Inguinal Hernia — VA Disability Rating (DC 7338)

Diagnostic Code 7338 · 38 CFR §4.114

What Is It?

An inguinal hernia is a defect in the abdominal wall of the groin through which fat or a loop of intestine pushes out, producing a bulge that enlarges when you cough, strain, stand, or lift. It is one of the most commonly claimed conditions among veterans, for reasons that are not mysterious: repeated heavy lifting, rucking under load, carrying equipment, and the sustained abdominal strain of physical training are all recognized risk factors, and the incidence in service populations is high. Surgical repair — open or laparoscopic, usually with mesh — is routine and usually successful, but two things follow it often enough to matter: recurrence, and chronic post-surgical groin pain. The important thing to understand about claiming this condition in 2026 is that the criteria changed. The VA rewrote the digestive schedule effective 19 May 2024, and DC 7338 no longer rates on whether a truss supports the hernia or whether it is readily reducible. It now rates on two things: the size of the hernia in centimetres, and how many everyday activities it makes painful — with an entirely new 100 percent level that did not exist before.

Rating Criteria

Evidence Needed

The 2024 criteria ask for three specific facts, and a claim that supplies them beats one that does not. First, size in centimetres: get the largest dimension measured and written down, by ultrasound, CT, or a physical examination that records a number rather than "small" or "moderate." The thresholds are 3 cm and 15 cm, so an unmeasured hernia cannot be rated above 10 percent. Second, irreparability and duration: the compensable levels all require an irreparable hernia present for 12 months or more, so you need a surgical opinion stating that repair is not feasible — or that further repair is not advisable after recurrences — plus records establishing when it began. Third, the activities: treatment notes, a symptom diary, and lay statements documenting pain on bending over, on walking, on climbing stairs, and on activities of daily living, which Note (2) defines as bathing, dressing, hygiene, or transfers. Operative reports for every repair, and documentation of each recurrence, tie the history together.

C&P Exam Tips

Ask to be examined standing and while coughing or straining — an inguinal hernia can reduce completely when you lie down, and an examiner who checks you supine may record no hernia at all. Ask directly for the measurement in centimetres to be entered on the DBQ, because the size thresholds carry the rating and "palpable bulge" is not a number. Then work through the activity list explicitly and by name: bending over, activities of daily living, walking, climbing stairs. Say which ones hurt. Do not summarize this as "it bothers me" — the criteria count activities, so the examiner needs to record how many. If a surgeon has said the hernia cannot be repaired, or that further repair is inadvisable, bring that opinion in writing. If you have chronic pain at a repair site with no current hernia, that is a different claim and it belongs on the record separately as post-herniorrhaphy neuralgia.

How to File

File on VA Form 21-526EZ under DC 7338, and describe the in-service cause specifically — the lifting, load-bearing, or straining event or duty pattern that produced it. Attach imaging with the measured size, operative reports from every repair, documentation of each recurrence, any surgical opinion on reparability, and a statement listing which of the four named activities cause pain. If both sides are involved, claim both and cite Note (1), which adds 10 percent for a second compensable hernia. If you have chronic post-surgical groin pain, file it separately as ilioinguinal or genitofemoral neuralgia under the peripheral nerve codes rather than folding it into the hernia claim, and claim testicular atrophy or chronic orchialgia under the appropriate genitourinary code where they followed repair.

Common Mistakes

The most common mistake in 2026 is arguing the old criteria. Claims and even some decisions still discuss trusses, reducibility, and whether the hernia is "well supported" — language the 2024 revision removed. If your claim or your decision turns on those words, the current criteria are not being applied, and that is worth raising on review. The second mistake is not getting a measurement: without a centimetre figure the claim cannot clear the 3 cm threshold that separates 10 percent from 20 percent, or the 15 cm threshold that opens 60 and 100 percent. The third is describing pain in general terms rather than naming which of the four activities it affects, when the count is the criterion. The fourth, and the most valuable to fix, is treating chronic post-repair groin pain as part of the hernia rating. Post-herniorrhaphy inguinodynia affects a meaningful share of repair patients, it is nerve pain, and it is separately compensable under the peripheral nerve codes — but only if it is claimed and diagnosed as such. The fifth is accepting 0 percent after a successful repair without noting that recurrence is common and a new claim is available if it comes back.

Frequently Asked Questions

Did the VA change the inguinal hernia rating criteria?

Yes. The digestive schedule at 38 CFR §4.114 was revised effective 19 May 2024 — the final rule published 20 March 2024 — and DC 7338 was rewritten. The old criteria turned on whether the hernia was readily reducible and whether it was well supported by a truss or belt. The current criteria turn on the size of the hernia in centimetres and on how many of four named activities cause pain, and they add a 100 percent level that did not previously exist. If a decision on your claim discusses trusses, it is applying superseded criteria.

What are the four activities in the DC 7338 criteria?

Bending over, activities of daily living, walking, and climbing stairs. The number of them that cause pain is what moves you between evaluation levels once the size threshold is met. Note (2) provides that any one of bathing, dressing, hygiene, or transfers is enough to establish the activities-of-daily-living item, so you do not need to be impaired in all of them.

How big does the hernia have to be?

The thresholds are 3 cm and 15 cm in one dimension. Under 3 cm, an irreparable hernia present 12 months or more rates 10 percent. From 3 cm to under 15 cm, it rates 20 percent with pain on one activity and 30 percent with pain on at least two. At 15 cm or greater it rates 60 percent with pain on two activities and 100 percent with pain on at least three. Because every compensable level above 10 percent depends on a measurement, getting the size recorded in centimetres is the single most useful thing you can do for this claim.

Can I get a rating if my hernia was successfully repaired?

Not under DC 7338 by itself — the 0 percent row covers an asymptomatic hernia that is present and repairable, or repaired. What is compensable after a successful repair is what the repair left behind. Chronic groin pain from nerve entrapment in scar or mesh (post-herniorrhaphy inguinodynia) is rated under the peripheral nerve codes; a painful or unstable surgical scar is rated under DC 7804; testicular atrophy or chronic pain from compromised blood supply is rated under the genitourinary codes. Each has to be claimed and diagnosed separately.

What if I have hernias on both sides?

Note (1) under DC 7338 handles it: evaluate the more severely disabling hernia first, then add 10 percent to that evaluation to account for the second compensable hernia. The addition does not apply if the more severely disabling hernia is already rated 100 percent, and the second hernia must itself be of compensable degree. Bilateral inguinal hernias are common in veterans with long load-bearing histories, so claim both sides expressly rather than letting one be folded into the other.

How do I connect an inguinal hernia to my service?

Direct service connection works where the hernia was diagnosed or repaired during service, or where an in-service straining or lifting event is documented and a nexus opinion links it to the current condition. Where the service treatment records are silent, buddy statements describing your load-bearing duties, MOS records, and a medical opinion citing the recognized association between repeated heavy lifting and abdominal wall failure carry the claim. Secondary service connection also applies where a service-connected condition — chronic cough from a respiratory disability, or straining from constipation caused by medication for another rated condition — contributed to the hernia.

What is post-herniorrhaphy pain and why does it matter?

It is chronic groin pain that persists after hernia repair, usually because the ilioinguinal, iliohypogastric, or genitofemoral nerve has been entrapped in scar tissue or mesh. It is reported in roughly 10 to 15 percent of repairs and can be more disabling than the original hernia. It matters because it is not compensated by DC 7338 — that code rates the hernia — and it is rated instead under the peripheral nerve codes as neuralgia or neuritis. Veterans who assume their groin pain is covered by the hernia rating routinely leave this unclaimed.