Cholelithiasis (Gallstones) — VA Disability Rating (DC 7315)
Diagnostic Code 7315 · 38 CFR §4.114
What Is It?
Cholelithiasis is the medical term for gallstones — solid deposits of cholesterol or bilirubin pigment that form inside the gallbladder. Most cause no symptoms and sit silently for years. When a stone migrates into the cystic or common bile duct it triggers biliary colic: sudden, intense pain in the right upper abdomen, often radiating to the right shoulder blade, sometimes with nausea and vomiting. Repeated attacks can inflame the gallbladder, scar the ducts, or cause acute pancreatitis. DC 7315 carries no rating table of its own — its cell in 38 CFR §4.114 is empty and the entry reads, in full, "Rate as chronic biliary tract disease (DC 7314)." That destination was rewritten in 2024 and is now keyed to a count of documented attacks rather than to descriptive severity: 30 percent for three or more clinically documented attacks of right upper quadrant pain with nausea and vomiting during the past 12 months, or for requiring dilatation of a biliary tract stricture at least once in that period; 10 percent for one or two such attacks; and 0 percent when asymptomatic without a documented attack in the past 12 months.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 7315 assigns no percentages of its own — its rating cell in §4.114 is empty. The entry directs: rate as chronic biliary tract disease (DC 7314). That code runs 30 / 10 / 0, keyed to clinically documented attacks of right upper quadrant pain with nausea and vomiting in the past 12 months — three or more, or a biliary stricture dilatation at least once, for 30; one or two for 10; none for 0. A Note under DC 7314 lists what else that code covers (cholangitis, biliary strictures, Sphincter of Oddi dysfunction, bile duct injury, and choledochal cyst) and sends primary sclerosing cholangitis to DC 7345 instead. |
Evidence Needed
An abdominal ultrasound — the standard imaging study for gallstones — documents the presence, number, and size of stones. CT or MRCP characterizes more complex disease, particularly duct stones. Because the destination code counts documented attacks in a 12-month window, the decisive evidence is documentation of each attack: emergency department records, urgent care visits, primary care notes, and lab work showing elevated liver enzymes or bilirubin during an episode. Records of any biliary stricture dilatation carry the 30 percent criterion on their own. A symptom log covering the full 12 months captures the attacks that were managed at home and would otherwise be invisible. If a cholecystectomy has been performed, the evaluation moves to DC 7318.
C&P Exam Tips
Bring the ultrasound report and, more importantly, records of every attack in the past 12 months — the destination code counts them, so an attack that was ridden out at home with no note in the record does not exist for rating purposes. Describe what a typical attack looks like for you: the trigger, the location and quality of the pain, whether nausea and vomiting accompany it, how long it lasts, and how it resolves. If you have had a biliary stricture dilated, say so explicitly, because a single dilatation in the 12-month period meets the 30 percent criterion by itself. Note any episode that required emergency care or overnight observation.
How to File
File VA Form 21-526EZ listing chronic cholelithiasis under DC 7315 and cite DC 7314 as the code the entry routes to. Attach the ultrasound, records for every attack including the ones handled outside an emergency department, lab work drawn during episodes, and any record of biliary stricture dilatation. If a cholecystectomy has already been performed, file under DC 7318 instead, because that code captures the post-surgical complications that drive the ongoing evaluation.
Common Mistakes
Expecting DC 7315 to carry criteria of its own. It does not — the entry is one sentence directing evaluation as chronic biliary tract disease under DC 7314, and that is where the percentages live. Filing without imaging confirmation, leaving the rater nothing to anchor the diagnosis to. Documenting only emergency department visits and missing the at-home attacks, which understates the count the destination code turns on. Continuing to claim DC 7315 after gallbladder removal instead of moving to DC 7318.
Frequently Asked Questions
Can military service cause gallstones?
There is no single proven service-related cause, but several risk factors are common on active duty: rapid weight cycling, high-fat field rations, prolonged dehydration, and certain medications. The clearest pathway to service connection runs through documentation of in-service onset — abdominal pain episodes during active duty that fit the biliary colic pattern. Where those records exist, a nexus opinion linking them to the current cholelithiasis carries the claim.
What are the actual rating levels?
They come from DC 7314, chronic biliary tract disease, which the DC 7315 entry routes to. Thirty percent requires three or more clinically documented attacks of right upper quadrant pain with nausea and vomiting during the past 12 months, or requiring dilatation of biliary tract strictures at least once during that period. Ten percent requires one or two such attacks in the past 12 months. Zero percent is asymptomatic without a documented attack in the past 12 months. The word "documented" is doing real work in all three rows.
What happens to my rating after gallbladder removal?
The evaluation moves to DC 7318, which 38 CFR §4.114 titles "Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks)." It runs 30 percent for recurrent post-prandial or nocturnal abdominal pain together with chronic diarrhea of three or more watery bowel movements per day, 10 percent for intermittent abdominal pain together with one to two watery bowel movements per day, and 0 percent when asymptomatic. Many veterans assume removal ends the problem and drop the claim; the post-cholecystectomy complications are what DC 7318 exists for.