VA Disability Rating for Crohn's Disease 2026: DC 7326

Crohn's disease is rated under diagnostic code 7326 in 38 CFR 4.114 at 10, 30, 60, or 100 percent. There is no 20, 40, 50, 70, 80, or 90 percent level under that code. Each level requires three things together: a treatment level, a count of daily diarrhea episodes, and a finding about systemic toxicity. What most veterans miss is that DC 7326 rates the inflammation only. The complications Crohn's is known for, strictures, fistulas, perianal abscesses, bowel resections, and ostomies, are rated under separate diagnostic codes, and some of those pay more than 7326 ever can.

Which page do you want? If your diagnosis is ulcerative colitis, the rating math is identical because DC 7323 now says only "Rate as Crohn's disease or undifferentiated form of inflammatory bowel disease (DC 7326)." Our ulcerative colitis rating guide covers that route. If you have no confirmed structural disease and were diagnosed with irritable bowel syndrome, that is DC 7319 and a completely different claim. See our IBS rating guide. This page is for Crohn's disease and for the surgical and fistulizing complications that come with it.

Crohn's Disease Got Its Own Diagnostic Code in 2024

Before May 19, 2024, Crohn's disease had no diagnostic code. In the version of 38 CFR 4.114 that ran through 2023, DC 7326 read "Enterocolitis, chronic. Rate as for irritable colon syndrome." Crohn's was rated by analogy, usually as 7399-7323 (ulcerative colitis, which topped out at 100 percent) or as 7399-7319 (irritable colon syndrome, which topped out at 30 percent).

That second path is why a lot of veterans are sitting on a 30 percent Crohn's rating that could not legally go higher no matter how bad the disease got. The old DC 7319 ladder was 30 for "severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress," 10 for moderate, and 0 for mild. Thirty was the ceiling.

VA's digestive system final rule, published March 20, 2024 and effective May 19, 2024 (89 FR 19735), retitled DC 7326 to "Crohn's disease or undifferentiated form of inflammatory bowel disease" and gave it real criteria running to 100 percent. If you were rated by analogy under the old irritable colon code, you now have a schedular path above 30 that did not exist before.

DC 7326 Rating Criteria for 2026

This is the current text of the code.

Rating	Criteria (38 CFR 4.114, DC 7326)
100%	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
60%	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
30%	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
10%	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

Three notes follow the code:

Note (1): Following colectomy or colostomy with persistent or recurrent symptoms, rate either under DC 7326 or DC 7329 (Intestine, large, resection of), whichever provides the highest rating.
Note (2): VA requires diagnoses under DC 7326 to be confirmed by endoscopy or radiologic studies.
Note (3): Inflammation may involve small bowel (ileitis), large bowel (colitis), or inflammation of any component of the gastrointestinal tract from the mouth to the anus.

Note (3) exists because of Crohn's. Ulcerative colitis stays in the colon and rectum. Crohn's can sit anywhere from the mouth to the anus, and roughly a third of patients have disease confined to the small bowel. The note tells raters that ileal-only disease is fully within DC 7326 and does not need colonic involvement to qualify.

Proving the Diagnosis When the Colonoscopy Is Clean

Note (2) is the single most common reason a Crohn's claim dies, and it hits small bowel Crohn's hardest. A rater cannot apply DC 7326 on a symptom history alone. The file needs endoscopy or radiologic studies.

The "or radiologic studies" half of that note is the part that matters if your disease is in the terminal ileum or jejunum, where a standard colonoscopy may reach nothing abnormal. Evidence that satisfies Note (2) for small bowel disease includes CT enterography, MR enterography, small bowel follow-through, and video capsule endoscopy. Ileocolonoscopy with terminal ileal intubation and biopsy is still the gold standard when the scope can reach the diseased segment.

Get the actual reports into the claims file, not just a clinic note saying "history of Crohn's." Fecal calprotectin, C-reactive protein, and elevated sedimentation rate support the picture but do not by themselves satisfy Note (2).

