Change Date July 5, 2015 If the issue is service connection (SC) for dysentery or other gastrointestinal a. Considering Circumstances disease, assign great weight to any service under the following conditions of Service since these conditions may have been the etiological or aggravating factor Associated With tropical service imprisonment or internment under unsanitary conditions, or Disorders food deprivation. For more information on establishing SC for dysentery and other Reference: tropical diseases, see . specifies that evaluations of digestive conditions under certain diagnostic b. Digestive Condition codes (DCs) will be combined with each other or assigned separate not Evaluations evaluations. Instead, a single evaluation should be assigned under the DC Under 38 CFR which reflects the disability, with elevation to the next higher predominant 4.114 Which evaluation when the severity of the overall disability warrants such elevation. Will Not Be Combined With Do combine separate evaluations of digestive conditions with each other not Each Other under the following DCs 7301 to 7329, inclusive (meaning the DCs from 7301 to 7329) all 7331 7342, and 7345 to 7348, inclusive (meaning the DCs from 7345 to 7348). all A Veteran with a duodenal ulcer, evaluated as 20 percent disabling Example: under , and ulcerative colitis, evaluated as 30 percent disabling under , would be assigned a single 30-percent evaluation under as ulcerative colitis represents the predominant disability picture. evaluations for the Separate duodenal ulcer and ulcerative colitis are not permitted under . Do not assume the preexistence of a hernia. Determine preexistence on a c. Establishing SC for Inguinal factual basis. Hernia The following conditions are sufficient bases for SC in-service initial manifestation of hernial protrusion, and recurrence during service, by aggravation, of a hernia previously surgically repaired.
Change Date July 5, 2015 a. Considering Circumstances of Service Associated With Disorders If the issue is service connection (SC) for dysentery or other gastrointestinal disease, assign great weight to any service under the following conditions since these conditions may have been the etiological or aggravating factor tropical service imprisonment or internment under unsanitary conditions, or food deprivation. Reference: For more information on establishing SC for dysentery and other tropical diseases, see . b. Digestive Condition Evaluations Under 38 CFR 4.114 Which Will Not Be Combined With Each Other specifies that evaluations of digestive conditions under certain diagnostic codes (DCs) will not be combined with each other or assigned separate evaluations. Instead, a single evaluation should be assigned under the DC which reflects the predominant disability, with elevation to the next higher evaluation when the severity of the overall disability warrants such elevation. Do not combine separate evaluations of digestive conditions with each other under the following DCs 7301 to 7329, inclusive (meaning all the DCs from 7301 to 7329) 7331 7342, and 7345 to 7348, inclusive (meaning all the DCs from 7345 to 7348). Example: A Veteran with a duodenal ulcer, evaluated as 20 percent disabling under , and ulcerative colitis, evaluated as 30 percent disabling under , would be assigned a single 30-percent evaluation under as ulcerative colitis represents the predominant disability picture. Separate evaluations for the duodenal ulcer and ulcerative colitis are not permitted under . c. Establishing SC for Inguinal Hernia Do not assume the preexistence of a hernia. Determine preexistence on a factual basis. The following conditions are sufficient bases for SC in-service initial manifestation of hernial protrusion, and recurrence during service, by aggravation, of a hernia previously surgically repaired.