Reference: 38 CFR 4.114

Sources & Related Guides

What is the VA rating for Crohn's Disease / Undifferentiated IBD?

Review Crohn's disease/IBD guidance around DC 7326's four-tier table, covering treatment intensity, recurrent abdominal pain, daily diarrhea frequency, and signs of systemic toxicity, plus the highest tier's treatment-unresponsiveness and hospitalization findings.

Condition Overview & Clinical Scope

VA rates Crohn's disease or undifferentiated inflammatory bowel disease under a single table, DC 7326. Its four tiers (100%, 60%, 30%, 10%) look at treatment intensity, recurrent abdominal pain, daily diarrhea frequency, and signs of systemic toxicity together, not any one finding alone. The 100% tier adds two further required findings: the disease must be unresponsive to treatment and require hospitalization at least once per year, before either an inability to work or a specific abdominal-pain symptom pattern is evaluated.

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Explore Crohn's Disease / Undifferentiated IBD Criteria & Tools

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Common Questions & FAQs

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What are you trying to understand about crohn's disease / undifferentiated ibd?

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Overview

About this condition

VA rates Crohn's disease or undifferentiated inflammatory bowel disease under a single table, DC 7326. Its four tiers (100%, 60%, 30%, 10%) look at treatment intensity, recurrent abdominal pain, daily diarrhea frequency, and signs of systemic toxicity together, not any one finding alone. The 100% tier adds two further required findings: the disease must be unresponsive to treatment and require hospitalization at least once per year, before either an inability to work or a specific abdominal-pain symptom pattern is evaluated.

Regulatory authority: 38 CFR 4.114, Diagnostic Code 7326

This hub explains the published DC 7326 schedule and common record language. It does not diagnose Crohn's disease or inflammatory bowel disease, determine service connection, infer undocumented symptoms, estimate an outcome, or replace medical care or accredited representation. Note (1)'s post-colectomy comparison against DC 7329 (whichever provides the highest rating) is not automated here, disclosed, not silently applied. Section 4.114's predominant-disability-picture rule (diagnostic codes 7301-7329, 7331, 7342, 7345-7350, 7352, and 7355-7357 cannot be combined with each other via section 4.25; a single predominant code is chosen instead, possibly elevated one step) governs DC 7326 and is not automated here, disclosed, not silently applied.

Percentage Guides

Understanding Your Percentage

Select a pathway to see what the published criteria ask about, what records may clarify it, and what should not be assumed.

100%

Highest listed pathway

Severe inflammatory bowel disease unresponsive to treatment, requiring hospitalization at least once per year, and resulting in either an inability to work, or recurrent abdominal pain with at least two of four listed severe findings.

What separates the next level: The 60% level does not require treatment-unresponsiveness or hospitalization; it instead requires outpatient management with immunosuppressant or biologic agents together with a more moderate symptom pattern.

Review CFR criteria, examples, and evidence
Official CFR language
Severe inflammatory bowel disease that is unresponsive to treatment; and requires hospitalization at least once per year; and results in either an inability to work or is characterized by recurrent abdominal pain associated with at least two of the following: (1) six or more episodes per day of diarrhea, (2) six or more episodes per day of rectal bleeding, (3) recurrent episodes of rectal incontinence, or (4) recurrent abdominal distension.
Qualification explanation
The record should confirm treatment-unresponsiveness and at least one hospitalization per year together, then either a documented inability to work, or recurrent abdominal pain plus at least two of the four listed findings. Any single finding alone, without the treatment-unresponsiveness and hospitalization gate, does not establish this tier.
Examples
Records document treatment-resistant disease with at least one hospitalization in the past year and an inability to work.; Records document the same treatment-unresponsiveness and hospitalization pattern, plus recurrent abdominal pain with six or more daily rectal-bleeding episodes and recurrent rectal incontinence (two of the four listed findings).
Medical evidence
Hospitalization records; Treatment records documenting unresponsiveness; Intestinal Conditions DBQ; Employment impact records
Functional impact examples
A severe, treatment-resistant disease course requiring recurring hospitalization and preventing sustained employment.
Common misconceptions
Any one of the four listed abdominal-pain findings alone, without a second qualifying finding, does not establish this tier, at least two are required together.; Frequent hospitalization alone, without documented treatment-unresponsiveness, does not establish this tier.
Related topics
treatment unresponsiveness; hospitalization; inability to work; abdominal-pain symptom count
Source context
38 CFR 4.114; 7326; Current DC 7326 educational pathway and highest listed schedular percentage.

