Gastrointestinal diseases are those that involve the organs of the digestive tract and accessory organs that aid in digestion. The digestive tract and accessory organs include the small and large intestines, gallbladder, stomach, esophagus, rectum, liver, and pancreas, among others. Common gastrointestinal diseases and disorders include constipation, irritable bowel syndrome (IBS), diverticular disease and colitis.
Service Connection for Gastrointestinal Diseases
Veterans who experience gastrointestinal diseases may be entitled to service-connected compensation if their condition either began in service or is otherwise due to service. Common means of seeking service connection are through direct service connection or presumptive service connection.
Direct Service Connection
Direct service connection requires veterans to provide three things in order to receive service-connected compensation:
- That they have a diagnosed gastrointestinal disease;
- That they experienced an in-service event, injury or symptom; and
- A medical “nexus” linking their current condition to the in-service occurrence
Presumptive Service Connection
Presumptive service connection applies to veterans who were exposed to toxins or environmental hazards in service. For presumptive service connection, VA presumes that an instance or exposure in service caused your current condition. In essence, presumptive service connection does away with the medical nexus requirement of direct service connection.
Persian Gulf War Presumption
Under VA’s presumption for veterans who served in the Persian Gulf War (PGW), 38 C.F.R. 3.317, veterans can receive presumptive service connection for functional gastrointestinal disorders.
According to the International Foundation for Functional Gastrointestinal Disorders, “functional GI disorders are disorders of gut-brain interaction” and are “classified by GI symptoms related to any combination of the following: motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system (CNS) processing.”
Common functional gastrointestinal disorders include irritable bowel syndrome, functional constipation, functional diarrhea, and functional dyspepsia. Common gastrointestinal conditions such as gastroesophageal reflux disease (GERD), ulcers, or hernias are not included under this category of gastrointestinal disorders.
Prisoners of War
Former prisoners of war (POWs) who were captive for 30 days or more can receive presumptive service connection for certain digestive disorders, including peptic ulcer disease, chronic dysentery, irritable bowel syndrome, and cirrhosis of the liver.
Camp Lejeune Presumption
VA established a presumption for veterans who served at Camp Lejeune for 30 cumulative days between August 1, 1953 and December 31, 1987, due to veterans’ exposure to contaminated drinking water on the base. The gastrointestinal disease liver cancer is among the presumptive diseases eligible for presumptive service connection for veterans stationed at Camp Lejeune.
How Does VA Rate Gastrointestinal Diseases?
VA rates gastrointestinal diseases under 38 C.F.R. 4.114, the schedule of ratings for the digestive system. Each condition has specific ratings, and criteria that must be met in order to receive those disability ratings.