38 CFR Part 4 — 38 CFR § 4.114
Colitis Ulcerative
dc-7323-colitis-ulcerative
Digestive
Diagnostic code
7323
Why your DC matters: DC 7323 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7323 — Colitis Ulcerative — is listed under 38 CFR § 4.114 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7323) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7323”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7323 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7323 in the subpart for your body system (use Find in Page if needed).
Ulcerative colitis under DC 7323 has the highest top-tier in the entire digestive subpart — 100% for severe disease with frequent exacerbations and serious complications. But the schedule's 'severe' bar is much stricter than veterans expect: 'numerous attacks per year' + 'malnutrition' + 'health only fair during remissions.' Most veterans with even active disease land at 30%-60% because they don't document the systemic decompensation. The play is colonoscopy + biologic Rx + nutritional labs. Note: VA restructured § 4.114 in May 2024 — some references now point to DC 7326 (consolidated IBD).
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Pronounced; resulting in marked malnutrition, anemia, and general debility, OR with serious complication as liver abscess. | Albumin/prealbumin trending low; serial CBCs showing anemia; hospitalization records; complication-specific documentation (abscess, megacolon, perforation). |
| 60% | Severe; with numerous attacks a year and malnutrition, the health only fair during remissions. | Colonoscopy showing active inflammation; 5+ documented flares/year; albumin below normal; biologic/immunosuppressive therapy. |
| 30% | Moderately severe; with frequent exacerbations. | GI clinic notes documenting 3-4 flares per year; chronic medication (mesalamine, biologics, steroids). |
| 10% | Moderate; with infrequent exacerbations. | Diagnosis + maintenance Rx; 1-2 flares/year. |
What Qualifies Under DC 7323?
Diagnosis of ulcerative colitis
Confirmed by colonoscopy + biopsy showing characteristic findings (continuous mucosal inflammation starting at rectum). Distinct from Crohn's (DC 7326) which can affect any GI segment with skip lesions.
Severity tiers
DC 7323 schedule:
- • 10% — Moderate; infrequent exacerbations
- • 30% — Moderately severe; frequent exacerbations
- • 60% — Severe; numerous attacks + malnutrition + fair health between flares
- • 100% — Pronounced; marked malnutrition + anemia + debility, or serious complication
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Marked malnutrition, anemia, and general debility”
All three. 'Marked malnutrition' = albumin/prealbumin below normal, weight loss documented over months. 'Anemia' = serial Hb below normal. 'General debility' = functional decline note in chart. Without all three, 60% is the cap.
“Numerous attacks per year + malnutrition + fair health during remission”
All three required. 'Numerous' = 5+ flares/year. Need albumin documenting malnutrition AND chart notes that even between flares you're not fully well.
“Frequent exacerbations”
'Frequent' = more than 2/year. Most veterans actually qualify here but get rated 10% for lack of flare-count documentation. Keep a flare diary.
Evidence Checklist — Specific to This Condition
Colonoscopy reports with biopsy
CRITICALConfirms UC vs. Crohn's vs. other IBD. Each colonoscopy documenting active disease supports continued/worsening rating.
Flare diary documenting attacks per year
CRITICALDate, severity (bowel movements/day, blood, abdominal pain), treatment escalation. Drives the tier gates (frequent / numerous).
Medication history (mesalamine, steroids, biologics, immunomodulators)
CRITICALTreatment escalation from 5-ASA → steroids → biologics (infliximab, adalimumab, vedolizumab, ustekinumab) supports severity narrative.
Nutritional labs (albumin, prealbumin, weight trend)
CRITICALThe 60%/100% gates. Albumin below normal + weight loss is the 'malnutrition' criterion.
CBC trend showing anemia
IMPORTANTChronic GI blood loss + inflammatory anemia. Hb below normal on serial draws.
C&P Exam Tips
Bring flare diary covering ≥ 12 months
Number of flares per year is the tier gate. Hand the diary directly to the examiner.
Bring nutritional labs (albumin, prealbumin) + weight trend
These unlock 60%/100%. Most veterans don't realize albumin is the malnutrition proxy.
List every medication tried, with response
Failed mesalamine, steroids dependence, biologic escalation — this is the severity narrative.
Don't downplay between-flare symptoms
VA reads 'fair health during remissions' as ongoing fatigue, abdominal discomfort, dietary restriction. If you say 'I feel normal between flares,' you cap at 30%.
Common Mistakes That Cost Veterans Points
Filing as 'colitis' or 'IBD' instead of ulcerative colitis
Specific diagnosis = specific DC. Make sure GI clinic documents UC vs. Crohn's (DC 7326).
Not documenting nutritional status
Without albumin/prealbumin + weight trend, you cap at 30%. Get these labs annually.
Letting the rating stand after biologic escalation
Starting infliximab/adalimumab is fresh evidence of severity. File supplemental immediately after biologic initiation.
Tactical Plays
⚡ Get albumin drawn — it's the malnutrition proxy
VA reads 'malnutrition' through albumin/prealbumin + weight trend. Both are routine labs your GI can order. Without them, 60% and 100% are unreachable.
