Understand hernia guidance around DC 7338's 6-tier ladder -- driven by objective hernia size in centimeters and how many of 4 named activities (bending over, activities of daily living, walking, climbing stairs) cause pain, folding inguinal, femoral, umbilical, ventral, incisional, and other hernia types into one unified code since the 2024 rewrite.
Condition Overview & Clinical Scope
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DC 7338's current text (effective May 19, 2024) rates hernia -- inguinal, femoral, umbilical, ventral, incisional, and other types together under one unified code -- across a 6-tier ladder driven by two documented facts: the objective size of the hernia in centimeters, and how many of 4 named activities (bending over, activities of daily living, walking, climbing stairs) cause pain. The pre-2024 truss/belt-support scheme, along with the separate DC 7339 and DC 7340 codes, was removed outright and folded into this single code. Hiatal Hernia (DC 7346) is a separate, already-published RatingScope hub and is not covered here.
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DC 7338's current text (effective May 19, 2024) rates hernia -- inguinal, femoral, umbilical, ventral, incisional, and other types together under one unified code -- across a 6-tier ladder driven by two documented facts: the objective size of the hernia in centimeters, and how many of 4 named activities (bending over, activities of daily living, walking, climbing stairs) cause pain. The pre-2024 truss/belt-support scheme, along with the separate DC 7339 and DC 7340 codes, was removed outright and folded into this single code. Hiatal Hernia (DC 7346) is a separate, already-published RatingScope hub and is not covered here.
Regulatory authority: 38 CFR 4.114, DC 7338
Note (1)'s second-compensable-hernia adjustment is disclosed below rather than computed, because it is unresolved whether it generalizes beyond the literal two-inguinal-hernias case the text names (see NHD-1). This guide is educational only. RatingScope does not currently provide a Hernia record-comparison assessment, does not diagnose a hernia, does not infer missing size or pain-activity documentation, does not determine service connection, and does not predict a VA decision. The current text also does not address 3 or more compensable hernias (see NHD-2).
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
The 100% level describes an irreparable hernia present 12 months or more, 15 cm or greater in size, with pain on 3 or more of the 4 named activities.
What separates the next level: The 60% level shares the same 15 cm or greater size bracket but requires only 2 painful activities instead of 3 or more.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an irreparable hernia (new or recurrent) present for 12 months or more, with size 15 cm or greater in one dimension and pain when performing at least 3 of the 4 named activities, at 100 percent.
Qualification explanation
Both the size threshold (15 cm or greater) and the pain-activity count (3 or more of the 4 named activities) must be documented together.
Examples
A 16 cm irreparable hernia with documented pain bending over, with activities of daily living, and while walking.
Medical evidence
Hernia DBQ or C&P exam findings; Documented objective hernia measurement; Functional-impact documentation for each of the 4 named activities
Functional impact examples
Pain limiting most daily physical activity.
Common misconceptions
Size alone, without the required pain-activity count, does not reach 100 percent.
Related topics
hernia size; pain-activity count
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
60%
Next: 100%
The 60% level describes an irreparable hernia 15 cm or greater in size, with pain on exactly 2 of the 4 named activities.
What separates the next level: Moving to 3 or more painful activities at this same size bracket reaches 100%.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an irreparable hernia (new or recurrent) present for 12 months or more, with size 15 cm or greater in one dimension and pain when performing 2 of the 4 named activities, at 60 percent.
Qualification explanation
Same 15 cm or greater size bracket as the 100% level, distinguished only by a pain-activity count of 2 instead of 3 or more.
Examples
A 20 cm irreparable hernia with documented pain bending over and while climbing stairs, but not with activities of daily living or walking.
Medical evidence
Hernia DBQ or C&P exam findings; Documented objective hernia measurement; Functional-impact documentation for each of the 4 named activities
Functional impact examples
Pain affecting some, but not most, daily physical activity.
Common misconceptions
This tier does not apply to hernias smaller than 15 cm, regardless of pain-activity count.
Related topics
hernia size; pain-activity count
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
30%
Next: 60%
The 30% level describes an irreparable hernia 3 cm to less than 15 cm in size, with pain on 2 or more of the 4 named activities.
What separates the next level: The 20% level shares this same size bracket but requires only 1 painful activity instead of 2 or more.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an irreparable hernia (new or recurrent) present for 12 months or more, with size 3 cm or greater but less than 15 cm in one dimension and pain when performing at least 2 of the 4 named activities, at 30 percent.
