Ventral Hernia, Postoperative — VA Disability Rating (DC 7338)
Diagnostic Code 7338 · 38 CFR §4.114
What Is It?
DC 7339 no longer exists, and the criteria that replaced it work on a completely different measurement. VA rewrote the digestive schedule effective May 19, 2024 (89 FR 19743). It combined DC 7338 (inguinal), DC 7339 (ventral, postoperative) and DC 7340 (femoral) into a single code, DC 7338, "Hernia, including femoral, inguinal, umbilical, ventral, incisional, and other (but not including hiatal)." The old belt-and-support language is gone: today the table asks whether the hernia is irreparable and has been present 12 months or more, how large it is in centimetres, and how many of four named activities cause pain. 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. A ventral hernia is a bulge of abdominal contents through a weakness in the front wall of the abdomen; the common version for veterans is the incisional hernia, where the muscle layer never fully heals along a previous surgical scar.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Irreparable hernia, new or recurrent, present for 12 months or more, with both of the following present for 12 months or more: size equal to 15 cm or greater in one dimension; and pain when performing at least three of these four activities — bending over, activities of daily living, walking, 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: size equal to 15 cm or greater in one dimension; and pain when performing two of those four activities. |
| 30% | Irreparable hernia, new or recurrent, present for 12 months or more, with both of the following present for 12 months or more: size equal to 3 cm or greater but less than 15 cm in one dimension; and pain when performing at least two of those four activities. |
| 20% | Irreparable hernia, new or recurrent, present for 12 months or more, with both of the following present for 12 months or more: size equal to 3 cm or greater but less than 15 cm in one dimension; and pain when performing one of those four activities. |
| 10% | Irreparable hernia, new or recurrent, present for 12 months or more, with hernia size smaller than 3 cm. |
| 0% | Asymptomatic hernia; present and repairable, or repaired. Note 1: with two compensable inguinal hernias, evaluate the more severely disabling one first and then add 10 percent for the second — but not if the more disabling hernia is already at 100 percent. Note 2: bathing, dressing, hygiene, and toileting or transfers each count as an activity of daily living for this table. |
Evidence Needed
A current physical examination by a general surgeon documenting hernia size, reducibility, and the state of the surrounding muscle and fascia is the centerpiece. Cross-sectional imaging (CT or MRI of the abdomen) characterizes the defect more precisely — particularly important for large or recurrent hernias. Photographs taken with the abdomen relaxed and then tensed (Valsalva) show how the hernia presents in daily life. Records from the original surgery establish the postoperative connection. Records of any repair attempts, recurrence, mesh complications, or revisions document the progressive nature. A prescription for or note about an abdominal support belt is directly relevant to the rating language.
C&P Exam Tips
Bring imaging and the original operative report. The examiner needs to assess the hernia size, whether you wear a belt, and how well the belt controls the bulge during routine activity. Demonstrate the hernia under both relaxed and Valsalva conditions — many ventral hernias only appear with abdominal pressure. Describe activities you can no longer do because of the hernia: lifting, bending, certain types of exercise, sleeping in certain positions. If the hernia has been declared inoperable by a surgeon, bring that documentation explicitly, because that finding drives the 100% rating tier.
How to File
File VA Form 21-526EZ naming ventral or incisional hernia; the rater assigns DC 7338. What the current criteria need is specific: a measurement of the defect in centimetres in its largest dimension, a statement that the hernia is irreparable if that is the surgical opinion, the date it was first documented (the 12-month clock), and a record of pain on bending over, activities of daily living, walking and climbing stairs. Ask your surgeon to put the centimetre measurement in writing — it is the single most decisive fact and it is routinely missing from the file.
Common Mistakes
Bringing belt-and-support evidence to a criteria set that no longer mentions belts. Not obtaining a centimetre measurement of the defect, which decides the 100 and 60 rows against the 30 and 20 rows. Not documenting the date of onset, since every compensable row requires the hernia to have been present 12 months or more. Failing to describe pain in terms of the four named activities the table actually lists.
Frequently Asked Questions
The old criteria talked about a supporting belt. What replaced that?
Size and function. Since May 19, 2024, DC 7338 asks whether an irreparable hernia has been present for 12 months or more, whether it measures 15 cm or more, or 3 cm to under 15 cm, or under 3 cm, and how many of four activities — bending over, activities of daily living, walking, climbing stairs — cause pain. Belt tolerance is no longer a criterion.
My rating decision cites DC 7339 at 20 percent. What happens now?
Nothing automatically. 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 grounded on the schedule change alone. If you file for an increase, the new claim is decided under DC 7338’s current table — so gather the centimetre measurement first.
What counts as an activity of daily living here?
Note 2 to DC 7338 answers it: "bathing, dressing, hygiene, and/or transfers." Any one of them is sufficient for the activities-of-daily-living item in the table.