38 CFR Part 4 — 38 CFR § 4.116
Endometriosis
dc-7629-endometriosis
Gynecological / breast
Diagnostic code
7629
Why your DC matters: DC 7629 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 7629 — Endometriosis — is listed under 38 CFR § 4.116 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 (7629) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7629”. 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 7629 (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 7629 in the subpart for your body system (use Find in Page if needed).
DC 7629 has its OWN dedicated tier ladder (10/30/50%) — distinct from the General Rating Formula used for DCs 7610-7615. Critical: diagnosis MUST be substantiated by laparoscopy per the explicit code note (imaging alone, even MRI, is not sufficient — the rater can lawfully deny without surgical confirmation). Tiers: 10% (pelvic pain/irregular bleeding requiring continuous treatment), 30% (uncontrolled pelvic pain or irregular bleeding), 50% (lesions involving bowel or bladder, confirmed by laparoscopy, plus uncontrolled symptoms). The 50% gate is striking — bowel or bladder involvement essentially means deep infiltrating endometriosis (DIE), which is the highest-severity phenotype. Critical lanes: (1) average delay from symptom onset to diagnosis is 7-10 years — many female veterans have undiagnosed endometriosis from service onward; (2) MST-related chronic pelvic pain is frequently misattributed when endometriosis is the actual diagnosis; (3) infertility is a major functional consequence + mental health secondary driver; (4) endometriosis treated with hysterectomy + bilateral oophorectomy escalates to DC 7617 + SMC-K. File aggressively — endometriosis is the most-underclaimed gynecologic condition for female veterans.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 50% | Lesions involving bowel or bladder, confirmed by laparoscopy, plus uncontrolled symptoms (pelvic pain, irregular bleeding). | Laparoscopy report confirming endometriosis lesions involving bowel or bladder (deep infiltrating endometriosis / DIE); ongoing pelvic pain or irregular bleeding refractory to continuous treatment. |
| 30% | Pelvic pain or irregular bleeding NOT controlled by treatment. | Gynecology consult documenting refractory pelvic pain or refractory abnormal bleeding despite continuous treatment (hormonal suppression, GnRH agonists, NSAIDs); symptom diary. |
| 10% | Pelvic pain or irregular bleeding requiring continuous treatment for control. | Prescription history showing continuous treatment (continuous OCPs, progestin therapy, GnRH agonists, NSAIDs); gynecology follow-up notes. |
What Qualifies Under DC 7629?
Endometriosis confirmed by laparoscopy (MANDATORY)
Per explicit § 4.116 note: diagnosis MUST be substantiated by laparoscopy. Imaging alone (TVUS, MRI) is NOT sufficient. The operative note + pathology confirmation are the diagnostic anchors.
Tier ladder — 10/30/50%
Distinct from General Rating Formula:
- • 10% — Pelvic pain or irregular bleeding requiring continuous treatment
- • 30% — Pelvic pain or irregular bleeding NOT controlled by treatment
- • 50% — Lesions involving bowel or bladder (laparoscopy-confirmed) + uncontrolled symptoms
50% gate = deep infiltrating endometriosis (DIE) involving bowel or bladder
Highest-severity phenotype. DIE involves rectum, sigmoid, small bowel, or bladder. Surgical confirmation required.
Escalation to DC 7617 + SMC-K if hysterectomy + bilateral oophorectomy
Definitive surgical treatment escalates to DC 7617 (3mo 100% → 50% + SMC-K for loss of creative organ).
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.
“Lesions involving bowel or bladder, confirmed by laparoscopy, plus uncontrolled symptoms”
50% gate — highest tier under DC 7629. Anchor with laparoscopy report documenting deep infiltrating endometriosis (DIE) involving bowel (rectum, sigmoid, small bowel) or bladder + ongoing refractory pelvic pain / irregular bleeding. Bowel/bladder involvement = deep infiltrating endometriosis, the highest-severity phenotype.
“Pelvic pain or irregular bleeding NOT controlled by continuous treatment”
30% gate. Anchor with gynecology consult documenting refractory symptoms despite continuous treatment (continuous OCPs, GnRH agonists, NSAIDs). Refractoriness = the rating driver.