Qualification explanation
Uses the mid-size bracket (3 cm to less than 15 cm), together with a pain-activity count of 2 or more.
Examples
An 8 cm irreparable hernia with documented pain walking and climbing stairs.
Medical evidence
Hernia DBQ or C&P exam findings; Documented objective hernia measurement; Functional-impact documentation for each of the 4 named activities
Functional impact examples
Pain affecting more than one of the 4 named activities.
Common misconceptions
A hernia 15 cm or greater does not fall into this bracket even if the pain-activity count would otherwise match.
Related topics
hernia size; pain-activity count
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
20%
Next: 30%
The 20% level describes an irreparable hernia 3 cm to less than 15 cm in size, with pain on exactly 1 of the 4 named activities.
What separates the next level: Moving to 2 or more painful activities at this same size bracket reaches 30%.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an irreparable hernia (new or recurrent) present for 12 months or more, with size 3 cm or greater but less than 15 cm in one dimension and pain when performing 1 of the 4 named activities, at 20 percent.
Qualification explanation
Same mid-size bracket as the 30% level, distinguished only by a pain-activity count of 1 instead of 2 or more.
Examples
A 5 cm irreparable hernia with documented pain only when climbing stairs.
Medical evidence
Hernia DBQ or C&P exam findings; Documented objective hernia measurement; Functional-impact documentation for each of the 4 named activities
Functional impact examples
Pain limited to one specific physical activity.
Common misconceptions
Documenting 0 painful activities at this size bracket does not reach 20 percent -- this hub treats that combination as the asymptomatic 0 percent level instead.
Related topics
hernia size; pain-activity count
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
10%
Next: 20%
The 10% level describes an irreparable hernia smaller than 3 cm, regardless of the pain-activity count.
What separates the next level: Higher tiers require a documented size of 3 cm or greater, together with a qualifying pain-activity count.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an irreparable hernia (new or recurrent) present for 12 months or more, with hernia size smaller than 3 cm, at 10 percent.
Qualification explanation
This is the only tier whose text does not condition on the pain-activity count -- size alone under 3 cm controls.
Examples
A 2 cm irreparable hernia, present 12 months or more.
Medical evidence
Hernia DBQ or C&P exam findings; Documented objective hernia measurement
Functional impact examples
A small but persistent hernia finding.
Common misconceptions
The pain-activity count does not change this tier's outcome -- it is size-only.
Related topics
hernia size
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
0%
Next: 20%
The 0% level describes an asymptomatic hernia that is present and repairable, or already repaired.
What separates the next level: Any documented pain on at least 1 of the 4 named activities, together with a size of 3 cm or greater, instead reaches the 20% or 30% level.
Review CFR criteria, examples, and evidence
Official CFR language
DC 7338 rates an asymptomatic hernia; present and repairable, or repaired, at 0 percent.
Qualification explanation
DC 7338's actual regulatory basis for this tier is reparability, not size: the text rates an asymptomatic hernia that is "present and repairable, or repaired" at 0 percent, distinct from every higher tier's "Irreparable hernia" requirement. Reparability is not an intake fact this hub's assessment currently collects, so this hub models this level using the closest fact-driven proxy available: a documented hernia size of 3 cm or greater together with a pain-activity count of 0.
Examples
A hernia documented as present and repairable, with no reported pain on any of the 4 named activities.
Medical evidence
Hernia DBQ or C&P exam findings; Documentation confirming no pain on any named activity
Functional impact examples
No documented functional impact from the hernia at this level.
Common misconceptions
A hernia diagnosis alone does not place a finding at a higher level without a documented size and pain-activity count.
Related topics
asymptomatic hernia
Source context
38 CFR 4.114; 7338; Current text effective May 19, 2024.
Learn
Understand the details behind the criteria
Use these short guides to connect published terms with the records and observations that may clarify them.
How hernia size and pain-activity count combine into a rating tier
DC 7338's current text uses 2 objective facts together -- hernia size in centimeters, and how many of 4 named activities cause pain -- to resolve a 6-tier ladder.
Size brackets: smaller than 3 cm, 3 cm to less than 15 cm, and 15 cm or greater.
