, activities of daily living, walking, climbing stairs — bring on pain.

Possible VA ratings for Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional are 100%, 60%, 30%, 20%, 10%, 0%. Examples: 100%: Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 15 cm or greater in one dimension; and 2. Pain when performing at least three of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs; 60%: Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 15 cm or greater in one dimension; and 2. Pain when performing two of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs; 30%: Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 3 cm or greater but less than 15 cm in one dimension; and 2. Pain when performing at least two of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs.

Vetrify estimates the typical rating awarded for Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional at around 10%, based on VA claims data and the rating schedule. An estimated 120,000 veterans are service-connected for Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional.

Strong evidence for a Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional claim includes: A clinical or imaging measurement giving the hernia's size in centimeters in one dimension; A statement in the record that the hernia is irreparable, together with the date it was first documented, since the criteria require 12 months or more; Examination or treatment notes addressing pain with bending over, activities of daily living, walking, and climbing stairs; Operative reports for any repair, and for any recurrence after one.

VA's Hernias (Including Abdominal, Inguinal and Femoral Hernias) Disability Benefits Questionnaire (DBQ) is on its public list of DBQs. VA's page says: "You can use these forms to submit medical evidence from your health care providers."

Common pitfalls when filing for Hernia, Including Inguinal, Femoral, Umbilical, Ventral, and Incisional: Building the claim around a truss or support belt, or around whether the hernia is reducible. Neither appears in the current criteria, which turn on an irreparable hernia present for 12 months or more, its size in centimeters, and pain on four named activities; Filing with no measurement in the file, since the size bands cannot be applied to a record that does not state a size; Claiming only the inguinal hernia when a femoral, umbilical, ventral, or incisional hernia is also documented — this one code covers all of them; Treating a past repair as the whole claim. The 0 percent row covers an asymptomatic hernia that is present and repairable, or repaired, while the compensable levels describe a hernia that is irreparable.

Not by combining them. DC 7338's Note (1) is written for exactly this case: with two compensable inguinal hernias, evaluate the more severely disabling hernia first, and then add 10% to that rating to account for the second compensable hernia. Do not add 10% to that rating if the more severely disabling hernia is rated at 100%. That is an addition to the first evaluation, not a second rating run through the combined-ratings table, and it applies only where both hernias are compensable and both are inguinal.

Because repairability is the first thing DC 7338 asks. Its 0 percent row reads, in full, "Asymptomatic hernia; present and repairable, or repaired" — and every compensable row above it opens with an irreparable hernia, new or recurrent, present for 12 months or more. From there the percentage is set by two things together: the hernia's size in one dimension (smaller than 3 cm; 3 cm or greater but less than 15 cm; 15 cm or greater) and how many of four named activities bring on pain, which are bending over, activities of daily living, walking, and climbing stairs. Note (2) says any one of bathing, dressing, hygiene and/or transfers is sufficient to count the activities-of-daily-living item. So a hernia that was repaired successfully has no route to a compensable evaluation under this code, and a recurrence is what reopens one.