How VA Rates Hernias: DC 7338 Inguinal and DC 7346 Hiatal Hernia Guide

Diagnostic Code 7338 evaluates inguinal, femoral, ventral, and incisional hernias. A 0% rating is assigned for a small, reducible hernia. A 10% rating is awarded for a hernia that is not reducible, or reducible but not well supported by an orthopedic truss or abdominal binder. A 20% rating is assigned for bilateral inguinal hernias that are not well supported by a truss. A 30% rating is awarded for a large, postoperative recurrent hernia that cannot be well supported by a truss or surgical repair.

Hiatal hernia occurs when the upper part of the stomach pushes through the diaphragm into the chest cavity, frequently causing severe acid reflux. Under DC 7346, ratings are based on symptom severity: 10% for mild symptoms, including epigastric distress, heartburn, pyrosis, and regurgitation; 30% for moderately severe symptoms with persistent vomiting, severe pain, hematemesis, or melena with moderate anemia; and 60% for severe symptoms causing extensive anemia, weight loss, and recurrent vomiting.

Abdominal wall and inguinal hernias are commonly linked directly to military service as a result of heavy physical labor, lifting ammunition crates, carrying heavy rucksacks, or airborne operations. Hiatal hernias are often linked to chronic military stress, physical strain, or claimed secondary to service-connected gastrointestinal disorders.

Under the anti-pyramiding rule in 38 CFR 4.14, the VA does not permit separate ratings for hiatal hernia (DC 7346) and Gastroesophageal Reflux Disease (GERD, DC 7346) when both share identical digestive symptoms such as heartburn and regurgitation. The VA assigns a single rating under DC 7346 representing the predominant disability picture.

Documentation should include an Abdominal Hernias DBQ or Esophageal Conditions DBQ. Key evidence includes barium swallow studies, endoscopy reports confirming hiatal hernia size, surgical consultation and operative notes, and physical examination records documenting whether an abdominal hernia protrudes during the Valsalva maneuver.