The 4 named activities -- bending over, activities of daily living, walking, and climbing stairs -- appear directly in each tier's own criteria language (100%, 60%, 30%, and 20%), not in a separate Note.
At the smaller-than-3-cm bracket, the pain-activity count does not change the outcome -- that tier is 10 percent regardless.
At the 3-cm-to-less-than-15-cm bracket, 1 painful activity reaches 20 percent and 2 or more reaches 30 percent.
At the 15-cm-or-greater bracket, 2 painful activities reaches 60 percent and 3 or more reaches 100 percent.
A hernia 15 cm or greater with exactly 1 painful activity has no directly-stated row in the current text -- a genuine gap in the regulation itself, not a RatingScope omission.
Records to review: Hernia DBQ or C&P exam findings; Documented objective hernia measurement.
Reparability, not size, is DC 7338's actual 0% threshold
DC 7338's text distinguishes the 0% tier from every compensable tier by reparability status, not by size or pain-activity count. This hub's 0% tier uses a size-and-pain proxy because reparability is not an intake fact it currently collects.
DC 7338 rates "Asymptomatic hernia; present and repairable, or repaired" at 0 percent.
Every tier above 0 percent instead requires an "Irreparable hernia (new or recurrent) present for 12 months or more," together with the size and pain-activity facts.
Reparable versus irreparable is a clinical/surgical determination that this hub's assessment does not currently collect as an intake fact.
This hub's 0% percentageGuide instead uses the closest fact-driven proxy available -- a documented hernia size of 3 cm or greater together with a pain-activity count of 0 -- as an approximation of the reparability threshold, not the literal regulatory criterion.
Records to review: Hernia DBQ or C&P exam findings documenting reparability; Operative or surgical consultation notes.
The 2024 rewrite: DC 7339 and DC 7340 removed, folded into DC 7338
Effective May 19, 2024, the same Federal Register rule that rewrote several other digestive-system codes also replaced the pre-2024 truss/belt-support hernia scheme with a single unified DC 7338.
DC 7339 and DC 7340 both existed continuously since the section's 1964 origin and were removed outright, not merely renumbered.
The current DC 7338 folds inguinal, femoral, umbilical, ventral, incisional, and other hernia types into one code, rated by objective size and pain-activity count rather than the prior truss/belt/reducibility language.
Hiatal Hernia (DC 7346) is a completely separate code and RatingScope hub, structurally unrelated to this rewrite.
Records to review: Federal Register final rule for digestive system updates.
A second compensable hernia: disclosed, not resolved (NHD-1)
DC 7338 Note (1) adds a 10 percent bump for a second compensable inguinal hernia, but it is unresolved whether this generalizes beyond the literal two-inguinal-hernias case.
Note (1) states: with two compensable inguinal hernias, evaluate the more severely disabling hernia first and add 10 percent for the second, unless the more severely disabling hernia is already rated at 100 percent.
This bump is textually scoped to "inguinal" hernias, but the official DBQ (VA Form 21-0960I) also collects bilateral Right/Left/Both documentation for femoral hernias.
It is unresolved whether the bump generalizes to any two compensable hernias regardless of type, or is limited to the literal two-inguinal-hernias case.
RatingScope does not resolve this ambiguity or add 10 percent to a computed result on its own -- a second compensable hernia is surfaced only as an advisory disclosure.
Records to review: Hernia DBQ documentation of a second, separately compensable hernia.
3 or more compensable hernias: not addressed in the current text (NHD-2)
DC 7338's current text only addresses exactly two compensable hernias through Note (1). It does not address 3 or more, or mixed-type combinations.
Note (1)'s bump mechanism is built around exactly two compensable inguinal hernias.
Three or more compensable hernias, or combinations mixing hernia types beyond the named two-inguinal-hernias case, are not addressed anywhere in the current regulation text.
This is a gap in the regulation itself. RatingScope does not guess at how a third or later compensable hernia would be evaluated.
Records to review: Hernia DBQ documentation of each distinct hernia.
Evidence
Evidence that may clarify the published criteria
Hernia DBQ
Organizes diagnosis, hernia type, objective size measurement, and functional-impact findings for hernia.
A DBQ is useful context, but RatingScope does not require uploads and this hub does not accept records.
Diagnosis and treatment records
Treatment notes can show hernia type, current condition, and clinician observations over time.
A diagnosis alone does not identify which percentage tier applies.
