On this page
- Celiac disease VA rating criteria (DC 7355)
- Gastroparesis VA rating criteria (DC 7356)
- One rating for the stomach: the digestive anti-pyramiding rule
- How much VA pays for celiac disease and gastroparesis
- How to prove celiac disease or gastroparesis is service connected
- The C&P exam and the DBQ
- Why VA denies celiac disease and gastroparesis claims
- Questions veterans ask about celiac disease and gastroparesis
- Sources
For years VA had no code for celiac disease or for gastroparesis. Veterans were rated by analogy to other digestive codes that were written for different diseases. That changed when VA rewrote the digestive section of the rating schedule in a final rule that took effect May 19, 2024. Celiac disease got DC 7355, and a new code, DC 7356, covers gastrointestinal dysmotility, the family of problems where the stomach and bowel do not move food along the way they should.
This page covers both codes word for word, what each level pays, how to prove the condition is service connected, the C&P exam, and why these claims are denied. The Board section further down shows how celiac and dysmotility appeals have ended.
Celiac disease VA rating criteria (DC 7355)
38 CFR § 4.114 rates celiac disease at three levels:
| Rating | DC 7355, celiac disease |
|---|---|
| 80% | "Malabsorption syndrome with weakness which interferes with activities of daily living; and weight loss resulting in wasting and nutritional deficiencies; and with systemic manifestations including but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels; and anemia related to malabsorption; and episodes of abdominal pain and diarrhea due to lactase deficiency or pancreatic insufficiency" |
| 50% | "Malabsorption syndrome with chronic diarrhea managed by medically-prescribed dietary intervention such as prescribed gluten-free diet, with nutritional deficiencies due to lactase and pancreatic insufficiency; and with systemic manifestations including, but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels, or atrophy of the inner intestinal lining shown on biopsy" |
| 30% | "Malabsorption syndrome with chronic diarrhea managed by medically-prescribed dietary intervention such as prescribed gluten-free diet; and without nutritional deficiencies" |
Two notes follow. Note (1): "An appropriate serum antibody test or endoscopy with biopsy must confirm the diagnosis." Note (2): when malabsorption is the main problem, VA uses whichever is higher, DC 7355 or DC 7328 (resection of the small intestine).
Three details in that table decide most celiac ratings:
- The diet has to be prescribed. Going gluten-free on your own does not meet the 30 percent wording. Make sure a doctor's note says the diet is medically prescribed.
- The 50 percent level turns on deficiencies or biopsy findings. Low vitamin or calcium levels, anemia, skin rash from celiac, or intestinal atrophy on biopsy move you up. Ask for the lab work.
- The 80 percent level uses "and." Every listed element has to be present, including weight loss with wasting.
There is no 0 or 10 percent level in DC 7355. Under 38 CFR § 4.31, a condition that does not meet the lowest level still rates 0 percent, which keeps it service connected.
Gastroparesis VA rating criteria (DC 7356)
Gastroparesis, delayed stomach emptying, is not named anywhere in the schedule. The code built for motility problems is DC 7356, and its 50 percent level names "poor gastric emptying," which is what gastroparesis is:
| Rating | DC 7356, gastrointestinal dysmotility syndrome |
|---|---|
| 80% | "Requiring complete dependence on total parenteral nutrition (TPN) or continuous tube feeding for nutritional support" |
| 50% | "Requiring intermittent tube feeding for nutritional support; with recurrent emergency treatment for episodes of intestinal obstruction or regurgitation due to poor gastric emptying, abdominal pain, recurrent nausea, or recurrent vomiting" |
| 30% | "With symptoms of chronic intestinal pseudo-obstruction (CIPO) or symptoms of intestinal motility disorder, including but not limited to, abdominal pain, bloating, feeling of epigastric fullness, dyspepsia, nausea and vomiting, regurgitation, constipation, and diarrhea, managed by ambulatory care; and requiring prescribed dietary management or manipulation" |
| 10% | "Intermittent abdominal pain with epigastric fullness associated with bloating; and without evidence of a structural gastrointestinal disease" |
The 30 percent level is where most gastroparesis claims should land when the condition needs ongoing outpatient care and a prescribed diet, such as small, low-fat, low-fiber meals. The 50 percent level needs intermittent tube feeding together with repeated emergency visits for vomiting, obstruction or poor gastric emptying. Keep the emergency room records; they are the evidence for that level.
One rating for the stomach: the digestive anti-pyramiding rule
The digestive section opens with a rule (the first paragraph of 38 CFR § 4.114) that shapes every rating on this page:
Do not combine ratings under diagnostic codes 7301 through 7329 inclusive, 7331, 7342, 7345 through 7350 inclusive, 7352, and 7355 through 7357 inclusive, with each other. Instead, when more than one rating is warranted under those diagnostic codes, assign a single evaluation under the diagnostic code that reflects the predominant disability picture, and elevate it to the next higher evaluation if warranted by the severity of the overall disability.