“Pelvic pain or irregular bleeding requiring continuous treatment”
10% gate. Continuous treatment = ongoing hormonal suppression, scheduled GnRH agonist injections, ongoing NSAID regimen. 'Continuous' = months-long, not days-long.
“Diagnosis of endometriosis MUST be substantiated by laparoscopy”
Per the explicit § 4.116 note for DC 7629. Imaging alone (TVUS, MRI) is NOT sufficient — even though MRI can suggest DIE, the rater can lawfully deny without surgical confirmation. If you have suspected endometriosis without laparoscopy, push your gynecologist for diagnostic laparoscopy before filing.
“If endometriosis treated with hysterectomy + bilateral oophorectomy, file DC 7617 + SMC-K”
Definitive surgical treatment for severe refractory endometriosis is hysterectomy + bilateral salpingo-oophorectomy. File under DC 7617 (3 months 100% → 50% + SMC-K for loss of creative organ) — better than DC 7629's 50% cap.
Evidence Checklist — Specific to This Condition
Laparoscopy report confirming endometriosis (MANDATORY)
CRITICALPer explicit § 4.116 note: diagnosis MUST be substantiated by laparoscopy. Imaging alone is NOT sufficient. Pull the operative report + pathology confirmation. Document lesion locations (bowel, bladder involvement = 50% gate).
Gynecology consult + treatment regimen documentation
CRITICALContinuous OCPs, progestin therapy, GnRH agonists, NSAIDs all qualify as continuous treatment.
Symptom diary — pelvic pain, dysmenorrhea, dyspareunia, irregular bleeding, infertility
CRITICALDocuments functional impact and refractoriness.
Pelvic imaging — TVUS, MRI for deep infiltrating endometriosis (DIE)
IMPORTANTSupports laparoscopy findings. MRI can identify DIE involving bowel or bladder.
Etiology + onset documentation
IMPORTANTAverage symptom-to-diagnosis delay is 7-10 years. Document symptom onset in service (dysmenorrhea, pelvic pain) even if diagnosis came later.
Infertility workup if applicable (HSG, ovarian reserve, partner workup)
IMPORTANTEndometriosis-related infertility is a major functional consequence + mental health secondary driver.
Surgical history — laparoscopic excision, hysterectomy, bilateral oophorectomy (if performed)
SUPPORTINGHysterectomy + bilateral oophorectomy for endometriosis escalates to DC 7617 + SMC-K.
C&P Exam Tips
Bring the laparoscopy report — this is the mandatory diagnostic anchor
Without laparoscopy, the claim can lawfully be denied per the § 4.116 note. Push your gynecologist for diagnostic laparoscopy before filing if not already performed.
Document bowel or bladder involvement explicitly for the 50% gate
Deep infiltrating endometriosis (DIE) involving rectum, sigmoid, small bowel, or bladder anchors the 50% tier.
Request a female C&P examiner if preferred
VA must accommodate reasonable preference for sensitive gynecologic exams.
Document treatment-refractoriness explicitly + escalation history
Continuous OCPs → progestin → GnRH agonists → surgery. Each escalation documents refractoriness for the 30% / 50% gates.
Don't file endometriosis without laparoscopy
MRI alone (even with classic DIE findings) is NOT sufficient per the § 4.116 note. The rater can lawfully deny.
Common Mistakes That Cost Veterans Points
Filing endometriosis without laparoscopy confirmation
The § 4.116 note for DC 7629 explicitly requires laparoscopy substantiation. Imaging alone (TVUS, MRI) is not sufficient even if findings are classic. The rater can lawfully deny. Push your gynecologist for diagnostic laparoscopy before filing.
Not documenting bowel or bladder involvement for the 50% gate
Deep infiltrating endometriosis (DIE) involving rectum, sigmoid colon, small bowel, or bladder anchors the 50% tier. Pull the laparoscopy operative note for lesion locations.
Not anchoring service-period onset despite delayed diagnosis
Average symptom-to-diagnosis delay is 7-10 years. Many female veterans have undiagnosed endometriosis from service onward. Document symptom onset (dysmenorrhea, pelvic pain, dyspareunia) in service treatment records or lay statements even if formal diagnosis came later.
