Hernia Claims Guide

A hernia is an organ or tissue pushing through a weak spot in the muscle wall, most often in the groin. For veterans, years of heavy lifting make them common, and many are first repaired in service. The rating surprises people: a hernia that was fixed and stayed fixed often rates 0 percent, while a hernia that keeps coming back or cannot be supported rates much higher. This guide walks the whole path: how service connection works, how a hernia gets connected to your service (directly, or secondary to another condition), what evidence you need, why these claims get denied, a checklist before you file, what the claims process looks like step by step, how to read your decision letter, and what to do whether you win or you're denied. It also covers the DC 7338 rating criteria, the bilateral add-on, and why hiatal hernia is rated differently.

Last updated: July 2026 · Educational use only. Not legal advice. Verify current rules at VA.gov or eCFR.

What a Hernia Claim Covers

The most-claimed hernia is the inguinal (groin) hernia, diagnostic code 7338, under the digestive schedule (see 38 CFR § 4.114). Femoral, ventral, and umbilical hernias are rated on their own related codes using a similar recurrence-and-support test.

Hiatal hernia is different. A hiatal hernia, where part of the stomach pushes up through the diaphragm, is not rated under the hernia codes at all. It is rated under the GERD and esophagus criteria, because its disability is acid reflux, not a bulge that needs support. If your claim is really about reflux, see the GERD guide.

Types of Hernia

Inguinal hernia is the most common type claimed, where tissue pushes through the inguinal canal in the groin. It is rated under DC 7338.

Ventral (incisional) hernia develops through a weakness in the abdominal wall, often at the site of an earlier surgical incision, and is rated under a related code (DC 7339) using a similar recurrence-and-support framework.

Femoral and umbilical hernia occur at the femoral canal (upper thigh, near the groin) and the belly button, respectively. Both are evaluated by analogy to the same recurrence-and-support test used for inguinal hernia.

A hernia is diagnosed on physical exam, sometimes confirmed with imaging, and the diagnosis generally records the type, side (or sides), whether it is reducible (can be pushed back in), and whether it is supported by a truss or belt. This guide is built from a set of real 2026 Board of Veterans' Appeals decisions involving a hernia. Most of those appeals were not actually about whether the hernia connects to service at all, they were about how much the rating should be, the effective date, painful surgical scars from the repair, or whether VA improperly took away an existing rating. Only a small share were genuine wins or losses on whether service connection itself should be granted.

How Service Connection Works, At a High Level

Before getting into the specific pathways below, it helps to understand the three things every hernia claim ultimately has to show. This is the same basic test that applies to any VA disability claim, just applied to this condition.

  1. A current hernia. You must actually have a hernia, or its lasting effects, now. If a hernia was repaired long ago and has not come back, and there is no current diagnosis or documented residual, VA may find there is no current disability to connect.
  2. An in-service cause or event. Something in service must have caused the hernia, or a hernia you already had must have gotten worse in service.
  3. A medical link (nexus). A doctor must connect the hernia to service, or to a service-connected condition, and explain why, ideally after reviewing your records.
The tie goes to you. If the evidence for and against your claim is evenly balanced, the law resolves that reasonable doubt in your favor rather than requiring you to prove your case beyond any doubt (38 U.S.C. § 5107(b)). This three-part framework is sometimes called the Shedden elements, after Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004), which laid out the current-disability, in-service-event, and nexus test. See the Service Connection Guide for how this test works generally.

What VA Looks For: Tests, Records, and Diagnostic Codes

Whether you are filing directly or secondary to another condition, the record VA actually reviews centers on a small set of documents and data points.

  • A current exam or treatment record: documenting whether the hernia is present, its type, which side (or both), whether it is reducible, and whether it is supported by a truss or belt.
  • Surgical and treatment records: showing the original hernia, any repair, and any recurrence. This is what the recurrence-based rating is built from, and hernias are often diagnosed and repaired by private doctors, so those private records matter as much as VA's own.
  • The diagnostic codes involved: DC 7338 for inguinal hernia, DC 7339 for ventral hernia, plus whatever code applies to a condition you're connecting it to as secondary, for example a chronic cough or a bowel condition that causes straining.
  • The actual form the examiner fills out: the Hernias Disability Benefits Questionnaire (DBQ), discussed in more detail later in this guide.

Service Connection Pathways: Direct and Secondary

Direct service connection is not the only path into a hernia claim. Across published DC 7338 decisions, here is how often the Board granted by the legal theory the claim was argued on:

Direct Service Connection

A hernia that appeared in service, or was repaired in service, from the heavy lifting, straining, and load-bearing of military duty, with a current diagnosis or documented residuals. See our Service Connection Guide.

Residuals of an In-Service Repair

Even if the original hernia was fixed in service, a later recurrence, or lasting pain, numbness, or weakness at the surgical site, can be service-connected as a residual. A later recurrence or residual symptoms at the repair site can be service-connected even long after discharge, with a current diagnosis and a link back to the original in-service repair.