60%

Next: 100%

Moderate inflammatory bowel disease managed on an outpatient basis with immunosuppressant or other biologic agents, with recurrent abdominal pain, four to five daily diarrhea episodes, and intermittent signs of toxicity such as fever, tachycardia, or anemia.

What separates the next level: The 30% level requires oral or topical (non-biologic) management instead, three or fewer daily diarrhea episodes, and only minimal signs of toxicity.

Review CFR criteria, examples, and evidence
Official CFR language
Moderate inflammatory bowel disease that is managed on an outpatient basis with immunosuppressants or other biologic agents; and is characterized by recurrent abdominal pain, four to five daily episodes of diarrhea; and intermittent signs of toxicity such as fever, tachycardia, or anemia.
Qualification explanation
The record should document immunosuppressant or biologic management, recurrent abdominal pain, four-to-five daily diarrhea episodes, and intermittent toxicity signs together; no single finding alone establishes this tier.
Examples
Treatment records document ongoing biologic-agent management, recurrent abdominal pain, four to five daily diarrhea episodes, and intermittent fever or anemia findings.
Medical evidence
Intestinal Conditions DBQ; Treatment records documenting biologic/immunosuppressant therapy; Laboratory findings (fever, tachycardia, anemia)
Functional impact examples
A moderate, ongoing symptom burden requiring biologic-level outpatient management.
Common misconceptions
Biologic-agent management alone, without the matching diarrhea frequency and toxicity findings, does not establish this tier.; Immunosuppressant/biologic management is the specific dividing line between this tier and the 30/10 percent tiers below, which require oral or topical agents instead.
Related topics
treatment intensity; daily diarrhea frequency; toxicity signs
Source context
38 CFR 4.114; 7326; Current DC 7326 educational pathway.

30%

Next: 60%

Mild to moderate inflammatory bowel disease managed with oral or topical agents (not immunosuppressants or biologics), with recurrent abdominal pain, three or fewer daily diarrhea episodes, and minimal signs of toxicity.

What separates the next level: The 10% level shares the identical management, abdominal-pain, and diarrhea-frequency findings, but requires no signs of systemic toxicity at all, rather than minimal signs.

Review CFR criteria, examples, and evidence
Official CFR language
Mild to moderate inflammatory bowel disease that is managed with oral and topical agents (other than immunosuppressants or other biologic agents); and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and minimal signs of toxicity such as fever, tachycardia, or anemia.
Qualification explanation
The record should document oral or topical (non-biologic) management, recurrent abdominal pain, three or fewer daily diarrhea episodes, and minimal toxicity signs together.
Examples
Treatment records document oral or topical medication management, recurrent abdominal pain, three or fewer daily diarrhea episodes, and occasional low-grade fever or mild anemia.
Medical evidence
Intestinal Conditions DBQ; Treatment records documenting oral/topical medication; Laboratory findings
Functional impact examples
A mild-to-moderate, managed symptom pattern with occasional systemic signs.
Common misconceptions
This tier's toxicity signs are described as "minimal," the specific distinction from the 10 percent tier's "no signs of systemic toxicity."
Related topics
treatment intensity; daily diarrhea frequency; toxicity signs
Source context
38 CFR 4.114; 7326; Current DC 7326 educational pathway.

10%

Next: 30%

Minimal to mild symptomatic inflammatory bowel disease managed with oral or topical agents (not immunosuppressants or biologics), with recurrent abdominal pain, three or fewer daily diarrhea episodes, and no signs of systemic toxicity.

What separates the next level: The 30% level shares the identical management, abdominal-pain, and diarrhea-frequency findings, but requires minimal signs of toxicity instead of none at all.