Not pursuing endometriosis-related infertility as functional consequence + secondary
Endometriosis is a leading cause of female infertility. The functional consequence is part of DC 7629 rating; the psychological impact (depression, MDD) is separate DC 9434 secondary.
Not escalating to DC 7617 + SMC-K when hysterectomy + bilateral oophorectomy is performed
Definitive surgical treatment for severe refractory endometriosis is hysterectomy + bilateral salpingo-oophorectomy. File under DC 7617 (3mo 100% → 50% + SMC-K) — better than DC 7629's 50% cap.
Settling for 10% with refractory disease
Treatment escalation (from continuous OCPs to progestin to GnRH agonists) documents refractoriness for the 30% gate. Don't accept 10% if symptoms persist despite treatment.
Tactical Plays
⚡ Get the laparoscopy FIRST — diagnosis MUST be substantiated by surgery
Per the explicit § 4.116 note for DC 7629, diagnosis MUST be substantiated by laparoscopy. Imaging alone (TVUS, MRI) is NOT sufficient — the rater can lawfully deny. If you have suspected endometriosis without laparoscopy, push your gynecologist for diagnostic laparoscopy BEFORE filing. The operative note + pathology confirmation are the rating anchors.
⚡ Anchor 50% via deep infiltrating endometriosis (DIE) involving bowel or bladder
The 50% gate requires laparoscopy-confirmed lesions involving bowel (rectum, sigmoid, small bowel) or bladder + uncontrolled symptoms. Pull the laparoscopy operative note for lesion locations. If DIE involves bowel/bladder and symptoms are refractory, the 50% rating is clearly supported.
⚡ Document service-period onset despite delayed diagnosis
Average symptom-to-diagnosis delay for endometriosis is 7-10 years. Many female veterans have undiagnosed endometriosis from service onward. Document symptom onset in service treatment records: dysmenorrhea requiring missed duty, recurrent pelvic pain ER visits, dyspareunia. Lay statements from family / partner / battle buddies support service-period symptoms. Even if formal diagnosis came years post-service, the SC pathway is anchored by service-period symptoms.
⚡ Pursue infertility as functional consequence + mental health secondary
Endometriosis is a leading cause of female infertility (30-50% of women with endometriosis). Functional consequence is part of DC 7629 rating; psychological impact is separate DC 9434 secondary. Many female veterans miss the secondary stack entirely.
⚡ Escalate to DC 7617 + SMC-K if definitive surgery is performed
Definitive surgical treatment for severe refractory endometriosis is hysterectomy + bilateral salpingo-oophorectomy. File under DC 7617 (3 months 100% → 50% permanent + SMC-K for loss of creative organ) — strictly better than DC 7629's 50% cap because of the SMC-K stack ($139.87/mo) + surgical menopause secondaries (osteoporosis, MDD, vasomotor symptoms).
Secondary Conditions to File With This One
PTSD secondary to MST (if applicable)
MODERATEDC 9411
MST-related chronic pelvic pain is frequently misattributed when endometriosis is the actual diagnosis. If both are SC, file each separately.
Infertility secondary to endometriosis
STRONGEndometriosis is a leading cause of female infertility (30-50% of women with endometriosis have infertility). Functional consequence; drives mental health secondaries.
Major depressive disorder secondary to chronic pelvic pain + infertility
STRONGDC 9434
Chronic pelvic pain + infertility + treatment burden + dyspareunia drive depression. Well-documented secondary.
DC 7615 ovarian endometrioma (if ovarian involvement)
MODERATEDC 7615
Endometrioma is the ovarian manifestation of endometriosis. If ovarian endometrioma is documented separately, file DC 7615 stacked with DC 7629.
DC 7617 / 7618 hysterectomy ± bilateral oophorectomy (if performed)
SITUATIONALDefinitive surgical treatment for severe refractory endometriosis. DC 7617 + SMC-K is better than DC 7629's 50% cap.
Bowel dysfunction (post-bowel-resection or DIE-related)
MODERATEDeep infiltrating endometriosis involving bowel may require bowel resection. Bowel dysfunction rates under digestive system codes separately.