The 30 to 60 Percent Line Is Your Medication Class

The largest jump in this schedule is 30 to 60, and it turns on drug class more than on how you feel.

The 30 percent tier covers disease "managed with oral and topical agents (other than immunosuppressants or other biologic agents)." That is mesalamine, sulfasalazine, budesonide, and rectal preparations. The 60 percent tier covers disease "managed on an outpatient basis with immunosuppressants or other biologic agents." That is the anti-TNF, anti-integrin, and anti-interleukin biologics, plus azathioprine, 6-mercaptopurine, and methotrexate.

If you are infusing or injecting a biologic, the record should name the drug, name the class, and show current use. A surprising number of veterans on infliximab or ustekinumab are rated 30 percent because no one in the file ever connected the prescription to the criterion.

The 60 percent level also requires recurrent abdominal pain with four to five daily episodes of diarrhea and intermittent signs of toxicity such as fever, tachycardia, or anemia. Anemia is the easiest of the three to document because it appears in routine labs, and iron deficiency anemia is common in Crohn's. Make sure hemoglobin, ferritin, and iron saturation results are in the file.

What 100 Percent Under DC 7326 Requires

The 100 percent criterion is conjunctive. All three parts must be present:

Severe inflammatory bowel disease unresponsive to treatment, and
Hospitalization at least once per year, and
Either an inability to work, or recurrent abdominal pain with at least two of these four: six or more daily episodes of diarrhea, six or more daily episodes of rectal bleeding, recurrent rectal incontinence, or recurrent abdominal distension.

"Unresponsive to treatment" is the gate that stops most claims. A veteran doing well on vedolizumab is responsive by definition, and that record supports 60, not 100, no matter how disruptive the disease is day to day. The files that reach 100 percent typically show failed or exhausted biologic therapy, at least one inpatient admission in the last 12 months, and either a work history that ended because of the disease or a dated symptom log hitting two of the four findings.

If you cannot meet the schedular criteria but Crohn's keeps you from holding substantially gainful employment, the target is total disability based on individual unemployability, which pays at the 100 percent rate without a 100 percent schedular rating. Our TDIU guide covers the 38 CFR 4.16 thresholds.

Crohn's Complications That Rate Under Other Codes

This is where Crohn's claims differ most from ulcerative colitis claims, and where the real money often sits. DC 7326 rates inflammation. It does not rate what the inflammation did to your anatomy.

Code	Condition	Range
7301	Peritoneum, adhesions of, due to surgery, trauma, disease, or infection	0 to 80%
7327	Diverticulitis and diverticulosis	0 to 30%
7328	Intestine, small, resection of	0 to 80%
7329	Intestine, large, resection of	10 to 100%
7330	Intestinal fistulous disease, external	30 to 100%
7332	Rectum and anus, impairment of sphincter control	0 to 100%
7333	Rectum and anus, stricture of	10 to 100%
7335	Ano, fistula in, including anorectal fistula and anorectal abscess	10 to 60%

Strictures and Bowel Obstruction, DC 7301

Stricturing Crohn's is common and DC 7301 names the disease directly. Every compensable level of 7301 describes "symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn's disease, or infection, as determined by a healthcare provider."

The levels are 80 percent for "persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition (TPN) for obstructive symptoms"; 50 percent when there is recurrent obstruction requiring hospitalization at least once a year plus medically directed dietary modification plus at least one of abdominal pain, nausea, vomiting, colic, constipation, or diarrhea; 30 percent for the same picture with dietary modification but without the annual hospitalization; and 10 percent with one of those symptoms and no dietary modification. Note the 80 percent ceiling. A veteran with refractory obstructive disease can reach a higher evaluation under DC 7301 than the 60 percent that outpatient biologic management gets under DC 7326.

