Hernia VA Rating: Inguinal, Umbilical, and Ventral Criteria

Types of hernias and breakdown of DC 7338 criteria

In the digestive system rulemaking (87 FR 1534–1535), the VA explained that non-hiatal abdominal wall and groin hernias—inguinal (groin canal), umbilical (navel), ventral (anterior abdominal wall), incisional (prior surgical scar site), femoral (upper thigh/groin canal), epigastric, and spigelian hernias—share common functional impairments. Every compensable rating under Diagnostic Code 7338 rests on four elements:

1. Repairable versus irreparable status and the 12-month duration rule

Because tension-free mesh herniorrhaphy and laparoscopic repair correct most initial hernias, Diagnostic Code 7338 restricts compensable ratings (10%–100%) to irreparable hernias (new or recurrent) present for 12 months or more. On the VA Hernias DBQ, an examiner evaluating whether a hernia is irreparable considers whether the hernia type can typically be surgically repaired, surgical records classifying the defect as irreparable (due to extensive loss of domain, dense adhesions, or multiple failed mesh repairs), and significant medical contraindications (such as severe cardiopulmonary or liver disease) prohibiting surgery. Both the irreparable hernia and the required size and pain criteria must be present for 12 months or more.

2. Hernia defect size and “loss of domain”

For irreparable hernias present for at least 12 months, Diagnostic Code 7338 divides size in one dimension into three brackets:

• Smaller than 3 cm: Warrants 10% ($180.42 per month for a veteran alone, effective 2025-12-01) without requiring separate proof of activity-induced pain.
• 3 cm to less than 15 cm in one dimension: Warrants 20% ($356.66 per month alone) with pain during one listed activity for 12+ months, or 30% ($552.47 per month alone) with pain during at least two listed activities for 12+ months.
• 15 cm or greater in one dimension: Reflects clinically significant surgical “loss of domain” (LOD), where abdominal contents permanently inhabit the hernia sac (87 FR 1535). Warrants 60% ($1,435.02 per month alone) with pain during two listed activities, or 100% ($3,938.58 per month alone) with pain during at least three listed activities.

3. Functional pain under the Carolinas Comfort Scale activities

The VA adapted four activity categories from the Carolinas Comfort Scale (CCS) (87 FR 1535): (1) bending over, (2) activities of daily living (ADLs)—where under Note (2), pain during any one of bathing, dressing, hygiene, and/or transfers is sufficient—(3) walking, and (4) climbing stairs.

4. The 0 percent evaluation for repairable or repaired hernias

Diagnostic Code 7338 assigns 0% for an “asymptomatic hernia; present and repairable, or repaired.” Under 38 CFR 4.31, a service-connected hernia that does not meet the 10% criteria—such as a newly diagnosed repairable hernia, a small reducible hernia, or a repaired hernia without recurrent protrusion—also receives 0%. A 0% rating establishes service connection, qualifying you for VA surgical repair, a temporary 100% convalescent rating under 38 CFR 4.30 when surgery requires at least one month of convalescence, and separate ratings for postoperative scar or nerve residuals.

Bilateral inguinal hernias under Note (1)

Under Note (1) to Diagnostic Code 7338, with two compensable inguinal hernias, the VA evaluates the more severely disabling inguinal hernia first and adds 10% directly to that rating for the second compensable hernia (unless the first is rated at 100%). Both inguinal hernias must independently qualify for 10% or higher; if the second is rated at 0%, Note (1) does not apply. If the right inguinal hernia warrants 30% and the left warrants 10% or 20%, the VA adds 10% directly to the 30% rating for a single 40% evaluation under DC 7338, rather than applying 38 CFR 4.25 or the extremity bilateral factor in 38 CFR 4.26.

Legacy hernia criteria before May 19, 2024 and rating protection

Before May 19, 2024, 38 CFR 4.114 evaluated groin and abdominal wall hernias under three codes (87 FR 1534):

• Legacy DC 7338 (Hernia, inguinal): Rated at 60% (large, postoperative, recurrent, not well supported under ordinary conditions and not readily reducible, when inoperable), 30% (small, postoperative recurrent, or unoperated irremediable, not well supported by truss, or not readily reducible), 10% (postoperative recurrent, readily reducible and well supported by truss or belt), and 0% (not operated, but remediable; or small, reducible, or without true hernia protrusion), adding 10% for a second compensable bilateral hernia.
• Legacy DC 7339 (Hernia, ventral, postoperative): Rated at 100% (massive, persistent, severe diastasis of recti muscles or extensive diffuse destruction/weakening of muscular and fascial support so as to be inoperable), 40% (large, not well supported by belt under ordinary conditions), 20% (small, not well supported by belt, or healed ventral hernia/postoperative wounds with abdominal wall weakening and indication for a supporting belt), and 0% (healed postoperative wounds, no disability, belt not indicated). Removed May 19, 2024.
• Legacy DC 7340 (Hernia, femoral): Rated as inguinal hernia (DC 7338); removed May 19, 2024.

