Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory bowel disease of the colon and rectum causing bloody diarrhea, urgency, and abdominal pain. Since May 2024 it keeps its own code (7323) but is rated using the Crohn's/IBD criteria under DC 7326, from 10 to 100 percent.
How the VA rates it
The May 19, 2024 revision directs that ulcerative colitis be rated under the criteria for Crohn's disease or undifferentiated inflammatory bowel disease (DC 7326). Ratings depend on daily episode counts of diarrhea and rectal bleeding, treatment intensity (oral/topical agents versus immunosuppressants or biologics), systemic toxicity signs, hospitalizations, and work impact. Diagnosis must be confirmed by endoscopy or radiologic studies. The old UC-specific severity tiers (10/30/60/100 with malnutrition language) no longer apply to new ratings.
Rating criteria by percentage
Rated up to 100%Severe IBD unresponsive to treatment, requiring hospitalization at least once per year, and resulting in either inability to work or recurrent abdominal pain with at least two of: six or more daily episodes of diarrhea, six or more daily episodes of rectal bleeding, recurrent rectal incontinence, or recurrent abdominal distension.
Moderate IBD managed outpatient with immunosuppressants or biologic agents, with recurrent abdominal pain, four to five daily episodes of diarrhea, and intermittent signs of toxicity such as fever, rapid heart rate, or anemia.
Mild to moderate IBD managed with oral and topical agents (not immunosuppressants or biologics), with recurrent abdominal pain, three or fewer daily episodes of diarrhea, and minimal signs of toxicity.
Minimal to mild symptomatic IBD managed with oral or topical agents, with recurrent abdominal pain, three or fewer daily episodes of diarrhea, and no signs of systemic toxicity.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Anemia — Chronic bloody diarrhea from UC commonly causes iron-deficiency anemia.
Evidence that strengthens this claim
- A colonoscopy with biopsy confirming UC is required evidence - VA will not rate on symptoms alone under DC 7326's confirmation note.
- Submit pharmacy records: treatment with a biologic or immunosuppressant is a gate for the 60 percent tier.
- Log daily diarrhea and bleeding episodes during flares and keep ER/hospitalization records - annual hospitalization is part of the 100 percent criteria.
- After a total colectomy, compare the DC 7329 resection ratings (60-100 percent for total colectomy scenarios) against DC 7326 - VA must use the higher.
Rating rules to know
DC 7323 is on the digestive no-combining list: VA assigns one rating for the predominant digestive disability picture rather than combining intestinal codes.
Related diagnostic codes
More digestive conditions
GERD (Gastroesophageal Reflux Disease)
GERD is chronic acid reflux from the stomach into the esophagus, causing heartburn, regurgitation, and sometimes difficulty swallowing. Since May 19, 2024 it has its own diagnostic code (7206) and is rated on esophageal stricture criteria - how badly documented narrowing of the esophagus affects swallowing and what treatment it requires.
Rated up to 80%
Irritable Bowel Syndrome (IBS)
IBS is a functional bowel disorder causing abdominal pain tied to bowel movements, with diarrhea, constipation, bloating, or urgency. Since the May 2024 revision it is rated 10, 20, or 30 percent based on how often pain related to defecation occurs.
Rated up to 30%
Hemorrhoids
Hemorrhoids are swollen veins in the rectum or anus that can bleed, prolapse, or form painful clots (thrombosis). Under the May 2024 criteria they are rated 10 or 20 percent based on bleeding with anemia, prolapse, and how many thrombosis episodes occur per year.
Rated up to 20%
Inguinal Hernia
An inguinal hernia is tissue bulging through a weak spot in the groin wall. Since May 2024, DC 7338 covers all abdominal wall hernias (inguinal, femoral, umbilical, ventral, incisional - but not hiatal) and rates 0 to 100 percent based on whether the hernia is irreparable, its size, and pain during daily activities.
Rated up to 100%
Peptic Ulcer Disease
Peptic ulcer disease is open sores in the stomach or duodenum causing abdominal pain, nausea, and sometimes bleeding. The May 2024 revision consolidated the old separate gastric, duodenal, and marginal ulcer codes into a single DC 7304 rated on episode frequency, bleeding, and hospitalization.
Rated up to 100%
Gallbladder Disease (Chronic Biliary Tract Disease)
Chronic gallbladder and biliary tract disease causes recurring attacks of right-upper-abdominal pain with nausea and vomiting. Since May 2024, DC 7314 covers chronic biliary tract disease broadly and rates 0, 10, or 30 percent based on documented attack frequency over the past 12 months.
Rated up to 30%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.