Small Bowel Resection and Short Bowel Syndrome, DC 7328

Ileal resection is the most common Crohn's surgery, and its consequences rate under DC 7328: 80 percent for "status post intestinal resection with undernutrition and anemia; and requiring total parenteral nutrition (TPN)"; 60 percent for the same with oral dietary supplementation, continuous medication, and intermittent TPN; 40 percent with four or more daily diarrhea episodes producing undernutrition and anemia and requiring supplementation plus continuous medication; 20 percent for resection with four or more daily diarrhea episodes; and 0 percent when asymptomatic. The note under DC 7328 says the code "includes short bowel syndrome, mesenteric ischemic thrombosis, and post-bariatric surgery complications," and adds that where short bowel syndrome causes high-output syndrome, including a high-output stoma, VA should consider a higher evaluation under DC 7329.

Colectomy and Ostomy, DC 7329

Under DC 7329, total colectomy with formation of ileostomy plus high-output syndrome plus more than two episodes of dehydration requiring intravenous hydration in the past 12 months is 100 percent. Total colectomy with or without a permanent colostomy or ileostomy and without high-output syndrome is 60 percent. Partial colectomy with a permanent colostomy or ileostomy without high-output syndrome is 40 percent. Partial colectomy with reanastomosis, loss of the ileocecal valve, and recurrent diarrhea more than three times per day is 20 percent, and partial colectomy with reanastomosis alone is 10 percent.

Two cross-references matter. DC 7326 Note (1) directs the rater to use DC 7326 or DC 7329, whichever is higher, after colectomy or colostomy with persistent symptoms. DC 7333 Note (2) instructs raters to "evaluate an ostomy as Intestine, large, resection of (DC 7329)."

Fistulas, DC 7330 and DC 7335

Perianal fistulizing disease is a defining feature of Crohn's and it has its own code. DC 7335, now titled "Ano, fistula in, including anorectal fistula and anorectal abscess," pays 60 percent for "more than two constant or near-constant fistulas with abscesses, drainage, and pain, which are refractory to medical and surgical treatment," 40 percent for one or two simultaneous fistulas with abscess, drainage, and pain, 20 percent for two or more simultaneous fistulas with drainage and pain but no abscess, and 10 percent for one fistula with drainage and pain without abscess.

Enterocutaneous fistulas rate under DC 7330 at 30, 60, or 100 percent depending on nutritional support and discharge volume, measured in ostomy bags per day, pad changes per day, and body mass index. The note limits DC 7330 to "external fistulas that have developed as a consequence of abdominal trauma, surgery, radiation, malignancy, infection, or ischemia," so a fistula that followed bowel surgery fits, and a spontaneous internal enteroenteric fistula generally does not.

Repeated seton placement, fistulotomy, and abscess drainage can also leave lasting sphincter impairment, rated under DC 7332 at 0 to 100 percent based on incontinence frequency, pad use, and how well a physician-prescribed bowel program controls it. Anal stricture rates under DC 7333 at 10 to 100 percent based on how much the lumen is narrowed, from narrowing managed by diet at 10 percent to inability to open the anus with inability to expel solid feces at 100 percent.

Which Ratings Stack and Which Do Not

The opening paragraph of 38 CFR 4.114 controls this: "Do not combine ratings under diagnostic codes 7301 through 7329 inclusive, 7331, 7342, 7345 through 7350 inclusive, 7352, and 7355 through 7357 inclusive, with each other. Instead, when more than one rating is warranted under those diagnostic codes, assign a single evaluation under the diagnostic code that reflects the predominant disability picture, and elevate it to the next higher evaluation if warranted by the severity of the overall disability."

Code	Inside the no-combine list?	Effect with DC 7326
7301 adhesions and obstruction	Yes	One evaluation only, under the predominant code, with possible elevation
7319 IBS	Yes	One evaluation only
7327 diverticular disease	Yes	One evaluation only
7328 small bowel resection	Yes	One evaluation only
7329 large bowel resection, ostomy	Yes	One evaluation only, and DC 7326 Note (1) says take the higher
7330 external fistula	No	May be separately evaluated
7332 sphincter control	No	May be separately evaluated
7333 anal stricture	No	May be separately evaluated
7335 fistula in ano, anorectal abscess	No	May be separately evaluated

Two practical consequences. First, the elevation clause is a real benefit. A veteran whose predominant picture is 30 percent Crohn's under DC 7326 with a separate 30 percent picture under another code inside the list can be assigned a single evaluation elevated to the next level, 60 percent, when the overall severity warrants it. Ask for that elevation by name.