Under 38 CFR 3.951(a), veterans holding an established rating under Diagnostic Codes 7338, 7339, or 7340 before May 19, 2024 are protected against reductions caused solely by the schedule revision.

Excluded and related hernia codes

• Hiatal and paraesophageal hernias (Diagnostic Code 7346): Excluded from DC 7338 and rated under 38 CFR 4.114, Diagnostic Code 7346 as esophagus, stricture of (Diagnostic Code 7203) at 0%, 10%, 30%, 50%, or 80% alongside GERD (Diagnostic Code 7206).
• Muscle hernias (Diagnostic Code 5326): Rated under 38 CFR 4.73, Diagnostic Code 5326, at 10% for an extensive muscle hernia without other injury to the muscle.
• Anti-pyramiding rule in 38 CFR 4.114: The introductory paragraph of 38 CFR 4.114 bars combining ratings across DCs 7301–7329, 7331, 7342, 7345–7350, 7352, and 7355–7357. Because DC 7338 is excluded from that bar, it can be combined with other digestive ratings and separate scar or nerve evaluations when based on distinct symptoms under 38 CFR 4.14.

Service connection and secondary conditions

Direct service connection under 38 CFR 3.303 requires a current hernia diagnosis (or residual of an in-service repair), in-service injury or surgery documentation, and a medical nexus. Under 38 CFR 3.310(a), secondary service connection applies when a condition is proximately due to or aggravated by an already service-connected disability:

• Hernias secondary to other service-connected conditions: An incisional or ventral hernia may develop at the site of abdominal surgery for another service-connected condition, or a hernia may be caused or aggravated by chronic intra-abdominal pressure from service-connected COPD/asthma coughing, IBS/constipation straining, or ascites from liver disease.
• Painful surgical scars (38 CFR 4.118, Diagnostic Code 7804): When a repaired hernia is rated 0% under DC 7338, a painful or unstable surgical scar may warrant a separate rating under scars (Diagnostic Code 7804) at 10% (1–2 scars), 20% (3–4), or 30% (5 or more), plus 10% under Note 2 if both unstable and painful, provided the same pain is not counted twice under 38 CFR 4.14.
• Ilio-inguinal nerve damage from hernia mesh (38 CFR 4.124a, Diagnostic Codes 8530, 8630, 8730): Mesh contraction, sutures, or scar tissue during inguinal hernia repair may entrap the ilio-inguinal nerve. Under 38 CFR 4.124a, Diagnostic Code 8530 (Paralysis), DC 8630 (Neuritis), and DC 8730 (Neuralgia) rate mild or moderate impairment at 0% and severe to complete paralysis (or severe neuritis with organic changes under 38 CFR 4.123) at 10% (neuralgia under 38 CFR 4.124 is capped at the 0% moderate level).

How the C&P exam and Hernias DBQ measure your condition

At a C&P exam, the clinician completes the Hernias (Including Abdominal, Inguinal and Femoral Hernias) Disability Benefits Questionnaire (DBQ) (updated July 2024 on the VA Public DBQs page). Across Sections III (Femoral), IV (Inguinal), and V (Umbilical, Ventral, Incisional, and Other), the examiner records:

1. Prior hernia surgeries, dates, and affected sides (right, left, or both).
2. Whether a current or recurrent hernia is present, whether it is repairable or irreparable, and the medical justification and source if irreparable.
3. The size of the irreparable hernia in one dimension (15 cm or greater, 3 cm to less than 15 cm, or smaller than 3 cm).
4. Whether the irreparable hernia causes pain during activities of daily living (bathing, dressing, hygiene, and/or transfers), bending over, climbing stairs, or walking for 12 months or more.
5. Associated surgical scars or nerve complications (Section VI).

Combining hernia ratings and getting accredited help

Evaluations under Diagnostic Code 7338 combine with other service-connected ratings using the Combined Ratings Table in 38 CFR 4.25. Estimate your total monthly payment using our VA combined rating calculator.

If you need help documenting an irreparable recurrent hernia or claiming postoperative scar or nerve residuals, a VA-accredited Veterans Service Organization (VSO) such as the DAV, VFW, or American Legion provides free representation, while accredited claims agents and attorneys handle appeals. No representative can guarantee an outcome; verify accreditation through the VA Office of General Counsel Accreditation Search.