38 CFR Part 4 — 38 CFR § 4.114
Crohn S Disease Or Undifferentiated Form Of Inflammatory Bowel Disease
dc-7326-crohn-s-disease-or-undifferentiated-form-of-inflammatory-bowel-disease
Digestive
Diagnostic code
7326
Why your DC matters: DC 7326 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 7326 — Crohn S Disease Or Undifferentiated Form Of Inflammatory Bowel Disease — 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 (7326) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7326”. 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 7326 (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 7326 in the subpart for your body system (use Find in Page if needed).
Crohn's disease moved to DC 7326 in the May 2024 § 4.114 restructure (older claims were rated by analogy to DC 7323 ulcerative colitis). DC 7326 is the consolidated IBD code covering Crohn's, indeterminate colitis, and other IBD variants. The tier-driver isn't bowel movement frequency — it's steroid dependence, biologic therapy, and surgical history. Veterans on chronic prednisone or biologics + with multiple bowel resections should be at 60%+.
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 (fistula, abscess, obstruction). | Albumin/prealbumin low; serial CBCs anemic; hospitalization records; complication documentation (enterocutaneous fistula, intra-abdominal abscess, obstruction). |
| 60% | Severe; with numerous attacks per year, malnutrition, and only fair health between flares. | Colonoscopy/imaging showing active disease; 5+ documented flares/year; albumin low; biologic therapy; possible prior bowel resection. |
| 30% | Moderately severe; with frequent exacerbations. | GI clinic notes documenting 3-4 flares/year; chronic medication (mesalamine, biologics, immunomodulators). |
| 10% | Moderate; with infrequent exacerbations. | Diagnosis + maintenance Rx; 1-2 flares/year. |
What Qualifies Under DC 7326?
Diagnosis of Crohn's disease or non-UC inflammatory bowel disease
Confirmed by colonoscopy + biopsy or imaging (MR/CT enterography). Characteristic findings: transmural inflammation, skip lesions, can affect any GI segment (mouth to anus).
Severity tiers
DC 7326 tiers:
- • 10% — Moderate; infrequent exacerbations
- • 30% — Moderately severe; frequent exacerbations
- • 60% — Severe; numerous attacks + malnutrition + only fair health between flares
- • 100% — Pronounced; marked malnutrition + anemia + debility, OR serious complication (fistula, abscess, obstruction)
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.
“Serious complication such as fistula, abscess, or obstruction”
Crohn's complications uniquely qualify for 100% even without severe malnutrition. Enterocutaneous fistula, intra-abdominal abscess, or bowel obstruction documented = 100% pathway distinct from the malnutrition criteria.
“Numerous attacks per year + malnutrition + fair health between flares”
All three. Malnutrition = albumin or prealbumin below normal. Numerous = 5+ flares per year. Fair health = chronic fatigue / dietary restriction / ongoing symptoms even between flares.
“Frequent exacerbations”
More than 2/year qualifies. Most veterans on biologics actually qualify here but get rated 10% for lack of flare-count documentation.
Evidence Checklist — Specific to This Condition
Colonoscopy + biopsy (or imaging if small-bowel)
CRITICALConfirms Crohn's vs. UC vs. other IBD. CT enterography or MR enterography for small-bowel disease.
Flare diary
CRITICALEpisodes per year + treatment escalation for each. Drives the tier.
Medication history including biologics
CRITICALMesalamine → steroids → biologics (infliximab, adalimumab, ustekinumab, vedolizumab, risankizumab). Treatment escalation = severity proof.
Surgical history
CRITICALBowel resections, strictureplasties, abscess drainage, fistula repairs. Each surgery + complications strengthens the severity case.
Nutritional labs + weight trend
CRITICALAlbumin, prealbumin, B12, vitamin D, weight trend. Crohn's frequently causes malabsorption.
C&P Exam Tips
Bring all imaging reports (MR/CT enterography)
Examiners often focus on colonoscopy. Crohn's small-bowel disease requires enterography for severity assessment.
Bring complete surgical history with op reports
Each bowel resection is significant. Some veterans have multiple resections years apart and never realized this drives a 60%+ rating.
Mention every biologic infusion / injection schedule
Infliximab every 8 weeks, adalimumab every 2 weeks, ustekinumab every 8 weeks. Show the chronicity.
Don't say 'I'm doing OK on Humira'
Needing a biologic IS the severity. If you say you're 'fine' on the biologic, the rater reads that as well-controlled. Frame it as: 'I require ongoing biologic therapy to prevent severe disease.'
Common Mistakes That Cost Veterans Points
Filing under DC 7323 instead of DC 7326
Post-May 2024, Crohn's has its own code (DC 7326). Using the right DC matters for tier criteria interpretation.
Not claiming surgical scar separately
Every bowel resection leaves an abdominal scar — DC 7804 if painful, DC 7800/7801 by size. Stack on top.
Skipping fistula/abscess as separate complications
Enterocutaneous fistula or perianal disease are separately ratable conditions, often under DC 7332 (rectum/anus impairment).
Tactical Plays
⚡ Audit every bowel resection — each one matters
Multiple bowel resections over a Crohn's lifetime is severity evidence. Pull all op reports. Multiple resections + biologic dependence = clear 60% case.