Second, the codes outside the list are still subject to the general anti-pyramiding rule at 38 CFR 4.14, which prohibits evaluating the same manifestation twice. Perianal fistula drainage under DC 7335 and diarrhea frequency under DC 7326 are different manifestations. Rectal incontinence counted toward the 100 percent level of DC 7326 and incontinence counted again under DC 7332 is the same manifestation, and VA will not pay for it twice.

Extraintestinal manifestations, including inflammatory arthritis, sacroiliitis, uveitis, and skin involvement, are rated under the diagnostic codes for those body systems rather than under 4.114, and they combine normally under 38 CFR 4.25 once secondary service connection is established.

Claims Filed Before May 19, 2024

If your Crohn's claim or appeal was pending when the new schedule took effect, both versions of the criteria apply and VA uses whichever is more favorable, with one limit. The Board of Veterans' Appeals put it this way in a 2025 decision applying the new DC 7326: "the old and new regulations are both for consideration with regard to rating the Veteran's disability, and the more favorable regulation will be applied, with the exception that if the revised criteria are more favorable to the Veteran and provide for an increased rating, that award may not be made effective before the effective date of the regulatory change."

That limit comes from 38 U.S.C. 5110(g) and 38 CFR 3.114. An increase driven by the new criteria cannot be paid earlier than May 19, 2024.

Going the other direction, a rating change alone cannot cost you anything. 38 CFR 3.951(a) says "a readjustment to the Schedule for Rating Disabilities shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." The caveat is that filing for an increase triggers a reexamination, and a reexamination showing genuine medical improvement can support a reduction under the ordinary rules. Our rating increase guide covers that tradeoff.

Service Connection for Crohn's Disease

Crohn's disease is not on any presumptive list. It is not a PACT Act burn pit presumptive condition and it is not a Camp Lejeune presumptive condition, so claims are built directly or secondarily.

Direct service connection requires a current diagnosis confirmed by endoscopy or imaging, an in-service event or symptom onset, and a medical nexus opinion connecting them. Many veterans first present in service with chronic diarrhea, urgency, right lower quadrant pain, perianal abscess, or unexplained weight loss and are treated for a presumed infection. Service treatment records documenting that episode, paired with a later confirmed diagnosis, are the backbone of most successful claims, and a well built nexus letter addressing the gap between in-service symptoms and post-service diagnosis is usually the deciding document. Secondary service connection uses the same structure but points the nexus at an already service-connected condition or its long-term treatment.

The Gulf War undiagnosed illness presumption at 38 CFR 3.317 generally does not help. That regulation covers functional gastrointestinal disorders defined as conditions unexplained by any structural, endoscopic, laboratory, or other objective signs of injury or disease. Crohn's is the opposite of that, since DC 7326 Note (2) requires objective confirmation. Gulf War veterans with IBS can use the presumption. Gulf War veterans with Crohn's generally cannot.

2026 VA Disability Pay

These rates took effect December 1, 2025 with the 2.8 percent cost of living adjustment. Monthly, veteran with no dependents.

Combined rating	Monthly payment
10%	$180.42
20%	$356.66
30%	$552.47
40%	$795.84
50%	$1,132.90
60%	$1,435.02
70%	$1,808.45
80%	$2,102.15
90%	$2,362.30
100%	$3,938.58

Dependents are added at 30 percent and above. A veteran rated 100 percent with a spouse receives $4,158.17 per month, and $4,318.99 with a spouse and one child. The full 2026 rate chart has the dependent tables.

