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7301
§ 4.114 Schedule of ratings—digestive system.

Peritoneal adhesions

Bands of scar tissue in the abdominal lining that form after surgery, infection, trauma, or disease.

What the rating means

VA rates peritoneal adhesions under diagnostic code 7301. Five ratings are possible: 80%, 50%, 30%, 10%, and 0%.

The 80% rating applies when you have a persistent partial bowel obstruction that is either inoperable and cannot be controlled with treatment, or requires total parenteral nutrition (TPN) to manage obstructive symptoms. The 50% rating applies when a healthcare provider has confirmed symptomatic adhesions persisting or recurring after surgery, trauma, an inflammatory disease such as chronic cholecystitis or Crohn's disease, or infection; recurrent obstruction requiring hospitalization at least once a year; medically-directed dietary modification short of TPN; and at least one symptom such as abdominal pain, nausea, vomiting, colic, constipation, or diarrhea. The 30% rating shares those same requirements but drops the hospitalization requirement. The 10% rating requires confirmed symptomatic adhesions and at least one of those same symptoms, without the dietary modification requirement. The 0% rating covers a history of peritoneal adhesions when you are currently asymptomatic.

VA does not combine this rating with most other digestive condition ratings. When more than one digestive code would apply, VA assigns a single rating under the code that best reflects the overall disability, and may raise it one level if the combined picture warrants it.

Evidence that helps

Medical records that document the origin of your adhesions — operative reports, discharge summaries, records of trauma, or records of infection or inflammatory disease — help establish that adhesions are confirmed and symptomatic as required at every rating level above 0%.

For the 10% level, records or provider notes showing at least one symptom such as abdominal pain, nausea, vomiting, colic, constipation, or diarrhea are central. For the 30% level, documentation of a healthcare provider's dietary instructions — such as a low-fiber or low-residue diet prescription — adds the medically-directed dietary modification element. For the 50% level, hospital admission records showing at least one inpatient stay per year for recurrent obstruction are also needed. For the 80% level, surgical or specialist notes stating that the bowel obstruction is inoperable or refractory to treatment, or records showing TPN has been prescribed for obstructive symptoms, directly address those criteria.

Your own statements and statements from people who know you, describing how symptoms affect your ability to eat, work, and carry out daily activities, can support the overall picture of severity at any level.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.