Review CFR criteria, examples, and evidence
Official CFR language
Minimal to mild symptomatic inflammatory bowel disease that is managed with oral or topical agents (other than immunosuppressants or other biologic agents); and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and no signs of systemic toxicity.
Qualification explanation
The record should document oral or topical (non-biologic) management, recurrent abdominal pain, three or fewer daily diarrhea episodes, and no signs of systemic toxicity together. This is the lowest listed DC 7326 schedular percentage.
Examples
Treatment records document oral or topical medication management, recurrent abdominal pain, three or fewer daily diarrhea episodes, and no documented fever, tachycardia, or anemia findings.
Medical evidence
Intestinal Conditions DBQ; Treatment records documenting oral/topical medication
Functional impact examples
A mild, managed symptom pattern without systemic signs.
Common misconceptions
DC 7326 has no listed 0 percent tier. A confirmed diagnosis that does not reach this 10 percent tier's findings is evaluated under general rating principles rather than an invented 0 percent DC 7326 criterion.
Related topics
treatment intensity; daily diarrhea frequency; toxicity signs
Source context
38 CFR 4.114; 7326; Current DC 7326 educational pathway and lowest listed schedular percentage.

Learn

Understand the details behind the criteria

Use these short guides to connect published terms with the records and observations that may clarify them.

Why VA requires endoscopy or radiologic confirmation

Note (2) states that VA requires DC 7326 diagnoses to be confirmed by endoscopy or radiologic studies. A diagnosis label alone, without this confirmation, is not sufficient.

  • This confirmation gate applies before any DC 7326 percentage tier can be evaluated.
  • Endoscopy or radiologic-study records should be paired with the treatment-intensity, symptom-frequency, and toxicity findings the specific tiers require.
  • Note (3) clarifies the condition's scope broadly: inflammation may involve the small bowel (ileitis), large bowel (colitis), or any component of the gastrointestinal tract from the mouth to the anus, so long as the endoscopy/radiologic confirmation requirement is met.

Records to review: endoscopy report; radiologic imaging study; Intestinal Conditions DBQ.

The DC 7329 post-colectomy comparison (not yet automated)

Note (1) states that following a colectomy or colostomy with persistent or recurrent symptoms, DC 7326 is compared against DC 7329 (resection of the large intestine), and whichever code provides the highest rating applies. RatingScope does not automate this comparison.

  • This comparison matters specifically when persistent or recurrent symptoms are documented following a colectomy or colostomy, it is not a general alternative available at every severity level.
  • DC 7329 has not yet been separately researched and built in RatingScope, so this hub cannot yet calculate which code would provide the higher rating.
  • RatingScope discloses this as a known, deferred gap rather than guessing which code would win the comparison.
  • If your records document persistent or recurrent symptoms following a colectomy or colostomy, this hub's DC 7326 guidance alone should not be treated as the final word, the DC 7329 comparison may change the outcome.

Records to review: surgical records documenting colectomy or colostomy; treatment records documenting persistent or recurrent post-surgical symptoms.

The predominant-disability-picture combination rule (not yet automated)

38 CFR 4.114 states that diagnostic codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357 cannot be combined with each other using the standard combined-ratings table. DC 7326 (Crohn's disease/undifferentiated IBD) falls within that range. Instead, a single predominant-disability code is chosen, possibly elevated one step. RatingScope does not automate this rule.

  • This rule can matter when a veteran has documented findings under more than one of the diagnostic codes named in section 4.114's non-combination list at the same time, for example, Crohn's disease/IBD alongside a documented peptic disease or celiac disease finding within that same list.
  • In the much more common case (Crohn's disease/IBD is the only digestive-system diagnosis documented), this rule does not apply, this hub already handles that correctly by rating DC 7326 on its own.
  • RatingScope discloses this as a known, deferred gap rather than guessing which code would predominate or attempting the elevation itself.
  • This is the same treatment given to Peptic Disease's identical section 4.114 disclosure, Sleep Apnea's section 4.96(a) combination rule, and Hand/Fingers' Rule (e), a genuinely open-ended clinical judgment, not a lookup table.

