Diverticulitis VA Rating

Diverticulitis has been one of the more confusing conditions in the rating schedule, and the confusion was structural, not incidental. Until 2024 there was no schedule of rating percentages written for diverticulitis itself. The diagnostic code that governs it, DC 7327 (opens in a new tab), told the rater to evaluate diverticulitis as irritable colon syndrome, peritoneal adhesions, or ulcerative colitis, whichever best matched the predominant disability picture.

That framework was repealed effective May 19, 2024. DC 7327 now carries its own criteria, and the lever moved: the claim no longer turns on choosing a favorable analogous code, it turns on whether there was a qualifying hospitalization in the past 12 months and whether a listed complication is named in the record.

The second rule veterans trip over is the bar on combining digestive ratings. 38 CFR § 4.113 (opens in a new tab) and 38 CFR § 4.114 (opens in a new tab) keep most coexisting abdominal and digestive conditions from being rated separately, so diverticulitis plus IBS generally gets one rating under the predominant code. This page walks through the current DC 7327 tiers, the rule for claims pending across the change, the surgical residual codes that open up after a colectomy, service connection and the PACT Act question, the C&P exam, and why VA denies diverticulitis claims.

TL;DR

• DC 7327 now has its own rating tiers. The final rule at 89 FR 19735, effective 2024-05-19, gave "Diverticulitis and diverticulosis" three levels of its own: 0, 20, and 30 percent. Any guide describing DC 7327 as a pointer to DC 7319, DC 7301, or DC 7323 is describing the superseded rule.
• Hospitalization is the gate. Both compensable tiers require diverticular disease that required hospitalization for abdominal distress, fever, and leukocytosis one or more times in the past 12 months. Without that, the rating is 0 percent.
• A listed complication decides 20 versus 30. With hemorrhage, obstruction, abscess, peritonitis, or perforation, the rating is 30 percent. With the hospitalization but none of those, it is 20 percent.
• Managed by diet and medication rates 0 percent, as does asymptomatic disease. There is no intermediate rung for symptomatic disease controlled without admission.
• Diverticulitis plus IBS generally yields a single evaluation under the predominant code, not two stacked ratings. GERD, now rated under DC 7206, is not on the § 4.114 no-combine list and can be rated separately, as long as the same symptoms are not counted twice under § 4.14.
• Surgery changes the analysis. After a colectomy or colostomy, VA uses DC 7327 or DC 7329 (large intestine resection), whichever is higher, and impaired sphincter control can be rated under DC 7332.
• No PACT Act presumption covers diverticulitis, but a toxic-exposed veteran can still be owed a VA medical opinion on the exposure.
• A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 945 decided Board rulings on diverticulitis from 2021 to 2026, 14.2% were granted, 27.2% denied and 58.6% remanded. Remand is the most common outcome by a wide margin.

Diverticulitis VA rating criteria (DC 7327)

VA rewrote the digestive section in a final rule published March 20, 2024 (89 FR 19735), effective May 19, 2024, and DC 7327 came out of it with its own criteria. Here is the current text in full.

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and with at least one of the following complications: (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation, 30%

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and without associated (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation, 20%

Asymptomatic; or a symptomatic diverticulitis or diverticulosis that is managed by diet and medication, 0%

A note follows the tiers: for colectomy or colostomy, use DC 7327 or DC 7329 (Intestine, large, resection of), whichever results in a higher evaluation.

Hospitalization is the gate

Every compensable rating requires a hospitalization in the past 12 months, and not merely any hospitalization. The regulation specifies admission for abdominal distress, fever, and leukocytosis. All three findings are named. A veteran admitted for abdominal pain with normal white counts and no fever has a weaker claim on the text than one whose chart records the full triad.

Below that gate there is one rung and it pays nothing. A veteran with genuinely symptomatic diverticular disease, on daily medication, avoiding trigger foods, having several painful flares a year that resolve at home, rates zero under this code. That is a harsh result and it is what the text says.

A listed complication decides 20 versus 30 percent

The five complications are a closed list: hemorrhage, obstruction, abscess, peritonitis, perforation. There is no catch-all. So the whole 20-versus-30 argument is a documentation question with a yes-or-no answer: does an operative note, a CT report, or a discharge summary name one of those five words?

Under the old analogy framework, the rating ran on the texture of chronic symptoms: how constant the abdominal distress was, whether bowel function was disturbed, whether there was weight loss. Those facts still describe the disease, but under the current text they no longer set the tier. The admission record and the imaging or operative report do.