⚡ Perianal fistula = separate rating
Perianal Crohn's is common and rates under DC 7335 (fistula-in-ano) as a separate condition. Most veterans miss this.
⚡ Document the biologic as 'required for control'
Frame Humira/Remicade as ongoing medical necessity, not 'doing well.' If you stopped the biologic, you'd flare — that's the severity proof.
Secondary Conditions to File With This One
Surgical abdominal scar
STRONGDC 7804
Every bowel resection leaves a scar — painful/unstable = DC 7804. Large = DC 7801 by size.
Perianal disease / fistula-in-ano
STRONGDC 7335
Perianal Crohn's is common; rates separately under DC 7335 (fistula-in-ano).
Iron-deficiency anemia
STRONGDC 7700
Crohn's commonly causes chronic blood loss + malabsorption-induced anemia.
Mental health (anxiety/depression)
STRONGDC 9434
Chronic GI illness drives well-documented mood disorders; rate as secondary.
Osteoporosis (chronic steroid use)
MODERATELong-term prednisone for Crohn's flares causes osteoporosis; rate by analogy if disabling.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Moderate Crohn's; infrequent flares; mesalamine maintenance.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Frequent flares (3-4/yr); chronic medication or biologic.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Severe; 5+ flares/yr + biologic + malnutrition + post-resection.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Pronounced or with serious complication (fistula, abscess, obstruction).
60% Crohn's + 30% perianal fistula + 30% MDD + 10% anemia
Base rating
$2,362.30
TOTAL
$2,362.30/mo
Combined ~88% rounds to 90% with stacked secondaries — a realistic Crohn's profile.
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 does 'Steroid-Dependent' mean for Crohn's?
Inability to taper off prednisone without flaring. Steroid dependence + recurrent flares is severity evidence supporting 60%+.
💉What is a 'Biologic' in IBD?
Targeted immunomodulator — infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), vedolizumab (Entyvio), risankizumab (Skyrizi). Used for moderate-to-severe Crohn's; their use IS severity evidence.
🩺What is Perianal Crohn's?
Crohn's affecting the perianal area — fistulas, abscesses, fissures. Distinct from intestinal disease and rates separately under DC 7335 or by analogy.
How to File Your Claim
Pull colonoscopy + imaging history
Each documenting Crohn's location, extent, and complications.
Compile complete surgical history with op reports
Every resection, stricturoplasty, abscess drainage, fistula repair.
Build flare diary + biologic infusion schedule
Chronic biologic + frequent flares = 60%+ case.
File 21-526EZ specifying 'Crohn's disease (DC 7326)'
Post-May 2024 code. Pre-2024 filings used DC 7323 by analogy.
Stack secondaries: scars, perianal disease, anemia, MH, osteoporosis
Each rates separately. Most veterans miss 2-3 of these.
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
DC 7326 is post-May 2024 — use the right code
Pre-May 2024 Crohn's claims used DC 7323 by analogy. New filings should use DC 7326.
Perianal disease is a separate rating
Don't let perianal fistula/abscess get absorbed into the Crohn's rating. DC 7335 rates separately.
Biologic Rx = severity evidence
Needing infliximab/adalimumab/ustekinumab IS the severity. Frame ongoing biologic therapy as medical necessity, not 'well-controlled.'
Audit every surgical scar (DC 7804)
Each bowel resection leaves a scar. Painful = own rating.
Related Tools & Resources
Frequently Asked Questions
Why is Crohn's now DC 7326 instead of 7323?
Per the May 2024 § 4.114 restructure, Crohn's disease and other non-UC IBD were consolidated under a new DC 7326. UC retained DC 7323. The tier criteria (10/30/60/100%) are essentially parallel between the two codes.
Does taking Humira mean I'm 'severe'?
Biologic therapy is strong evidence of moderate-to-severe disease. Combined with flare frequency + malnutrition labs, biologic use anchors a 60% case.
Can I rate ostomy (colostomy/ileostomy) separately?
Yes — DC 7329 / 7330 rate intestinal stomas. Many post-resection Crohn's veterans have permanent or temporary stomas that rate separately.
What if my Crohn's is in remission?
Even in remission, ongoing biologic/immunomodulator Rx + frequent monitoring + history of flares typically supports at least 30%. Don't accept 0% just because current colonoscopy looks clean.
Is Crohn's presumptive for Camp Lejeune?
No — Crohn's is not on the Camp Lejeune presumptive list. But direct service connection through in-service GI complaints or post-service onset is viable.
Official Regulatory Source
Crohn's disease is rated under 38 CFR § 4.114, DC 7326 (post-May 2024). Pre-2024 claims used DC 7323 by analogy.
38 CFR § 4.114 — Digestive System (eCFR) →Scroll to DC 7326. § 4.114 was substantially restructured effective May 19, 2024.
⚠️ Verify with a VSO
DC 7326 was added/restructured in the May 19, 2024 § 4.114 amendments to consolidate IBD other than UC. Pre-2024 Crohn's claims used DC 7323 by analogy. Verify current text on eCFR.
Next Steps
If your rating decision lists DC 7326, 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 7326 • 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.