Secondary Service Connection (38 CFR § 3.310)

A hernia caused or worsened by another service-connected condition, for example chronic straining from a bowel condition or a chronic cough, can be connected on this theory. It also runs the other direction: a new problem caused by an already service-connected hernia, such as gastrointestinal symptoms that develop in connection with the hernia or its repair, can itself be service-connected as secondary to the hernia. Secondary service connection covers disabilities proximately due to a service-connected disease or injury. See secondary conditions and our Secondary Service Connection Guide.

Aggravation of a Preexisting Hernia

Many people have a hernia, or a repair, before they enlist. If a preexisting hernia was not noted when you entered service, VA must consider whether service made it worse beyond its natural course, not just whether service caused it outright. A veteran can win service connection on this theory even when the hernia clearly predates service, where a doctor explains that specific in-service events aggravated it beyond its natural progression. Aggravation of a preexisting condition can be service-connected under 38 CFR § 3.304, and where a hernia was not noted at entry, the presumption of soundness under 38 U.S.C. § 1111 also comes into play.

Toxic Exposure, With Caution

Hernias are not automatically presumed from Agent Orange, radiation, or other toxic exposures, they are not on VA's presumptive lists. A toxic-exposure theory still needs a medical opinion specifically linking the exposure to the hernia; a claim built only on the general fact of exposure, without an examiner or doctor connecting it to this specific disability, is a weak claim on its own.

How the VA Rates a Hernia (DC 7338)

The rating turns on three things: whether the hernia has come back after surgery (recurrence), whether it can be pushed back in (reducible), and whether a truss or belt controls it (support). A well-repaired hernia rates low; a recurrent one that cannot be supported rates high. Under the rating rules that took effect May 19, 2024, a hernia generally must be irreparable, meaning surgery cannot fix it, to be paid at a compensable level; size and pain with everyday activities set the specific level within that.

RatingInguinal hernia
60%Large, postoperative, recurrent, not well supported under ordinary conditions and not readily reducible, considered inoperable
30%Small, postoperative recurrent, or unoperated and irremediable, not well supported by a truss or not readily reducible
10%Postoperative recurrent, readily reducible and well supported by a truss or belt
0%Not operated but remediable, or small and reducible without a true protrusion
The bilateral add-on. If hernias are present on both sides, the VA rates the more disabling one and adds 10 percent for the second, as long as the second side would itself be compensable. Make sure a bilateral hernia is claimed as bilateral.
Painful scars can be rated separately. A painful surgical scar left over from a hernia repair can be rated on its own, in addition to the hernia rating itself, under the scar criteria. If your repair left a tender or painful scar, raise it as its own issue rather than assuming it is folded into the hernia rating.
Go deeper: open the full hernia breakdown
  • What the VA measures at your C&P exam
  • Evidence that has won at the Board
  • Inside the rater's playbook: grant, denial, and remand rates
  • Secondary condition map
See the full DC 7338 breakdown →

Evidence That Wins

Across the Board's published DC 7338 decisions, a private nexus opinion in the file goes with a much higher grant rate, shown below.

  • Surgical and treatment records showing the original hernia, any repair, and any recurrence, this is what the recurrence-based rating is built from.
  • A current exam documenting whether the hernia is present, reducible, and supported by a truss, and whether it is one side or both.
  • Records of residual symptoms after repair, pain, numbness, or weakness at the site, which can support service connection even when the hernia itself is fixed.
  • A nexus opinion that explains its reasoning, tying the hernia or its residuals to service, or to another service-connected condition, and explaining why, ideally after the doctor reviews your records. A detailed opinion that walks through the specific in-service event and rules out other explanations carries far more weight than a brief, vague one; a vague opinion that ignores your records, or an opinion built on the wrong facts, is given little weight even if it sounds favorable. See nexus letters.
  • Clear, consistent testimony about when it started. You are competent to describe what you felt and when, for example noticing a knot or bulge during a specific activity or deployment. Lay statements are competent evidence of symptoms you can personally observe, but keep your account consistent across every form, exam, and statement.
  • The Hernias DBQ, which records the type, side, recurrence, and support the rating depends on. See the DBQ guide.

Why These Claims Get Denied

Beyond the general "no current hernia" and "no nexus" reasons, a few specific denial patterns show up often enough in published hernia decisions to call out on their own.

  • A hernia that was repaired long ago, with nothing current in the record. Claims are denied where the hernia had been fixed years earlier and there was no current diagnosis, or no medical records at all showing a present hernia. Without a current disability, there is no valid claim to connect.
  • The veteran's own belief about what caused it, without a doctor's opinion behind it. A veteran can describe symptoms, but is generally not considered qualified to say what medically caused a hernia. A general assertion that an in-service activity caused the hernia, without a supporting medical opinion, does not carry the claim when it is weighed against a specific, reasoned opinion on the other side.
  • A long gap between service and the first record of the hernia, or between discharge and when the veteran first raised it. Where the record shows decades between separation and the first documented connection to service, that gap itself becomes a reason for denial.
  • Toxic or radiation exposure argued alone. Hernias are not on VA's presumptive exposure lists. A claim resting only on general exposure, without a medical opinion explaining a specific mechanism connecting that exposure to the hernia, is a weak claim on its own.
  • A generic, unsupported medical opinion. An opinion that only restates the veteran's own account, ignores the record, or could describe anyone, is given little weight, even when it reaches a favorable-sounding conclusion.

