Veterans often assume a repaired hernia is a closed chapter and a painful one speaks for itself. DC 7338 after the 2024 consolidation runs on three measurable things: irreparability, size in centimeters, and pain during specific named activities, bending over, daily living tasks, walking, and stairs. Naming the painful activities is criteria language, and the two hernia rule adds 10 points by straight addition, a generosity found almost nowhere else in the schedule.
Since the 2024 digestive revision, one diagnostic code covers nearly every hernia: DC 7338 rates inguinal, femoral, umbilical, ventral, and incisional hernias from 0 to 100 percent based on size, duration, and pain during everyday activities. The criteria math is specific, and the two-hernia rule adds 10 points by straight addition, a method found almost nowhere else in the rating schedule.
Many veterans assume a repaired hernia is a closed chapter and a painful one speaks for itself. Neither is quite right. DC 7338 runs on three measurable things: irreparability, size in centimeters, and pain during specific named activities. Naming those activities in your records is criteria language. Vague pain descriptions are not.
How VA rates hernias
The May 19, 2024 digestive revision consolidated hernia ratings into a single code: DC 7338 now covers femoral, inguinal, umbilical, ventral, incisional, and other hernias, everything except hiatal hernias (38 CFR 4.114). The old code-by-code criteria are gone, replaced by a formula built on three measurable things: whether the hernia is irreparable, how large it is, and whether it causes pain during specific everyday activities.
The percentage levels
Every compensable level requires an irreparable hernia (new or recurrent) present for 12 months or more. The four activities the criteria count are bending over, activities of daily living (bathing, dressing, hygiene, or transfers), walking, and climbing stairs.
- 0 percent: asymptomatic hernia that is present and repairable, or repaired.
- 10 percent: irreparable hernia smaller than 3 cm.
- 20 percent: 3 cm or larger but under 15 cm, with pain during one of the four activities.
- 30 percent: 3 cm or larger but under 15 cm, with pain during at least two of the four activities.
- 60 percent: 15 cm or larger in one dimension, with pain during two of the four activities.
- 100 percent: 15 cm or larger, with pain during at least three of the four activities.
The two-hernia rule is addition, not combination
A note to DC 7338 handles bilateral inguinal hernias in a way found almost nowhere else in the schedule: rate the more severe hernia, then add 10 percentage points for the second compensable hernia. Straight addition beats the combined ratings table, so a 30 percent hernia plus a second compensable one is 40 percent, not the 37-rounds-to-40 of ordinary combination.
"Irreparable" is the gatekeeper
Everything above 0 percent requires a hernia that cannot be repaired, or has recurred, and has persisted 12 months or more. Medical documentation establishing irreparability is central to the claim, including surgical notes, imaging reports, and treating-provider opinions explaining why repair is not feasible (prior mesh failure, comorbidities, recurrence risk). No single document type is required; a complete picture combining clinical findings and provider rationale is stronger than any one record alone. Size belongs in the record too, in centimeters, from imaging or examination, because 3 cm and 15 cm are literal thresholds.
Hiatal hernias are different
A hiatal or paraesophageal hernia is rated as esophageal stricture under DC 7203, the same criteria family that now rates GERD. Symptoms like reflux and swallowing difficulty drive that evaluation, not size-and-pain measurements. If you carry both an abdominal wall hernia and a hiatal hernia, they are separate ratings under separate criteria.
Common rating details veterans overlook
- A repaired, asymptomatic hernia is 0 percent, but still service connected. Recurrence, common after years, becomes a simple increase claim.
- Name the painful activities. "Pain when bending over and climbing stairs" is criteria language; "it hurts sometimes" is not.
- Claims pending before May 19, 2024 get whichever criteria, old or new, are more favorable.
- Post-repair residuals count separately: a surgical scar is separately ratable under DC 7800 to 7805 based on size, stability, and symptoms, and a scar that is painful or unstable may rate 10 percent or higher depending on how it meets those specific criteria, and nerve pain (ilioinguinal neuralgia) can be rated under the nerve codes.