Urinary dysfunction (post-bladder-resection or DIE-related)
MODERATEDIE involving bladder may require partial cystectomy or cause refractory urinary symptoms. Rates under § 4.115a separately.
Sexual dysfunction / dyspareunia
STRONGEndometriosis commonly causes severe dyspareunia. Functional component of DC 7629 + drives mental health secondaries.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Pelvic pain / irregular bleeding requiring continuous treatment (continuous OCPs, progestin therapy, GnRH agonists, NSAIDs).
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Pelvic pain / irregular bleeding NOT controlled by continuous treatment (refractory despite hormonal suppression + GnRH agonists).
50% — single, no dependents
Base rating
$1,132.90
TOTAL
$1,132.90/mo
Deep infiltrating endometriosis with lesions involving bowel or bladder (laparoscopy-confirmed) + uncontrolled symptoms.
50% DC 7629 + 30% DC 9434 MDD (infertility secondary)
Base rating
$1,808.45
TOTAL
$1,808.45/mo
Endometriosis-related infertility + depression stack.
If progressed to hysterectomy + bilateral oophorectomy → escalate to DC 7617 (50% + SMC-K) instead
Base rating
$1,132.90
SMC-K
+$139.87
TOTAL
$1,272.77/mo
Definitive surgical treatment escalates rating to DC 7617.
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 Endometriosis?
A chronic estrogen-dependent inflammatory condition in which endometrial-like tissue grows OUTSIDE the uterus — on ovaries (endometrioma), fallopian tubes, pelvic peritoneum, bowel, bladder, ureters, or distant sites. Symptoms: dysmenorrhea (severe period pain), chronic pelvic pain, dyspareunia, infertility, cyclical bowel or bladder symptoms, abnormal bleeding. Average symptom-to-diagnosis delay is 7-10 years. Definitive diagnosis requires laparoscopy. Treatment: continuous hormonal suppression (continuous OCPs, progestin therapy, GnRH agonists), laparoscopic excision/ablation, definitive hysterectomy + bilateral oophorectomy for refractory disease.
🔥What is Deep Infiltrating Endometriosis (DIE)?
The highest-severity phenotype of endometriosis — endometriotic lesions infiltrating > 5mm beneath the peritoneal surface, commonly involving rectum, sigmoid colon, small bowel, bladder, ureters, or rectovaginal septum. Causes severe chronic pelvic pain, dyschezia (painful defecation), dysuria (painful urination), cyclical bowel/bladder symptoms. Often requires multidisciplinary surgical management (gynecology + colorectal surgery + urology). Anchors the 50% rating tier under DC 7629.
🔬Why is laparoscopy mandatory for DC 7629?
Per the explicit § 4.116 note: 'Diagnosis of endometriosis must be substantiated by laparoscopy.' Imaging alone (TVUS, MRI) is NOT sufficient — even though modern MRI can suggest DIE with high accuracy, the rater can lawfully deny without surgical confirmation. The historical reason: many conditions cause chronic pelvic pain (PID, adhesions, fibroids), and definitive diagnosis of endometriosis requires direct surgical visualization + pathology. Push for diagnostic laparoscopy BEFORE filing.
🚫How is endometriosis-related infertility documented?
Endometriosis is a leading cause of female infertility (30-50% of women with endometriosis have infertility). Anchored by infertility workup: HSG (tubal patency), AMH (ovarian reserve), partner semen analysis (rule-out male factor), laparoscopy findings (lesion locations, adhesion extent). The functional consequence is part of DC 7629 rating; the psychological impact (depression, anxiety, MDD) is separate DC 9434 secondary.
How to File Your Claim
Get diagnostic laparoscopy BEFORE filing (MANDATORY)
Per § 4.116 note, diagnosis must be substantiated by laparoscopy. Imaging alone is not sufficient.
Pull laparoscopy operative report + pathology + treatment regimen documentation
Lesion locations (bowel/bladder = 50% gate) + ongoing treatment + refractoriness documentation.
Document service-period symptom onset despite delayed diagnosis
STR for dysmenorrhea, pelvic pain, recurrent ER visits, missed duty. Lay statements from family/partner.