So a veteran with celiac disease and GERD, or gastroparesis and IBS, gets one rating, not two. The rating goes under whichever condition causes the most disability, and VA can raise that rating one level when the combined picture is worse than that code alone describes. If your decision lists two digestive conditions but rates only the lesser one, or never considers the step up, that is worth appealing. 38 CFR § 4.113 explains why: these conditions produce "a common disability picture" of pain, anemia and poor nutrition.
How much VA pays for celiac disease and gastroparesis
At VA's rates effective December 1, 2025, a veteran alone receives $180.42 a month at 10 percent, $552.47 at 30 percent, $1,132.90 at 50 percent and $2,102.15 at 80 percent. Those are the amounts for a single overall rating; when you have other ratings, VA combines them rather than adding the money. The combined rating calculator shows what a celiac or gastroparesis rating adds to the ratings you already have.
How to prove celiac disease or gastroparesis is service connected
Celiac disease that began in service
Celiac disease is a chronic inflammation of the small bowel triggered by gluten in people who are genetically susceptible, possibly with other environmental factors, and it ranges from no symptoms to severe malabsorption (Di Sabatino and Corazza, 2009). A diagnosis made in service, or symptoms in service that were later diagnosed as celiac, supports a direct claim. Infections may play a part in when it starts. A study of service members' medical records by Naval Medical Research Center researchers followed 1,753 cases of bacterial food poisoning and found a suggested higher risk of later celiac disease after Campylobacter infection, though not after the other infections studied (Riddle and colleagues, 2013). If you had documented gastroenteritis in service, especially during deployment, put it in front of the doctor writing your opinion.
Celiac disease that existed before service
VA may argue celiac disease began before you enlisted. Under 38 CFR § 3.304(b), you are presumed sound at entry except for conditions noted on the entrance exam, and VA can overcome that only with clear and unmistakable evidence that the condition existed before service and was not aggravated by it. If celiac was noted at entry, the question becomes whether service made it worse beyond its natural progress (38 CFR § 3.306).
Gastroparesis secondary to diabetes
Diabetes is one of the main known causes of gastroparesis; the others include surgery, medications and viral illness, and many cases have no known cause (Camilleri and colleagues, 2018). A confirmed diagnosis requires a test showing delayed emptying, such as gastric scintigraphy or a breath test. A 2023 meta-analysis put the pooled share of people with diabetes who have gastroparesis at 9.3 percent, though the authors called the estimate sensitive to study methods (Li and colleagues, 2023). Under 38 CFR § 3.310, gastroparesis caused or aggravated by service-connected diabetes is service connected too, and diabetes presumed from Agent Orange exposure counts. The opinion should say that diabetes caused the gastroparesis and also whether diabetes aggravated it, meaning it would be less severe but for the diabetes; an opinion that skips aggravation is inadequate under El-Amin v. Shinseki, 26 Vet. App. 136 (2013). See the diabetes page.
Gulf War veterans and functional stomach disorders
Under 38 CFR § 3.317, qualifying medically unexplained chronic multisymptom illnesses include "functional gastrointestinal disorders (excluding structural gastrointestinal diseases)." The PACT Act amended 38 U.S.C. § 1117(a)(1) to cover a qualifying chronic disability that became manifest "to any degree at any time." The older 10 percent threshold and December 31, 2026 manifestation deadline still printed in § 3.317 no longer govern eligibility. Qualifying service and the other illness requirements still apply. The regulation lists functional dyspepsia, functional vomiting, functional bloating and functional abdominal pain syndrome among them. The note to DC 7356 tells raters to use it "for illnesses associated with § 3.317(a)(2)(i)(B)(3)" that the irritable bowel code does not cover.
The word "functional" matters. A functional disorder has no structural or lab explanation. Gastroparesis from diabetes has a known cause, so it goes the secondary route; unexplained chronic nausea, fullness and vomiting in a Gulf War veteran may go the presumptive route. The Gulf War illness page covers the presumption in full.
The C&P exam and the DBQ
VA examines celiac disease and many bowel conditions with the Intestinal Conditions DBQ; stomach complaints may also bring in the Stomach and Duodenum DBQ. Before the exam:
- Bring the proof of diagnosis. For celiac, the antibody blood test or biopsy report Note (1) requires. For gastroparesis, the gastric emptying study.
- Bring the diet prescription. The 30 percent levels of both codes need a prescribed diet or dietary management.
- List the deficiencies and visits. Lab results showing low vitamins, iron or calcium, weight records, and every emergency visit for vomiting or obstruction.
- Describe a bad week. How often you have diarrhea, vomiting, pain or bloating, and what you miss because of it.