Records to review: treatment records documenting both conditions; clinician assessment of predominant disability.

IBS (DC 7319) is a separate disease family, out of scope here

DC 7326 (Crohn's disease/undifferentiated IBD) is a genuinely separate disease family from DC 7319 (IBS). This hub covers only DC 7326.

  • DC 7323 (ulcerative colitis) is rated entirely as DC 7326, not as IBS, under the current schedule.
  • DC 7325 (chronic enteritis) routes to either DC 7319 or DC 7326, depending on which disability predominates, a case-specific determination this hub does not make.
  • If your records point toward irritable bowel syndrome specifically (recurring abdominal pain related to defecation, without the treatment-intensity and toxicity findings above), see the separate IBS hub instead.

Records to review: treatment records documenting diagnosis; gastroenterology records.

Common Crohn's disease/IBD evidence

Crohn's disease/IBD evidence is strongest when different records describe the same confirmed pattern consistently across diagnosis confirmation, treatment intensity, symptom frequency, and toxicity findings.

  • Medical records can document endoscopy or radiologic confirmation, treatment history, and symptom findings.
  • The Intestinal Conditions DBQ's Inflammatory Bowel Disease section maps closely to DC 7326's current findings.
  • Hospitalization and employment-impact records are especially important for the 100 percent tier's severity path.
  • No single record automatically determines a percentage; the confirmed, documented pattern across treatment intensity, diarrhea frequency, and toxicity signs matters.

Records to review: medical records; Intestinal Conditions DBQ; hospitalization records.

How to read the Intestinal Conditions DBQ

The Intestinal Conditions DBQ's Inflammatory Bowel Disease section organizes findings that map closely to DC 7326's current criteria.

  • The DBQ's treatment-intensity fields map directly onto DC 7326's immunosuppressant/biologic vs. oral/topical distinction.
  • Its symptom-frequency fields map onto the diarrhea-episode and abdominal-pain findings across all four tiers.
  • Its systemic-signs fields map onto the toxicity findings distinguishing the 60/30/10 percent tiers.
  • The examiner gathers evidence; the examiner does not issue the final benefits decision.

Records to review: Intestinal Conditions DBQ; C&P examination; treatment history.

Evidence

Evidence that may clarify the published criteria

Medical and treatment records

May document diagnosis, endoscopy or radiologic confirmation, treatment intensity, and symptom findings.

Diagnosis or treatment alone does not establish a percentage without the applicable tier's specific documented findings.

Intestinal Conditions Disability Benefits Questionnaire

Organizes diagnosis confirmation, treatment intensity, diarrhea frequency, abdominal pain, and toxicity findings.

A DBQ organizes evidence but does not issue the final VA decision.

Hospitalization and surgical records

May document hospitalization frequency for the 100 percent tier, and colectomy/colostomy history for the Note (1) comparison.

Hospitalization history alone, without the specific documented findings, does not establish a percentage.

Official VA Forms & DBQs

Downloadable DBQs & Supporting Claim Forms

Take the public DBQ to your private physician or review it prior to your C&P examination.

Terminology

Plain-English terms

Endoscopy/radiologic confirmation

A diagnosis label alone is not enough. The record should include endoscopy or imaging confirmation.

This gate applies before any DC 7326 percentage tier can be evaluated.

endoscopy report; radiologic imaging study; diagnosis confirmation

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DC 7329 post-colectomy comparison

If your records document persistent or recurrent symptoms following a colectomy or colostomy, a separate comparison may apply. RatingScope discloses this but does not yet automate it.

This comparison depends on DC 7329, which has not yet been separately researched and built in RatingScope.

surgical records documenting colectomy or colostomy; policy review; DC 7329

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Crohn's disease / ulcerative colitis / IBD

Crohn's disease, ulcerative colitis, and inflammatory bowel disease (IBD) are all rated here, under this hub's own DC 7326 criteria, not on the separate IBS hub.

Records may use any of these clinical terms interchangeably; all route to the same DC 7326 table on this hub.

gastroenterology records; endoscopy or radiologic-study confirmation; rating-criteria

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IBS (DC 7319) scope boundary

If your records point to IBS specifically rather than Crohn's disease, ulcerative colitis, or IBD, DC 7326's criteria described here do not apply to that finding.