File 21-526EZ specifying 'endometriosis (DC 7629)' + cite laparoscopy in narrative
Identify severity (DIE involving bowel/bladder = 50%) in claim narrative.
Stack secondaries — DC 9434 MDD, infertility, DC 7615 endometrioma, escalation to DC 7617 if definitive surgery
Multiple secondaries common.
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
Diagnosis MUST be substantiated by laparoscopy
Per explicit § 4.116 note. Imaging alone is NOT sufficient. Get the laparoscopy BEFORE filing.
50% gate = bowel or bladder involvement (DIE)
Deep infiltrating endometriosis involving rectum/sigmoid/small bowel/bladder + uncontrolled symptoms.
Document service-period symptom onset despite delayed diagnosis
Average symptom-to-diagnosis delay is 7-10 years. Anchor service onset via STR + lay statements.
Escalate to DC 7617 + SMC-K if hysterectomy + bilateral oophorectomy
Better than DC 7629's 50% cap because of SMC-K stack + surgical menopause secondaries.
Related Tools & Resources
Frequently Asked Questions
Do I need a laparoscopy to file endometriosis?
Yes — per the explicit § 4.116 note for DC 7629, diagnosis MUST be substantiated by laparoscopy. Imaging alone (TVUS, MRI) is NOT sufficient even if findings are classic for deep infiltrating endometriosis. The rater can lawfully deny without surgical confirmation. If you have suspected endometriosis without laparoscopy, push your gynecologist for diagnostic laparoscopy BEFORE filing. The operative note + pathology confirmation are the diagnostic anchors.
What anchors the 50% gate under DC 7629?
50% requires laparoscopy-confirmed lesions involving bowel (rectum, sigmoid, small bowel) or bladder + uncontrolled symptoms (pelvic pain or irregular bleeding). This is deep infiltrating endometriosis (DIE) — the highest-severity phenotype. Pull the laparoscopy operative note for lesion locations. If DIE involves bowel/bladder and symptoms are refractory despite continuous treatment, the 50% rating is clearly supported.
My symptoms started in service but I wasn't diagnosed until years later — can I still file?
Yes — average symptom-to-diagnosis delay for endometriosis is 7-10 years, and many female veterans have undiagnosed endometriosis from service onward. Document symptom onset in service treatment records: dysmenorrhea requiring missed duty, recurrent pelvic pain visits, dyspareunia. Lay statements from family, partners, or battle buddies support service-period symptoms. Service-period symptom onset + post-service laparoscopy confirmation anchors the SC pathway.
What if my endometriosis was treated with hysterectomy + bilateral oophorectomy?
Definitive surgical treatment for severe refractory endometriosis is hysterectomy + bilateral salpingo-oophorectomy. File under DC 7617 instead — that grants 3 months 100% → 50% permanent + SMC-K for loss of creative organ ($139.87/mo) + surgical menopause secondaries (osteoporosis via DEXA, MDD, vasomotor symptoms). Strictly better than DC 7629's 50% cap because of the SMC-K stack.
Does endometriosis-related infertility add to my rating?
The functional consequence (infertility) is part of the DC 7629 rating itself. The psychological impact (depression, anxiety, MDD) is a separate secondary rating under DC 9434 (MDD) or DC 9400 (anxiety). Endometriosis is a leading cause of female infertility (30-50% of women with endometriosis). Document infertility workup (HSG, AMH for ovarian reserve, partner workup) for the secondary file. Many female veterans miss the secondary stack entirely.
Official Regulatory Source
Endometriosis rates under 38 CFR § 4.116, DC 7629 — 10/30/50% with its own dedicated tier ladder. Diagnosis MUST be substantiated by laparoscopy per explicit § 4.116 note.
38 CFR § 4.116 — Gynecological Conditions and Disorders of the Breast (eCFR) →Scroll to DC 7629. Diagnosis substantiation requirement is explicit. 50% gate requires bowel/bladder involvement (DIE). Escalate to DC 7617 + SMC-K if definitive surgery performed. Stack DC 7615 (ovarian endometrioma), DC 9434 (MDD secondary to infertility).
Next Steps
If your rating decision lists DC 7629, 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 7629 • 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.