Raven Scan reads your medical records and pulls out the lab values, diet orders and emergency visits that match these criteria, so you can hand the examiner dates instead of memories.
Why VA denies celiac disease and gastroparesis claims
The Board section below shows why the Board sent celiac and dysmotility appeals back and how the ones it decided turned out. These are the patterns behind those numbers.
No confirmed diagnosis. A celiac claim without the antibody test or biopsy that Note (1) requires, or a gastroparesis claim without a gastric emptying study, often stalls at the first element.
No link to service. Celiac is genetic and gastroparesis has many causes. The opinion has to explain why service or a service-connected condition is at least as likely as not the cause, or made it worse.
The wrong code. A rating assigned by analogy before May 2024 may be worth revisiting under DC 7355 or DC 7356. The new criteria apply only from May 19, 2024 forward.
An inadequate exam. An inadequate VA exam is a leading reason the Board sends these claims back; the remand reasons below show how often. An exam that never asks about tube feeding, emergency visits or deficiencies leaves the rater without the facts the higher levels need.
Records not obtained. Gastroenterology records, emptying studies and hospital records are often outside the VA system. Send them yourself.
Questions veterans ask about celiac disease and gastroparesis
Is celiac disease a VA disability?
Yes. Since May 19, 2024, celiac disease has its own diagnostic code, DC 7355, rated 30, 50 or 80 percent. It still has to be service connected, and an antibody test or biopsy must confirm the diagnosis.
What is the VA rating for celiac disease?
30 percent with chronic diarrhea managed by a medically prescribed diet and no nutritional deficiencies; 50 percent with deficiencies and systemic signs such as fatigue, rash, low vitamins or intestinal atrophy on biopsy; 80 percent with wasting, anemia and the other listed problems all present.
What is the VA rating for gastroparesis?
Gastroparesis rates under DC 7356 at 10, 30, 50 or 80 percent. Ongoing symptoms managed with outpatient care and a prescribed diet rate 30 percent; intermittent tube feeding with repeated emergency treatment rates 50 percent; complete dependence on IV or tube nutrition rates 80 percent.
Can gastroparesis be secondary to diabetes?
Yes. Diabetes is one of the main known causes of gastroparesis. If your diabetes is service connected, including by the Agent Orange presumption, gastroparesis caused or worsened by it can be service connected under 38 CFR § 3.310 with a medical opinion that explains the link.
Can I be rated for celiac disease and GERD separately?
Usually not. The digestive section gives one rating for the predominant problem among the listed digestive codes, and VA can raise that rating one level when the overall picture is more severe.
Is gastroparesis a Gulf War presumptive condition?
Not by name. Functional stomach disorders with no structural cause are covered by the Gulf War presumption in 38 CFR § 3.317. Gastroparesis with a known cause, such as diabetes, is claimed directly or as secondary instead.
Sources
- 38 CFR § 4.114, digestive system ratings, DCs 7355 and 7356 (opens in a new tab), eCFR text as of October 2, 2026, as amended at 89 FR 19743 (March 20, 2024), effective May 19, 2024
- 38 CFR § 4.113, coexisting abdominal conditions (opens in a new tab)
- 38 CFR § 3.317, Persian Gulf veterans (opens in a new tab)
- 38 U.S.C. § 1117, Gulf War eligibility after PACT Act section 405 (opens in a new tab)
- 38 CFR § 3.304 and § 3.306, soundness and aggravation (opens in a new tab)
- 38 CFR § 3.310, secondary service connection (opens in a new tab)
- 38 CFR § 4.31, zero percent ratings (opens in a new tab)
- El-Amin v. Shinseki, 26 Vet. App. 136 (2013)
- Riddle MS, Murray JA, Cash BD, Pimentel M, Porter CK. Pathogen-specific risk of celiac disease following bacterial causes of foodborne illness: a retrospective cohort study. Dig Dis Sci. 2013;58(11):3242-3245. doi:10.1007/s10620-013-2733-7 (opens in a new tab)
- Di Sabatino A, Corazza GR. Coeliac disease. Lancet. 2009;373(9673):1480-1493. doi:10.1016/S0140-6736(09)60254-3 (opens in a new tab)
- Camilleri M, Chedid V, Ford AC, and colleagues. Gastroparesis. Nat Rev Dis Primers. 2018;4(1):41. doi:10.1038/s41572-018-0038-z (opens in a new tab)
- Li L, Wang L, Long R, Song L, Yue R. Prevalence of gastroparesis in diabetic patients: a systematic review and meta-analysis. Sci Rep. 2023;13(1):14015. doi:10.1038/s41598-023-41112-6 (opens in a new tab)
- VA disability compensation rates (opens in a new tab), effective December 1, 2025
- Intestinal Conditions DBQ guide