DC 7323 (ulcerative colitis) rates entirely under DC 7326, and DC 7325 (chronic enteritis) can route to either DC 7319 or DC 7326 depending on the predominant disability.

gastroenterology records; treatment records documenting diagnosis; scope boundary

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TDIU

Even if the schedular rating for Crohn's Disease / Undifferentiated IBD does not reach 100 percent, TDIU may still provide a pathway to compensation at the 100 percent rate, based on unemployability from this and/or other service-connected disabilities combined.

A lower schedular percentage does not by itself foreclose TDIU eligibility, this hub computes only the schedular percentage for this specific condition and does not determine TDIU eligibility.

Employment history; vocational impact documentation; occupational impairment

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Common Questions

Questions veterans commonly ask

How does VA rate Crohn's disease or IBD?

VA uses Diagnostic Code 7326. The published tiers (100%, 60%, 30%, 10%) look at treatment intensity, recurrent abdominal pain, daily diarrhea frequency, and signs of systemic toxicity together, and, at the highest tier, treatment-unresponsiveness and hospitalization frequency.

What does VA require to confirm the diagnosis?

Note (2) requires DC 7326 diagnoses to be confirmed by endoscopy or radiologic studies. A diagnosis label alone is not sufficient.

What if I had a colectomy or colostomy?

Note (1) states that persistent or recurrent symptoms following a colectomy or colostomy are rated under either DC 7326 or DC 7329, whichever provides the highest rating. RatingScope discloses this comparison but does not yet automate it, since DC 7329 has not been separately researched.

Can Crohn's/IBD combine with another digestive-system rating?

Section 4.114 states that ratings under diagnostic codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357 (which includes DC 7326, Crohn's disease/IBD) cannot be combined with each other. A single predominant-disability code is chosen instead, possibly elevated one step. RatingScope discloses this rule but does not automate it.

Is IBS rated here too?

No. IBS (DC 7319) is a genuinely separate disease family and is out of this hub's scope. Ulcerative colitis (DC 7323) is rated entirely as DC 7326, and chronic enteritis (DC 7325) can route to either DC 7319 or DC 7326 depending on the case.

What evidence commonly helps explain Crohn's disease/IBD severity?

An Intestinal Conditions DBQ, endoscopy or radiologic reports, treatment records, and, for the highest tier, hospitalization and employment-impact records may help explain the confirmed pattern. No single record automatically determines a percentage.

What happens during a Crohn's disease/IBD C&P exam?

The examiner may review diagnosis confirmation, treatment intensity, abdominal pain, diarrhea frequency, toxicity signs, and, where applicable, hospitalization history. The examination gathers information for VA; the examiner does not issue the final benefits decision.

If my schedular rating for Crohn's Disease / Undifferentiated IBD is below 100%, can I still be compensated at the 100% rate?

Possibly, through TDIU (Total Disability rating based on Individual Unemployability, 38 CFR 4.16), a separate pathway to 100 percent compensation based on unemployability, from this and/or other service-connected disabilities combined, independent of whether the schedular rating itself reaches 100 percent. This hub computes only the schedular percentage and does not determine TDIU eligibility.

What separates the 100% rating from adjacent levels?

The 60% level does not require treatment-unresponsiveness or hospitalization; it instead requires outpatient management with immunosuppressant or biologic agents together with a more moderate symptom pattern.

What separates the 60% rating from adjacent levels?

The 30% level requires oral or topical (non-biologic) management instead, three or fewer daily diarrhea episodes, and only minimal signs of toxicity.

What separates the 30% rating from adjacent levels?

The 10% level shares the identical management, abdominal-pain, and diarrhea-frequency findings, but requires no signs of systemic toxicity at all, rather than minimal signs.

What separates the 10% rating from adjacent levels?

The 30% level shares the identical management, abdominal-pain, and diarrhea-frequency findings, but requires minimal signs of toxicity instead of none at all.

