Colon Cancer VA Rating

Colon cancer is rated under 38 CFR § 4.114, diagnostic code 7343, the code for malignant neoplasms of the digestive system, exclusive of skin growths. The code runs in two phases. During active malignancy and treatment, the rating is a flat 100 percent. After treatment ends, a mandatory VA exam decides whether the cancer is still active, and if it is not, the condition is re-rated on what treatment left behind.

The rating is only half the claim. Most Board appeals on colon cancer are about service connection, and that question turns on exposure: the PACT Act presumption for gastrointestinal cancer, the radiation presumption, or a direct claim with a medical opinion for veterans whose exposure, such as Agent Orange or Camp Lejeune, has no colon cancer presumption. This page covers both halves, the six-month exam and the notice rules around it, the residual codes, and the secondary conditions that follow treatment.

TL;DR

• Colon cancer is rated under 38 CFR § 4.114, DC 7343 (malignant neoplasms of the digestive system, exclusive of skin growths), at 100 percent during active malignancy and treatment.
• The 100 percent continues after treatment stops. Six months after the last surgical, X-ray, antineoplastic chemotherapy, or other therapeutic procedure, a mandatory VA exam decides the rating going forward.
• If there is no local recurrence or metastasis at that exam, the condition is rated on its residuals, commonly under resection of the large intestine (DC 7329, which also covers an ostomy) or impairment of sphincter control (DC 7332).
• Any change after that exam follows the notice procedure in 38 CFR § 3.105(e). Because DC 7343 sets an end point for the 100 percent, VA does not have to show improvement the way it would for an ordinary reduction, but it does have to give the notice.
• Gastrointestinal cancer of any type, which includes colorectal cancer, is a PACT Act presumptive disease for a covered veteran under 38 U.S.C. §§ 1119 and 1120. Cancer of the colon is also on the radiation-exposed veteran list. It is not on the Agent Orange or Camp Lejeune presumptive lists, so those claims need a medical nexus opinion.
• Treatment residuals open secondary chains under § 3.310: chemotherapy-induced peripheral neuropathy, anemia, ostomy complications, and scars.
• A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 1,102 decided Board rulings on colon cancer from 2021 to 2026, 23.9% were granted, 25.2% denied and 50.9% remanded, so remand is the most common outcome, 5.6 points above the Board-wide remand share of 45.3%.

Colon cancer VA rating criteria (DC 7343)

DC 7343 covers malignant neoplasms of the digestive system other than skin growths, so colon, rectal, and other colorectal cancers fall under it. It does not have symptom tiers. It assigns 100 percent and then sets a process, in this text.

7343 Malignant neoplasms of the digestive system, exclusive of skin growths: 100%

Note: A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

During active disease and treatment, you do not have to prove specific symptoms. The diagnosis and the treatment carry the rating, which pays $3,938.58 a month for a veteran alone at the 2026 rates. After treatment, the rating depends on what the mandatory exam finds. If the cancer has recurred or spread, the 100 percent continues, because there is again active malignant disease. If not, VA rates the residuals under whatever digestive code best fits them.

What happens six months after colon cancer treatment ends

The note sets the date: six months after the last surgery, radiation, chemotherapy, or other therapeutic procedure, VA schedules a mandatory exam. The exam answers one question first: is there local recurrence or metastasis? Everything else follows from that answer.

"Treatment ends" is not always a clean date. Adjuvant chemotherapy and follow-up procedures can move it. A clear treatment-end date in your oncology records protects the full 100 percent period, and an exam scheduled before treatment actually stopped is built on the wrong snapshot.

Any change after that exam follows 38 CFR § 3.105(e). When the change would lower your payments, VA has to send a proposed rating that sets out the reasons, give you 60 days to send evidence, and offer a predetermination hearing if you ask within 30 days of the notice. If you ask in time, payments continue at the old level until VA decides. The lower rating takes effect at the end of the month in which 60 days from the notice of the final action run out.

