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 . c. Establishing Do not assume the preexistence of a hernia. Determine preexistence on a 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. Operation for repair of a preexisting inguinal hernia is not necessarily Note: evidence of aggravation. For information on the presumption of soundness at entrance into Reference: service, see . Initial awards of SC for hemorrhoids are governed by customary rules for SC d. Considering Recurrence of included in . After SC is initially established, unless the award of SC for Hemorrhoids hemorrhoids was in error, consider recurrences after service as (SC). For more information on reversing an erroneous decision, see Reference:
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. Note: Operation for repair of a preexisting inguinal hernia is not necessarily evidence of aggravation. Reference: For information on the presumption of soundness at entrance into service, see . d. Considering Recurrence of Hemorrhoids Initial awards of SC for hemorrhoids are governed by customary rules for SC included in . After SC is initially established, unless the award of SC for hemorrhoids was in error, consider recurrences after service as (SC). Reference: For more information on reversing an erroneous decision, see