One consequence deserves flagging. A veteran whose diverticulitis is well controlled by diet and medication, with no admission in the past 12 months, rates 0 percent under this code even with real ongoing symptoms. If that describes you, ask whether a different code better captures the predominant disability picture, for example IBS under DC 7319, where the criteria run on how often abdominal pain related to defecation occurs rather than on admissions. That is a predominant-disability question under §§ 4.113 and 4.114, and it is now the main strategic decision in a mild-to-moderate diverticular claim.

Which criteria apply to a pending claim

If your claim or appeal was pending when the rule changed, VA uses the old analogy criteria for the period before May 19, 2024, and from that date it considers both the old and the new criteria and applies whichever is more favorable to you (Board citations A25006118 and 25000255). Under the old rule, DC 7327 rated diverticulitis "as irritable colon syndrome (DC 7319), peritoneal adhesions (DC 7301), or colitis, ulcerative (DC 7323), depending upon the predominant disability picture" (Board citation A25009242). If you are working from a decision issued before May 2024, check which framework it used.

Diverticulitis surgery: colectomy and sphincter residuals

When diverticulitis is severe enough to require surgery, the rating analysis can shift. A colectomy or bowel resection done for diverticular disease produces its own residuals, and some of them are rated under other codes.

DC 7329. For a colectomy or colostomy, the note to DC 7327 directs a comparison between DC 7327 and DC 7329, whichever pays more. DC 7329 runs from 10 percent for a partial colectomy with reconnection up to 100 percent for a total colectomy with ileostomy, high-output syndrome, and more than two episodes of dehydration needing IV fluids in the past 12 months. Run both. Nothing in the process does that comparison automatically.

DC 7332, impairment of sphincter control. Sigmoid resection for diverticular disease can be followed by long-term bowel dysfunction, including incontinence (PMID 36645511). DC 7332 is graded from a history of loss of sphincter control that is currently asymptomatic at 0 percent up to complete loss of sphincter control at 100 percent, and it is not on the § 4.114 no-combine list. For a veteran with significant fecal incontinence after diverticulitis surgery, it can capture a disability that the DC 7327 tiers do not reach.

DC 7301, peritoneal adhesions. DC 7301 itself names surgery as a cause of adhesions. A veteran who had an emergency resection for perforated diverticulitis, and who now has the obstructive, pulling-pain picture of adhesions, may be better described by DC 7301 than by IBS. Because DC 7301 is on the no-combine list with DC 7327, that is a predominant-code choice, not an extra rating.

The operative reports, the pathology, and the documented residuals (incontinence, adhesion symptoms, partial obstructions) become the evidence for a different and often higher code. Preserve operative notes, discharge summaries, follow-up imaging, and any documentation of bowel-control problems.

Diverticulitis, IBS and GERD: one rating or two

Under § 4.114, ratings under DCs 7301 through 7329 (and several other digestive codes) are not combined with each other. When more than one is warranted, VA assigns a single evaluation under the code for the predominant disability picture and elevates it to the next higher evaluation when the severity of the overall disability warrants it.

Diverticulitis can coexist with IBS and GERD. IBS (DC 7319) is on the no-combine list with DC 7327; GERD (DC 7206) is not. So the work on the digestive cluster is not about stacking ratings. It is about getting every condition recognized so the predominant-condition evaluation reflects the whole picture, and about establishing residuals like sphincter impairment that the single-rating rule does not absorb.

The rule cuts both ways. Some veterans expect separate ratings for diverticulitis and IBS and are surprised when § 4.114 collapses them into one. On the other side, raters sometimes use the single-rating rule to undercount, assigning the predominant code at a low tier without reflecting the combined severity. The correct application is a single rating under the predominant code, elevated one level when the overall disability warrants it.

Is diverticulitis service connected? Direct, secondary and the PACT Act

Direct service connection

Direct service connection needs a current diagnosis, an in-service event or disease, and a medical link. The strongest records show diverticular disease or its attacks in service, or a continuous course of treatment from service forward, plus an opinion that explains the link rather than stating it.

Secondary service connection

Under 38 CFR § 3.310 (opens in a new tab), secondary service connection covers a condition caused by a service-connected condition, or aggravated by it, meaning it would be less severe but for the service-connected condition (Allen v. Brown, 7 Vet. App. 439 (1995)). If service-connected diverticulitis required a resection, the residuals of that surgery flow from the service-connected condition and feed the code choice above. For a secondary theory that runs to diverticulitis from another condition or its treatment, the opinion has to identify the mechanism, address the time course, and be more than a bare conclusion.