What § 3.105(e) does not give you is the usual reduction test. Because DC 7343 sets its own end point for the 100 percent, the Board does not treat its end as an ordinary rating reduction, and VA does not have to show that your condition improved under the ordinary conditions of life (Foster v. McDonough, 34 Vet. App. 338 (2021); Love v. McDonough, 106 F.4th 1361 (Fed. Cir. 2024)). The real questions are whether the cancer is truly inactive, whether the residuals are rated correctly, and whether VA gave proper notice. In a March 2025 decision, the Board found that VA's later letters had left a veteran without a fair chance to send evidence or ask for a hearing, held the reduction void, and restored the veteran's 100 percent colon cancer rating along with the special monthly compensation that depended on it (Citation Nr. A25022357).

Colon cancer residuals: colectomy, ostomy and sphincter control

Once the cancer is inactive, VA rates what treatment left behind. In the 2025 Board decisions on colon and rectal cancer I read, the residuals were usually rated under DC 7329, resection of the large intestine, and sometimes under DC 7332 for sphincter control, written as a hyphenated code such as 7343-7329. Since May 19, 2024, DC 7329 reads as follows.

• 100%: Total colectomy with formation of ileostomy, high-output syndrome, and more than two episodes of dehydration requiring intravenous hydration in the past 12 months
• 60%: Total colectomy with or without permanent colostomy or ileostomy without high-output syndrome
• 40%: Partial colectomy with permanent colostomy or ileostomy without high-output syndrome
• 20%: Partial colectomy with reanastomosis (reconnection of the intestinal tube) with loss of ileocecal valve and recurrent episodes of diarrhea more than 3 times per day
• 10%: Partial colectomy with reanastomosis (reconnection of the intestinal tube)

A partial colectomy with the bowel reconnected is the 10 percent row. The 20 percent row adds two facts the record has to show: loss of the ileocecal valve and diarrhea more than three times a day. A permanent ostomy is the 40 percent row, so whether the stoma is permanent matters to the tier. At the 2026 rates for a veteran alone, 10 percent pays $180.42 a month, 20 percent $356.66, 40 percent $795.84 and 60 percent $1,435.02.

Impairment of sphincter control, DC 7332. When treatment affects rectal and anal sphincter control, the residual can be rated under DC 7332. The tiers turn on how often incontinence requires a pad (at least once every six months at 10 percent, two or more times a month at 30 percent, two or more times a week at 60 percent, and two or more times a day at 100 percent) or on how well the loss of control responds to a physician-prescribed bowel program. A history of lost sphincter control that is currently without symptoms rates 0 percent. In an April 2025 decision applying the criteria in effect before May 2024, the Board assigned 60 percent under DC 7343-7332 for rectal cancer residuals after a low anterior resection (Citation Nr. A25036483). The bowel incontinence page covers DC 7332 in full.

Pending claims. Before May 19, 2024, DC 7329 rated resection of the large intestine on slight, moderate, or severe symptoms. For a claim pending when the digestive rule changed (89 FR 19735), VA applies the old criteria to the period before May 19, 2024, and from that date uses whichever version is more favorable to you (38 U.S.C. § 5110(g); Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003)). In a June 2025 decision, the Board found the old DC 7329 more favorable for a reconnected partial colectomy with diarrhea and assigned a 20 percent rating (Citation Nr. A25049239).

Combining codes. The opening paragraph of § 4.114 bars combining codes 7301 through 7329 with each other, so DC 7329 cannot be added to a rating such as irritable bowel syndrome under DC 7319. VA assigns one rating under the code for the predominant disability and can raise it one level when the overall picture is more severe. Separately, § 4.14 bars rating the same symptom twice under any two codes. Surgical scars are rated on their own under the skin criteria at 38 CFR § 4.118; a 2025 rectal cancer appeal addressed a 30 percent rating for unstable scars (Citation Nr. A25019730).

