Intestinal Distomiasis (Fluke Infection) — VA Rating (DC 6320)
Diagnostic Code 6320 · 38 CFR §4.88b
What Is It?
DC 7324 no longer exists. VA rewrote the digestive schedule effective May 19, 2024 (89 FR 19743). VA’s explanation is worth quoting: the code "is currently titled ‘Distomiasis, intestinal or hepatic’ and refers to the early 20th century medical texts that used this now outdated term." A 2019 rule (84 FR 28227) had already created DC 6320, "Parasitic diseases otherwise not specified," and VA stated that "DC 6320 addresses conditions previously covered under DC 7321 and DC 7324." VA said so itself in the rulemaking, code by code: the removal "would not, in and of itself, alter existing evaluations or grants of service connection. Rather, VA would modify the individual’s record to reflect the grant of service connection under" the current code. 38 CFR § 3.951(a) says the same thing as a rule of general application — a readjustment to the rating schedule is not grounds for reducing an evaluation already in effect unless medical evidence establishes that the disability has actually improved. The old code still appears in this page’s web address because the address has not changed; the code the page teaches has. Distomiasis is chronic infection with trematodes — flukes — acquired from undercooked freshwater fish, contaminated aquatic plants or other infected food. The intestinal species colonise the gut; some, notably Fasciola hepatica, migrate to the liver and bile ducts.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | For active disease. The 100 percent runs while the infection is active. |
| 0% | After active disease has resolved, the infection itself is 0 percent. Any residual disability of the infection is rated within the appropriate body system — chronic bowel symptoms under the digestive codes, liver residuals under the liver codes, joint involvement under the musculoskeletal codes — and it is those residual ratings, not the infection code, that carry the compensation. |
Evidence Needed
Stool studies — microscopy for fluke eggs, PCR, or serology — confirm the diagnosis during active infection. For historical infections, service medical records or post-deployment medical evaluations documenting the original diagnosis and antiparasitic treatment establish the in-service event. Endoscopy or imaging showing chronic intestinal scarring documents residuals when present. A symptom diary capturing the recurrence pattern supports the rating tier. Deployment records to an endemic region close the nexus when service medical records are sparse.
C&P Exam Tips
Bring the original diagnosis records, any subsequent stool studies, imaging if performed, and the symptom diary. The rating turns on whether the chronic residuals are mild or moderate — quantify episode frequency, dietary restrictions, weight history. Mention any antiparasitic treatment courses and their outcomes. If you have continuing care from gastroenterology or infectious disease, describe that.
How to File
File VA Form 21-526EZ naming fluke infection or distomiasis, and name each chronic residual separately — post-infectious irritable bowel syndrome, malabsorption, iron-deficiency anemia, hepatobiliary disease. Under § 4.88b the infection is 0 percent once resolved and the residuals are rated in their own body systems, so the residual claims are where the compensation is. Hepatobiliary residuals now go to DC 7314, chronic biliary tract disease, which absorbed the old cholangitis code.
Common Mistakes
Filing without documentation of the original infection, which makes service connection harder years after deployment Confusing distomiasis with other parasitic intestinal infections (amebiasis under DC 7321, schistosomiasis under DC 7326 framework, bacillary dysentery under DC 7322) — each has its own code and the rating frameworks differ Letting post-infectious IBS go unclaimed when functional GI symptoms persist after fluke clearance Missing hepatobiliary complications when the fluke species involved migrates to the liver
Frequently Asked Questions
Nobody uses the word "distomiasis" any more. What should I call it?
Fluke infection, or the species name if you have it — fascioliasis, fasciolopsiasis, clonorchiasis, opisthorchiasis. VA itself called the term outdated when it removed the code. Name the condition on the claim form and let the rater map it to DC 6320.
Where do liver and bile duct residuals get rated?
Under the digestive codes for the organ involved. Bile duct disease is DC 7314, chronic biliary tract disease, whose Note expressly covers cholangitis, biliary strictures and bile duct injury. Liver injury residuals are DC 7311.
Does removing the code cost me an existing rating?
No. VA stated the removal "would not, in and of itself, alter existing evaluations or grants of service connection," and 38 CFR § 3.951(a) bars a reduction based on a schedule readjustment absent medical evidence of actual improvement.