How to File a Crohn's Disease Claim

Satisfy Note (2) first. Pull the ileocolonoscopy report, the pathology, and any CT or MR enterography, small bowel follow-through, or capsule study. Without objective confirmation the rater cannot apply DC 7326 at all.
Classify every medication. List each drug by name with start and stop dates, and label it as an aminosalicylate, corticosteroid, immunosuppressant, or biologic. That single classification decides 30 versus 60.
Inventory the complications separately. Strictures, obstructions, abscesses, perianal or enterocutaneous fistulas, resections, ostomies, and sphincter damage each need their own operative reports and imaging, because each may rate under its own code.
Document hospitalizations and keep a dated symptom log. Discharge summaries from the past 12 months drive the 50 percent level of DC 7301 and the 100 percent level of DC 7326. Log diarrhea episodes, rectal bleeding, incontinence events, distension, and pad changes by date, since the criteria are counted in episodes per day.
Get a nexus opinion if service connection is not established, from a physician who reviews the service treatment records and gives a rationale.
File VA Form 21-526EZ on VA.gov, by mail, or through an accredited representative, then prepare for the C&P exam. The examiner works from a disability benefits questionnaire built on the DC 7326 criteria, so answer in the units the criteria use: episodes per day, hospitalizations per year, current drug class.

Frequently Asked Questions

What is the VA rating for Crohn's disease in 2026?

Crohn's disease is rated under DC 7326 at 10, 30, 60, or 100 percent. There is no 20, 40, 50, 70, 80, or 90 percent evaluation under that code. Surgical and fistulizing complications may rate higher under separate codes.

Can Crohn's disease be rated 100 percent?

Yes, but the criteria are cumulative. You need severe disease unresponsive to treatment, plus hospitalization at least once per year, plus either an inability to work or recurrent abdominal pain with at least two of these four findings: six or more daily diarrhea episodes, six or more daily rectal bleeding episodes, recurrent rectal incontinence, or recurrent abdominal distension. A veteran stable on a biologic is responsive to treatment and will not meet the first element.

Can I get a separate rating for a perianal fistula?

Often yes. DC 7335 covers fistula in ano, including anorectal fistula and anorectal abscess, at 10 to 60 percent, and it sits outside the 7301 through 7329 range that 38 CFR 4.114 bars from being combined. Separate evaluation still has to satisfy 38 CFR 4.14, meaning the fistula findings must be distinct from the symptoms already counted under DC 7326.

Does an ileostomy or colostomy change my rating?

Yes. DC 7326 Note (1) says that after colectomy or colostomy with persistent or recurrent symptoms, VA rates under DC 7326 or DC 7329, whichever is higher. Under DC 7329, a partial colectomy with a permanent ostomy without high-output syndrome is 40 percent, a total colectomy with or without a permanent ostomy and without high-output syndrome is 60 percent, and a total colectomy with ileostomy plus high-output syndrome plus more than two dehydration episodes requiring IV hydration in the past 12 months is 100 percent.

What if my Crohn's is only in the small intestine?

DC 7326 still applies. Note (3) states that inflammation may involve small bowel (ileitis), large bowel (colitis), or any component of the gastrointestinal tract from the mouth to the anus. For small bowel disease, satisfy Note (2) with radiologic studies such as CT or MR enterography, small bowel follow-through, or capsule endoscopy, since a standard colonoscopy may look normal.

I was rated 30 percent for Crohn's years ago. Can I get more now?

Possibly. Before May 19, 2024, Crohn's had no code of its own and was often rated by analogy under the old irritable colon syndrome code, which capped at 30 percent. The current DC 7326 has 60 and 100 percent levels. An increase based on the revised criteria cannot be made effective earlier than May 19, 2024 under 38 U.S.C. 5110(g), and filing does trigger a reexamination.

Will VA reduce my old rating because the criteria changed?

Not for that reason alone. 38 CFR 3.951(a) says a readjustment to the rating schedule is not grounds for reduction unless medical evidence establishes actual improvement, and VA said in the final rule that the change would not disturb ratings currently in effect. Ratings continuously in effect 20 years or more get additional protection under 38 CFR 3.951(b).

Is Crohn's disease a PACT Act presumptive condition?

No. Inflammatory bowel disease is not on the burn pit presumptive list. Veterans with burn pit exposure can still claim Crohn's on a direct basis with a medical nexus opinion, but there is no presumption to fall back on.