Is colon cancer service connected? PACT Act, radiation and Agent Orange

The broadest pathway is the PACT Act. 38 U.S.C. § 1120 lists gastrointestinal cancer of any type as presumptive for a covered veteran, and 38 U.S.C. § 1119(c) defines covered veteran by duty station: assigned to a duty station in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates on or after August 2, 1990, or in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan on or after September 11, 2001, including the airspace above them. For a veteran who fits that definition, the presumption takes the nexus question off the table. The Board granted colon cancer on this basis in January 2025 (Citation Nr. A25004235) and rectal cancer in March 2025 (Citation Nr. A25023772).

A second presumptive lane covers radiation-exposed veterans. Cancer of the colon is on the list at 38 CFR § 3.309(d) for veterans who took part in a defined radiation-risk activity. Rectal cancer is not on that list, but colon cancer and cancer of the rectum are both listed radiogenic diseases under § 3.311, which handles other documented ionizing-radiation exposure through a dose assessment rather than a presumption.

Agent Orange and Camp Lejeune are not presumptive lanes for colorectal cancer. Colon cancer is not on the herbicide list at 38 CFR § 3.309(e), and the Camp Lejeune list at § 3.309(f) covers kidney cancer, liver cancer, non-Hodgkin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer. A veteran with either exposure can still win on a direct basis with a medical opinion (Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994)). An opinion that rejects the claim only because colon cancer is not presumptive is not enough (Polovick v. Shinseki, 23 Vet. App. 48 (2009)); the Board applied that rule to a Camp Lejeune colon cancer claim in February 2025 (Citation Nr. A25009509). In January 2025, the Board granted service connection for a Vietnam veteran's death from colon cancer on a detailed private opinion linking the cancer to herbicide exposure (Citation Nr. A25002524).

The practical point is that the exposure and the pathology both have to be documented. Service records have to establish the qualifying duty station, radiation-risk activity, or exposure. The pathology has to establish that the diagnosis is colorectal cancer rather than a different malignancy. Where the link is not presumptive, the medical opinion has to explain the mechanism and weigh your other risk factors.

Secondary conditions from colon cancer treatment

Colon cancer treatment produces conditions that are separately ratable under 38 CFR § 3.310, which allows secondary service connection for a condition caused by a service-connected disability, or aggravated by it, meaning the condition would be less severe but for the service-connected disability. Once the cancer is service-connected, the downstream conditions from surgery, chemotherapy, and radiation can be claimed.

Chemotherapy-induced peripheral neuropathy. Peripheral neuropathy is the most common dose-limiting side effect of oxaliplatin, a chemotherapy drug used for colorectal cancer, and it often persists: in a 2022 systematic review, about a quarter of patients still had it three years after adjuvant oxaliplatin (PMID 34410459). It is rated under the neurological codes. See peripheral neuropathy for how that condition rates on its own.

Anemia. Cancer-related anemia has several causes, including chemotherapy suppressing the bone marrow and blood loss (PMID 24532336). When it persists, it is rated under the hematologic criteria at 38 CFR § 4.117.

Ostomy complications. Where the ostomy is the residual rated under DC 7329, the rating already accounts for it, but complications such as skin breakdown around the stoma or a hernia at the stoma site can add to the picture.

Bowel dysfunction. Beyond what the residual code captures, chronic diarrhea, urgency, and incontinence after resection or radiation can be significant. Watch the § 4.114 combining rule above before claiming a second bowel code.

For any of these, the secondary opinion has to identify the mechanism, address the time course, and say whether the cancer or its treatment caused the condition or made it worse than it would otherwise be. An opinion that skips aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)). A bare statement that the neuropathy is "due to chemo" is weaker than an opinion that names the drug, its known nerve effects, and the timing in your records.

The colon cancer C&P exam

The residuals exam is the rating engine for the post-treatment phase, and it has to do two jobs at once. First, it has to confirm whether there is local recurrence or metastasis, because that decides whether the 100 percent continues at all. Second, if there is no recurrence, it has to document the residuals in enough detail for the rater to pick the right code and tier.

A complete residuals exam should record the following.