Objective hernia size measurement
The documented centimeter measurement in one dimension is one of the two facts DC 7338's tiers are built on.
An estimated or undocumented size cannot be substituted for a measured finding.
Pain-activity documentation
Records describing pain with bending over, activities of daily living, walking, or climbing stairs help establish the pain-activity count.
General pain descriptions are not the same as a documented finding tied to one of the 4 named activities.
Personal and firsthand lay evidence
Plain descriptions can explain how the hernia affects the 4 named activities.
Lay evidence can describe observed impact, but it should not invent measurements or diagnoses.
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
Hernia
DC 7338 rates hernia by objective size and pain-activity count, covering inguinal, femoral, umbilical, ventral, incisional, and other types together under one code.
The 2024 rewrite replaced the prior truss/belt-support scheme with this size-and-pain-driven ladder.
Even if the schedular rating for Hernia 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.
DC 7338 rates hernia across a 6-tier ladder (100/60/30/20/10/0 percent) driven by two facts: the objective hernia size in centimeters, and how many of 4 named activities (bending over, activities of daily living, walking, climbing stairs) cause pain.
What happened to DC 7339 and DC 7340?
Both were removed outright effective May 19, 2024, folded into the single unified DC 7338 along with the rest of the hernia types the pre-2024 scheme covered separately.
Does the 0% tier turn on hernia size, or something else?
The 0% tier's actual regulatory basis is reparability, not size: DC 7338's text rates "Asymptomatic hernia; present and repairable, or repaired" at 0 percent, while every tier above 0 percent requires an "Irreparable hernia (new or recurrent) present for 12 months or more." Reparable versus irreparable status is not a fact this hub's assessment currently collects, so the 0% tier instead uses the closest fact-driven proxy available: a documented hernia size of 3 cm or greater together with a pain-activity count of 0. This proxy is an approximation of the reparability threshold, not the literal regulatory criterion.
What if I have a second compensable hernia?
DC 7338 Note (1) adds a 10 percent bump for a second compensable inguinal hernia, unless the more severely disabling hernia is already rated at 100 percent. It is unresolved whether this bump generalizes to any two compensable hernias regardless of type, or is limited to the literal two-inguinal-hernias case the text names -- the official DBQ collects bilateral data for femoral hernias too. RatingScope discloses this rather than computing an adjusted percentage.
What if I have 3 or more compensable hernias?
The current regulation text does not address 3 or more compensable hernias, or mixed-type combinations. This is a gap in the regulation itself, not a RatingScope omission, and RatingScope does not guess at how it would be evaluated.
Is Hiatal Hernia the same as this hub?
No. Hiatal Hernia (DC 7346) is a separate, already-published RatingScope hub with its own distinct rating logic (a redirect to DC 7203, esophageal stricture) and shares no code or criteria with this Hernia (DC 7338) hub.
Is this an active RatingScope assessment?
No. This Hernia hub is educational only. Do not enter hernia findings into another condition's assessment.
If my schedular rating for Hernia 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 shares the same 15 cm or greater size bracket but requires only 2 painful activities instead of 3 or more.
What separates the 60% rating from adjacent levels?
Moving to 3 or more painful activities at this same size bracket reaches 100%.
What separates the 30% rating from adjacent levels?
The 20% level shares this same size bracket but requires only 1 painful activity instead of 2 or more.
What separates the 20% rating from adjacent levels?
Moving to 2 or more painful activities at this same size bracket reaches 30%.
What separates the 10% rating from adjacent levels?
Higher tiers require a documented size of 3 cm or greater, together with a qualifying pain-activity count.
What separates the 0% rating from adjacent levels?
Any documented pain on at least 1 of the 4 named activities, together with a size of 3 cm or greater, instead reaches the 20% or 30% level.
If more than one condition is involved, combined-rating math is educational context and does not simply add percentages.
Ready when you are
Hernia comparison is not active yet
RatingScope currently provides this Hernia hub as education only. Do not enter hernia findings into another condition's assessment. Use the supported assessment list only when your condition is available.
Informational guidance only. RatingScope does not predict, decide, or guarantee VA outcomes.
38 CFR 4.16 - Total disability ratings for compensation based on unemployability (TDIU)
Official source for TDIU, a separate pathway to 100 percent compensation based on unemployability, independent of the schedular percentage. This hub does not determine TDIU eligibility.