Diverticulitis and the PACT Act

No presumption covers diverticulitis. It is not among the diseases listed in the PACT Act presumption at 38 U.S.C. § 1120 (which names gastrointestinal cancer, not diverticular disease), in VA's burn pit and particulate matter rules at 38 CFR §§ 3.320, 3.320a and 3.320b, or on the Agent Orange list in § 3.309(e). The Gulf War rule in § 3.317 covers functional gastrointestinal disorders and excludes structural gastrointestinal diseases, and diverticular disease is a structural finding on CT or colonoscopy.

The PACT Act can still matter. For a veteran VA treats as toxic exposed, 38 U.S.C. § 1168 generally requires a medical opinion on whether the claimed disability is linked to the documented toxic exposure. In one 2025 decision, the Board sent a claim back for a toxic exposure opinion that addressed the veteran's diverticulosis (Board citation 25000183). The Board section below shows how direct, secondary, and presumptive arguments fared.

The diverticulitis C&P exam

The diverticulitis C&P exam runs off the DBQ for intestinal conditions. Under the current DC 7327 the exam has to establish two things above all: whether there was a qualifying hospitalization in the past 12 months, and whether any of the five listed complications occurred. A complete report also records the items below.

• The frequency and severity of diverticulitis attacks, including any hospitalizations
• Whether abdominal distress is occasional or more or less constant
• The bowel-function disturbance: diarrhea, constipation, alternation, urgency
• Weight history and any evidence of malnutrition or nutritional deficiency
• Surgical history, including any colectomy or resection, with residuals
• Any sphincter-control impairment or incontinence
• Other coexisting digestive conditions, so the rater can identify the predominant one

When the exam is thin, recording only "history of diverticulitis, currently stable," the claim rates 0 percent, because "managed by diet and medication" is exactly what the zero tier describes. The admission dates and the complication findings are what an examiner has to pull forward from the hospital records, and they are often the facts a stable-day exam leaves out. When the Board sent diverticulitis claims back, the most common reason was a VA exam or opinion that was not adequate; the Board section below shows the reasons.

Why VA denies diverticulitis claims

Across 945 decided Board rulings on diverticulitis from 2021 to 2026, 14.2% were granted, 27.2% denied and 58.6% remanded. That grant rate is 10.5 points below the Board-wide 24.7 percent, and the remand share is well above the 45.3 percent for decided rulings Board-wide. When the Board denied service connection, it most often found no link between the diverticulitis and service; the Board section below shows how often each part of the claim failed. Much of that window predates the current criteria, so those figures describe a mix of the old and new frameworks. A few patterns I see across Board decisions involving diverticulitis follow.

No link to service. The disease began years after separation, there is no in-service treatment, and no opinion explains a direct or secondary path.

Hospitalizations not pulled into the record. Under the current code an admission for abdominal distress, fever, and leukocytosis in the past 12 months is the gate for any compensable rating, and admissions at community hospitals or under emergency care often never reach the VA file. List every admission by date and facility and make sure the chart showing the fever and the white count is in the file.

The complication never named in the record. A CT report describing a "walled-off fluid collection" without the word abscess, or an operative note describing repair without the word perforation, leaves the rater without the finding. Where the clinical picture supports it, ask the treating surgeon or gastroenterologist to state the complication in the terms the regulation uses.

No record of attack frequency and severity. Without dated records of acute attacks, hospitalizations, IV antibiotic courses, and the between-attack picture, the rater cannot tell a mild episodic case from a severe one, and defaults low.

Misreading the single-rating rule. Expecting separate ratings for diverticulitis and IBS, or accepting a low predominant-code rating that ignores the combined severity.

Surgical residuals never developed. Sphincter-control problems (DC 7332) or adhesion symptoms (DC 7301) after a resection never make it into the rating analysis because the exam did not ask and the file did not document them.

Questions veterans ask about diverticulitis

What is the VA rating for diverticulitis?

Under DC 7327, diverticulitis rates 0, 20, or 30 percent. You need a hospitalization for abdominal distress, fever, and leukocytosis in the past 12 months for 20 percent, plus hemorrhage, obstruction, abscess, peritonitis, or perforation for 30 percent; disease managed by diet and medication rates 0 percent.

Is diverticulitis covered by the PACT Act?

Not as a presumptive condition. It is not on the PACT Act list in 38 U.S.C. § 1120 or in 38 CFR §§ 3.320 through 3.320b, so you prove it directly or on a secondary theory, though a toxic-exposed veteran can be owed a VA medical opinion on the exposure under 38 U.S.C. § 1168.

Does diverticulosis get a VA rating?