• Recurrence and metastasis status, with the imaging, colonoscopy, or oncology records that support it
• The surgical history, including the extent of resection, whether the bowel was reconnected, whether the ileocecal valve was removed, and whether a colostomy or ileostomy was created and is temporary or permanent
• Bowel function: frequency, consistency, urgency, incontinence episodes, and use of pads or appliances
• Sphincter control findings relevant to DC 7332, including the frequency of leakage and any bowel program
• Weight history and any malabsorption or nutritional impairment
• Anemia and other hematologic effects of treatment
• Peripheral neuropathy from chemotherapy, with the distribution and severity
• Surgical scars, with their size and whether they are painful or unstable

When those components are in the report, the residuals rating reflects the actual disability. When the exam records only "status post colon resection, no recurrence," the rating defaults low. When the Board sent colon cancer claims back, the most common reason was an inadequate VA exam or opinion; the Board section below shows each remand reason.

Why VA denies colon cancer claims

When the Board denied colon cancer service connection, the part it most often found missing was a link between the cancer and service; the Board section below shows how often each part of the claim failed. These are the gaps I see repeat across the decisions.

No link to service. The veteran's service does not fit the PACT Act or radiation presumption, and there is no medical opinion, or only one that says colon cancer is not on a presumptive list. For Agent Orange and Camp Lejeune claims, the direct opinion is the whole case.

The qualifying service is not documented. The PACT Act presumption turns on an assignment to a listed duty station on or after the listed date. When the personnel records do not show it, the presumption never starts.

The residuals exam treats "no recurrence" as the whole job. It confirms remission, which ends the 100 percent, but never documents the resection, ostomy, sphincter impairment, or treatment effects that should drive the residuals rating.

The notice before the reduction is defective. When VA ends the 100 percent without a proposal that gives its reasons, the 60-day evidence window, and the hearing offer that § 3.105(e) requires, the reduction is void and the 100 percent is restored.

The mandatory exam comes too early. When it is scheduled before treatment has actually ended, the resulting rating is built on a premature snapshot.

Treatment secondaries never get claimed. Chemotherapy-induced neuropathy, persistent anemia, ostomy complications, and scars are separately ratable, but they often go unclaimed because the focus stays on the cancer.

From Claim Raven's read of 1,102 decided Board rulings on colon cancer, remands ran at 50.9 percent, the single largest outcome category, grants at 23.9 percent, and denials at 25.2 percent. The Board section below also shows how service connection claims went when the Board relied on a favorable medical opinion or an opinion against the claim, and how direct, secondary, and presumptive claims fared. Those are associations, not proof that any one piece of evidence caused the result.

Questions veterans ask about colon cancer

What is the VA rating for colon cancer?

Colon cancer rates 100 percent under DC 7343 while it is active and during treatment, and for six months after treatment ends. After the mandatory exam, it is rated on its residuals, most often from 10 to 60 percent under DC 7329 depending on how much colon was removed and whether there is a permanent ostomy.

Is colon cancer a presumptive condition for veterans?

Yes, for some veterans. Gastrointestinal cancer of any type is presumptive under the PACT Act for a veteran assigned to a covered duty station, and cancer of the colon is presumptive for radiation-exposed veterans under 38 CFR § 3.309(d).

Is colon cancer linked to Agent Orange for VA purposes?

Not by presumption. Colon cancer is not on the Agent Orange list at 38 CFR § 3.309(e), so a Vietnam-era claim needs a medical opinion that links the cancer to herbicide exposure in your case, and the Board has granted such claims on a detailed private opinion.

What is the VA rating for a colostomy after colon cancer?

A partial colectomy with a permanent colostomy or ileostomy rates 40 percent under DC 7329, and a total colectomy rates 60 percent. A temporary ostomy that was later reversed falls under the reconnected-bowel rows instead.

Can I get a separate rating for neuropathy from chemotherapy?

Yes. Neuropathy caused by chemotherapy for a service-connected cancer can be service connected as a secondary condition under 38 CFR § 3.310 and rated under the neurological codes, apart from the cancer residuals.