⚡ Biologic escalation = re-file immediately
When you move from mesalamine → steroids → biologics (infliximab, adalimumab, vedolizumab, ustekinumab), that's fresh evidence of severity. File supplemental within 30 days of starting the biologic.
⚡ Pursue extra-intestinal manifestations as secondaries
UC arthropathy, erythema nodosum, primary sclerosing cholangitis (PSC), uveitis — all rate separately under their own DCs. Most veterans don't realize these are SC-eligible.
Secondary Conditions to File With This One
Iron-deficiency anemia
STRONGDC 7700
Chronic GI blood loss + inflammatory anemia in UC is very common and rates separately under DC 7700.
Mental health (depression, anxiety)
STRONGDC 9434
Chronic GI illness with frequent flares and dietary restriction drives well-documented secondary mood disorders.
Arthritis (peripheral or axial)
MODERATEDC 5009
UC has well-documented extra-intestinal manifestations including enteropathic arthritis. Rate separately under DC 5009/5002 (rheumatoid analog).
Erythema nodosum / pyoderma gangrenosum
SITUATIONALDC 7806
Extra-intestinal skin manifestations of UC; rate by analogy to dermatitis.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Moderate UC; infrequent flares; maintenance mesalamine only.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Frequent flares (3-4/yr); chronic medication.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Numerous flares (5+/yr) + albumin below normal + biologic therapy.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Pronounced UC with marked malnutrition + anemia + complications.
60% UC + 30% MDD + 10% anemia
Base rating
$2,102.15
TOTAL
$2,102.15/mo
Combined ~76% rounds to 80% with separately-rated secondaries.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
🥄What is 'Malnutrition' in this context?
Lab-confirmed nutritional deficiency — albumin below normal (~3.5 g/dL), prealbumin below 15 mg/dL, or documented unintentional weight loss > 10% in 6 months. The 60%/100% gate.
↔️What's the difference between UC and Crohn's?
UC = continuous inflammation limited to colon, starting at rectum. Crohn's = transmural inflammation, skip lesions, can affect any GI segment from mouth to anus. UC rates under DC 7323; Crohn's under DC 7326 (post-2024 consolidated IBD).
🔢What are 'Numerous Attacks Per Year'?
VA reads this as 5+ flare episodes per year. A flare = significant worsening requiring medication escalation, ER visit, or hospitalization.
How to File Your Claim
Pull all colonoscopy reports with biopsies
Confirms diagnosis + documents inflammation extent and severity.
Build a flare diary covering 12+ months
Number of flares/year is the primary tier gate. Severity + treatment for each.
Get nutritional labs (albumin, prealbumin) + weight trend
Unlocks 60%/100%. Order annually if possible.
File 21-526EZ specifying 'ulcerative colitis (DC 7323)'
Be specific — don't write 'IBD' or 'colitis.'
File secondaries simultaneously (anemia, MH, arthropathy)
Lock the effective date. Each can rate substantially on its own.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Severity gates are stricter than they sound
'Severe' = numerous attacks + malnutrition + fair health between flares (all three). Document all three or cap at 30%.
Biologic Rx is fresh evidence of severity
Starting infliximab/adalimumab/vedolizumab supports an immediate increase claim.
Extra-intestinal manifestations rate separately
Arthropathy, erythema nodosum, PSC, uveitis — each is its own potential rating.
May 2024 restructuring
VA updated § 4.114 May 19, 2024. Crohn's moved to DC 7326. UC retained DC 7323. Verify current language on eCFR before filing.
Related Tools & Resources
Frequently Asked Questions
What's the difference between DC 7323 and DC 7326?
DC 7323 = ulcerative colitis specifically. DC 7326 (post-May 2024) = inflammatory bowel disease consolidated code for Crohn's disease, indeterminate colitis, and other IBD that isn't UC. File under the specific diagnosis.
Can I claim UC and IBS separately?
Yes if both diagnoses are documented. IBS (DC 7319) is a functional disorder; UC is structural inflammatory. They can coexist.
Does colectomy (surgery) for UC change the rating?
Total colectomy with ileoanal pouch may be rated under DC 7332 (rectum/anus impairment) for the pouch, plus residual ratings for pouchitis and quality-of-life impact. Often results in a lower rating than pre-surgery active UC — pursue residuals carefully.
Is UC presumptive for any service period?
Not currently as a category. Direct service connection via in-service GI complaints or post-service onset within applicable presumptive windows is the path.
Official Regulatory Source
Ulcerative colitis is rated under 38 CFR § 4.114, DC 7323.
38 CFR § 4.114 — Digestive System (eCFR) →Scroll to DC 7323. § 4.114 was substantially restructured May 19, 2024.
⚠️ Verify with a VSO
§ 4.114 was restructured effective May 19, 2024. DC 7323 was retained for UC; Crohn's moved to DC 7326. Verify current criteria text on eCFR for claims filed after May 2024.
Next Steps
If your rating decision lists DC 7323, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7323 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.