Related Conditions

Continue learning through connected topics

IBS

IBS and Crohn's disease/IBD are both digestive conditions rated under 38 CFR 4.114, but each uses its own separate table.

Peptic Disease

Peptic disease and Crohn's disease/IBD are both digestive conditions commonly documented together, but each follows its own separate rating schedule.

Predominant-disability combination rule

Separate the question of DC 7326 severity from the unautomated question of which code predominates when both a Crohn's/IBD finding and another documented finding within section 4.114's non-combination list apply at once.

DC 7329 post-colectomy comparison

Separate the question of DC 7326 severity from the unautomated Note (1) comparison against DC 7329 when persistent or recurrent post-colectomy symptoms are documented.

Ready when you are

Compare documented Crohn's disease/IBD findings

Use the diagnosis, treatment-intensity, and symptom language already documented in your records. Do not upload records or enter Social Security numbers, claim numbers, full dates of birth, or other sensitive identifiers. RatingScope does not infer missing findings.

Informational guidance only. RatingScope does not predict, decide, or guarantee VA outcomes.

Compare my Crohn's disease/IBD records

Learn More

Continue Understanding

External source/reference

VA Intestinal Conditions DBQ

Official VA form; its Inflammatory Bowel Disease section maps closely to the current DC 7326 criteria.

Open VA Intestinal Conditions DBQ

RatingScope resource

C&P Exam Intelligence

Understand the purpose of a claim exam and the boundary between examination and final VA decision.

Open C&P Exam Intelligence

RatingScope resource

VA Claim Evidence Center

Understand common medical, lay, DBQ, and treatment evidence categories without treating one item as a guaranteed requirement.

Open VA Claim Evidence Center

RatingScope resource

RatingScope Learn Center

Continue understanding published criteria, evidence language, and the VA claim process.

Open RatingScope Learn Center

Secondary conditions

Conditions commonly connected to Crohn's Disease / Undifferentiated IBD

This reflects regulatory and clinical relationships already explained elsewhere on this site. It is not a diagnosis, not a prediction that you have or will develop a connected condition, and not personalized medical or legal advice.

Regulatory relationship

Crohn's Disease / Undifferentiated IBD Peptic Disease

Peptic disease and Crohn's disease/IBD are both digestive conditions rated under 38 CFR 4.114 and commonly documented together, but each follows its own separate rating schedule.

38 CFR 4.114

View Peptic Disease

Educational Guides & Evidence Resources

In-depth analysis of DBQ forms, medical evidence thresholds, and rating schedules for Crohn's Disease / Undifferentiated IBD.

Crohn's Disease and Ulcerative Colitis VA Rating: DC 7326 and DC 7323 Rating Schedule

Learn how the VA rates Crohn's disease, ulcerative colitis, and inflammatory bowel disease under 38 CFR 4.114 (DC 7326), treatment modalities, and toxicity criteria.

How VA Rates IBS: DC 7319 Abdominal Pain Frequency and Defecation Criteria

Understand how the VA rates Irritable Bowel Syndrome under 38 CFR 4.114 (DC 7319) based on abdominal pain frequency and bowel disturbance symptoms.

GERD vs. IBS: How the VA Rates Digestive Conditions and Pyramiding Rules

Compare how the VA evaluates GERD versus IBS, separate rating rules under 38 CFR 4.114, and how to avoid digestive pyramiding denials.

IBS VA Rating Criteria: DC 7319 Defecation Pain and Associated Features Guide

Learn how the VA evaluates Irritable Bowel Syndrome under 38 CFR 4.114 (DC 7319) using 3-month lookback pain frequency and two-of-six associated features.

IBS C&P Exam and Intestinal DBQ Guide: What to Expect and Evidence Needed

Understand the VA Intestinal Conditions Disability Benefits Questionnaire (DBQ), C&P examination requirements, symptom diaries, and medical documentation for IBS claims.

VA Digestive System Rating Combination Rules: 38 CFR 4.114 Non-Combination and Predominant Disability Picture

Master the specific non-combination rule in 38 CFR 4.114 governing digestive diagnostic codes, predominant disability picture, single step elevation, and anti-pyramiding.

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