Bottom Line

Colon cancer at the VA is a two-phase rating. During active disease and treatment, the rating under 38 CFR § 4.114, DC 7343, is a flat 100 percent, and you do not have to prove symptoms to hold it. Six months after treatment ends, a mandatory exam decides what comes next: if there is recurrence or metastasis the 100 percent continues, and if there is not, the rating shifts to residuals, most often under DC 7329 for the resection or ostomy, or DC 7332 for sphincter control. Ending the 100 percent does not require VA to show improvement, but it does require the § 3.105(e) notice, and a reduction without it is void. On service connection, the PACT Act and radiation presumptions cover some veterans, while Agent Orange and Camp Lejeune claims need a medical opinion. The claims that come out right have an exposure record that ties the cancer to qualifying service, a residuals exam that documents the full functional cost rather than just confirming remission, and the treatment secondaries claimed and rated on their own.

Related Conditions

Colon cancer claims share rating logic and proof issues with other malignancy and digestive pages. See prostate cancer and lung cancer for the same active-disease-then-residuals structure that runs across VA cancer codes, including the mandatory post-treatment exam and the § 3.105(e) notice. On the digestive side, ulcerative colitis and diverticulitis cover bowel criteria that overlap with the residuals analysis here. Veterans dealing with treatment residuals should also review the secondary conditions tool before assuming the cancer rating alone tells the whole story.

Methodology and Limitations

• Data source: Rating criteria from 38 CFR § 4.114, DC 7343 (malignant neoplasm of the digestive system, exclusive of skin growths), DC 7329 (resection of the large intestine) and DC 7332 (impairment of sphincter control) as amended effective May 19, 2024 (89 FR 19735), checked against the eCFR text in October 2026. Reduction procedure from 38 CFR § 3.105(e) and (i), with Foster v. McDonough and Love v. McDonough on time-limited 100 percent ratings. Pyramiding from § 4.14. Secondary service connection from § 3.310. Exposure presumptions from 38 U.S.C. §§ 1119 and 1120 (gastrointestinal cancer of any type) and 38 CFR § 3.309(d) and § 3.311 (radiation); the herbicide list at § 3.309(e) and the Camp Lejeune list at § 3.309(f) were checked and do not include colorectal cancer. Board decisions cited by citation number come from the 2025 Board decision files. Medical statements cite PubMed abstracts by PMID.
• Board snapshot: From 2021 to 2026, the Colon Cancer summary covers 1,102 decided Board rulings on colon cancer: 23.9% granted (including partial grants and mixed outcomes), 25.2% denied, and 50.9% remanded. Dismissed, withdrawn and moot rulings are excluded. These are appealed claims, not your personal odds.
• Sample size: Board figures in this post come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings. Of 1,214 Board rulings on colon cancer, 1,102 were decided (granted, denied or remanded); the rest were dismissed, withdrawn or closed another way. The colon cancer grant rate is 0.8 points below the Board-wide 24.7% on decided rulings. The Board section on this page breaks these down by denial reason, remand reason, medical opinion, claim theory and era; those figures are computed from the data, not typed here. The read does not code residual codes or rating tiers.
• Classification approach: Diagnostic code and procedure definitions drawn from the regulatory text. The two-phase structure and the six-month mandatory exam follow the note to DC 7343. Reduction analysis follows § 3.105(e). Exposure analysis follows the statutory and regulatory presumption lists named above.
• Limitations:
• The exact residuals rating after treatment depends on the surgery and the symptom picture and is a medical and factual question. The Board decisions cited here illustrate how the codes are applied; they are not a count of how often each code is used.
• PACT Act and radiation presumptions have specific service-and-exposure requirements. Not every exposure connects to a colorectal cancer diagnosis automatically, and non-presumptive theories require a medical nexus opinion.
• Selection bias: BVA-level patterns reflect cases that appealed. Most colon cancer claims resolve at the RO level and are not in any BVA dataset.
• Compensation amounts reflect the 2026 VA rate tables (effective December 1, 2025) for a single veteran with no dependents and change annually with COLA.
• These observations reflect patterns from the regulatory text and BVA decisions. They are not predictions of individual outcomes.