DC 7327 covers both diverticulitis and diverticulosis. Asymptomatic diverticulosis, or diverticular disease managed by diet and medication, rates 0 percent; a compensable rating needs the qualifying hospitalization.

Can I get separate VA ratings for diverticulitis and IBS?

Generally not. Both codes are on the § 4.114 list that is not combined, so VA assigns one rating under the predominant code and can raise it one level when the overall disability warrants it.

What is the VA rating after a colectomy for diverticulitis?

VA rates under DC 7327 or DC 7329 (large intestine resection), whichever is higher, and DC 7329 runs from 10 to 100 percent depending on how much colon was removed, whether there is an ostomy, and complications. Loss of bowel control after surgery can be rated separately under DC 7332 when the other rating does not already count it.

Bottom Line

Diverticulitis is now rated on its own terms. Until May 19, 2024, DC 7327 paid nothing by itself and routed the claim to irritable colon syndrome, peritoneal adhesions, or ulcerative colitis, and that single choice set the ceiling. DC 7327 now has three rungs of its own, and they are unusually blunt: a hospitalization for abdominal distress, fever, and leukocytosis in the past 12 months is the gate for any compensable rating, one of five named complications lifts it from 20 to 30 percent, and everything else, including genuinely symptomatic disease managed by diet and medication, rates 0 percent. That moves the whole claim onto the hospital record. The single-rating rule under §§ 4.113 and 4.114 still collapses diverticulitis, IBS, and the other listed digestive codes into one rating under the predominant code, and surgery opens DC 7329 and DC 7332. No PACT Act presumption covers diverticulitis, so the claim is won on the records and the medical opinion. The Board data is blunt about how often the record falls short, with 58.6 percent of decided rulings remanded.

Related Conditions

Diverticulitis sits inside a tightly linked digestive cluster, and the single-rating rule means the conditions around it directly affect how it gets rated. Review IBS, the condition most likely to compete for the predominant-disability designation, GERD, which can be rated separately under DC 7206, and ulcerative colitis, which the old version of DC 7327 pointed to and which was itself rewritten in the same 2024 rule. Hemorrhoids often coexist and follow their own separate code. Veterans with a GI cluster should run the secondary conditions tool before assuming any single digestive diagnosis tells the whole rating story.

Methodology and Limitations

• Data source: Rating criteria quoted verbatim from the current 38 CFR § 4.114, DC 7327, as amended by the final rule "Schedule for Rating Disabilities: The Digestive System," 89 FR 19735, published 2024-03-20, effective 2024-05-19, checked against the eCFR text current to October 2, 2026. Single-rating rules from §§ 4.113 and 4.114. Surgical residual codes DC 7301, DC 7329 and DC 7332 from § 4.114. Secondary service connection from § 3.310, with the aggravation theory from Allen v. Brown. Presumptive lists from §§ 3.309, 3.317, 3.320, 3.320a and 3.320b and from 38 U.S.C. § 1120. The pre-2024 DC 7327 wording, the rule for pending claims and the PACT Act opinion requirement are taken from Board decisions (citations A25009242, A25006118, 25000255 and 25000183).
• Board snapshot: Across 945 decided Board rulings on diverticulitis from 2021 to 2026, 14.2% were granted (including partial grants and mixed outcomes), 27.2% denied and 58.6% remanded. Dismissed, withdrawn and moot rulings are excluded. These are appealed claims, not your personal odds.
• Sample size: Patterns in this post are drawn from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings, including 1,028 Board rulings on diverticulitis (945 decided). The Board section on this page breaks these down by denial reason, remand reason, outcomes after a remand, claim theory and era since 1992; those figures are computed from the data, not typed here.
• Limitations:
• Much of this 2021 to 2026 window predates the current criteria, which took effect May 19, 2024. Before then DC 7327 had no tiers of its own and the rating depended on the choice among DC 7319, DC 7301, and DC 7323, and a later decision can still apply the old criteria to the period before the change. I have not split these rulings by which framework the Board applied, so the outcome and remand rates describe a mix of the two and are not a forecast under the current criteria.
• The current tiers are concrete but leave real questions open. The regulation does not define how completely the "abdominal distress, fever, and leukocytosis" triad must be documented for an admission to qualify, and it gives no rung between "managed by diet and medication" at 0 percent and a hospitalization at 20 percent.
• Application of the predominant-disability rule varies at the regional office level, and reasonable raters can disagree about which code best fits a given picture.
• Selection bias: Board-level patterns reflect cases that appealed. Most diverticulitis claims resolve at the regional office and are not in any Board dataset.
• These observations reflect patterns from the regulatory text and Board decisions. They are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical, or VA-accredited advice.