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VA Disability Benefits for Hernia

January 20, 2020
man clutching abdomen due to hernia pain

What is a Hernia?

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place.  Many hernias occur in the abdomen between your chest and hips, but they can also appear in the upper thigh and groin areas.  One of the most common types of hernia is an inguinal hernia, which occurs when tissue (e.g., part of the intestine) protrudes through a weak spot in the abdominal muscles.  Signs and symptoms of a hernia include the following:

  • A bulge or lump in the affected area that is more noticeable when upright
  • A burning or aching sensation at the bulge
  • Pain or discomfort when bending over, coughing, or lifting
  • A heavy or dragging sensation
  • Weakness or pressure
  • Occasionally, swelling around the bulge

Hernias are typically due to a combination of muscle weakness and strain.  Depending on the cause, hernias can develop quickly or over a long period of time.  Common causes of muscle weakness or strain that can lead to a hernia include:

  • A congenital condition that occurs during development in the womb and is present from birth
  • Aging
  • Damage from an injury or surgery
  • Chronic coughing or chronic obstructive pulmonary disorder (COPD)
  • Strenuous exercise or lifting heavy weights
  • Pregnancy
  • Constipation
  • Being overweight or obese

Importantly, many veterans suffer from hernias that are related to previous injuries or the strenuous nature of their service.  If a veteran can prove to VA that their hernia is due to their time in service, they may be eligible for VA disability benefits.

VA Service Connection for Hernias

In order to receive VA disability compensation for hernias, veterans must establish service connection.  The most common type of service connection is direct service connection, which is made up of three elements: (1) a current diagnosis of a hernia; (2) an in-service event, injury, or illness; and (3) a medical nexus linking the current, diagnosed hernia to the in-service event, injury, or illness.  To establish direct service connection, veterans should consider submitting argument and evidence in support of their hernia claims.  Examples of evidence may include service and medical personnel records, lay statements, and private doctor’s opinions.

If a veteran believes their hernia was caused or aggravated by another service-connected condition, they may be eligible for secondary service connection for their hernia.  In this case, veterans will have to demonstrate that their primary service-connected condition is medically linked to their hernia.  The above-mentioned types of evidence may be beneficial in claims for secondary service connection as well.

How VA Rates Hernias

The most common types of hernias involve the abdominal cavity and are rated under other codes according to the Digestive System rating schedule.  These types of hernias include inguinal, femoral, ventral, and hiatal.  Inguinal hernias in particular are rated as follows:

  • 60% – large, postoperative, recurrent, not well supported under ordinary conditions and not readily reducible, when considered inoperable
  • 30% – small, postoperative recurrent, or unoperated irremediable, not well supported by truss (i.e., a supportive undergarment), or not readily reducible
  • 10% – postoperative recurrent, readily reducible and well supported by truss or belt
  • 0% – not operated, but remediable; or, small, reducible, or without true hernia protrusion

All other types of hernias are rated under 38 CFR § 4.73, Schedule of Ratings – Muscle Injuries, Diagnostic Code 5326.  Hernias that have not been or cannot be repaired are rated at 10 percent disabling.  Importantly, a 0 percent disability rating is given for repaired and healed hernias; however, if there are lasting symptoms caused by the hernia (e.g., decreased organ function or muscle damage) they are rated separately.