Common Mistakes

The same handful of procedural missteps account for most lost or under-rated hernia claims. Among the Board's classified service-connection denials for hernia, here is what claims most often fell short on:

  • Assuming a repaired hernia is worthless. A fixed hernia can rate 0 percent, but recurrence or lasting pain, numbness, and weakness at the site can still be service-connected and rated.
  • Not documenting recurrence and support. The rating turns on whether the hernia came back and whether a truss controls it. If the exam does not record these, it lands on the wrong row.
  • Claiming one side when both are affected. Bilateral hernias get the more disabling rating plus a 10 percent add-on. Claim it as bilateral.
  • Filing a hiatal hernia under the hernia codes. Hiatal hernia is rated as reflux under the GERD and esophagus criteria, not as a hernia. Using the wrong framework loses the claim.
  • Missing the residuals path. When the original repair was in service, later problems at the site are residuals that can be service-connected even years afterward.
  • Waiting years to file or to raise the hernia at all. Long gaps between service and the first time a hernia is tied to it hurt credibility. File and document promptly.

Do's and Don'ts

A condensed version of everything above, in the order it actually matters when you sit down to build your file.

Do
  • Get a current diagnosis of your hernia in writing before you file.
  • Point to the in-service event, injury, or symptom, or to a hernia that got worse in service.
  • Get a medical nexus opinion that reviews your records and explains the why, not a bare conclusion.
  • Gather your private treatment and surgery records and give them to VA, hernias are often diagnosed and repaired outside the VA system.
  • If your hernia is linked to another service-connected condition, such as a chronic cough or a bowel condition that causes straining, claim it as secondary.
  • If your hernia existed before service, raise aggravation, don't assume it disqualifies you.
  • Give clear, consistent testimony about when your symptoms started, and keep it consistent across every form and exam.
  • File promptly and keep pursuing the same claim to protect your effective date.
  • Document any recurrence, pain with activities, size, and any need for a belt or truss for rating purposes.
  • Raise a painful surgical scar from your repair as its own separate issue.
Don't
  • Don't assume a diagnosis or symptoms alone will win the claim, you still need the current disability, the in-service link, and a nexus.
  • Don't rely only on your own opinion about what caused it, causation for a hernia is treated as a medical question.
  • Don't wait years to file or to raise the hernia, long gaps hurt credibility.
  • Don't assume a hernia is presumptive from Agent Orange or radiation, it isn't, so a toxic-exposure theory still needs its own medical link.
  • Don't submit a generic, unsupported medical opinion, or lean on one that ignores your actual records.
  • Don't claim only one side when both are affected.
  • Don't file a hiatal hernia under the hernia codes, it is rated under GERD and esophagus criteria instead.

Common Secondary Conditions

A hernia connects to other claims in both directions, through the strain that causes it and the surgery that treats it. Each bar below is the Board's grant rate for DC 7338 in that pairing, with the number of decisions under it. They describe the published record across many veterans, not a prediction about any one claim.

Conditions linked as causing a hernia (hernia as the secondary)

Claims where the hernia was argued as secondary to an already service-connected condition, most often chronic straining from a bowel condition or a chronic cough. This is the "ways to connect via another condition" list, and it's often an easier route than direct service connection:

Conditions a hernia is linked to causing (hernia as the primary)

Conditions veterans have claimed as caused or aggravated by a service-connected hernia or its repair, in other words, conditions secondary to the hernia once the hernia itself is already service-connected. Note: this page currently has enough published-decision data to chart DC 7338 in both directions; if a specific secondary code you're researching doesn't show a bar below, it means the corpus doesn't yet have enough decisions for that pairing to report a rate.

Quick Checklist Before You File

Bring these together before you submit anything.

  • A current diagnosis of your hernia, in writing.
  • The in-service event, injury, or symptom, or a hernia that got worse in service.
  • A medical nexus opinion that reviews your records and explains the why.
  • Your private treatment and surgery records, gathered and given to VA.
  • If your hernia is linked to another service-connected condition, it claimed as secondary, not filed as a standalone theory.
  • A plan to file promptly and keep pursuing the same claim, to protect your effective date.
  • For a rating, documentation of any recurrence, pain with activities, size, and any need for a belt or truss.

For the mechanics of actually submitting the claim, see the Standard Claim Guide and the Fully Developed Claim Guide (filing with all your evidence up front can speed up the decision).

The Claims Process, Step by Step

Once you file, your claim moves through a series of hand-offs. Understanding who does what helps you know who to contact, and what to expect, at each stage.

  1. You file the claim. Directly with VA, through VA.gov, or with the help of an accredited representative.
  2. VA acknowledges the claim and assigns it for development. A Veteran Service Representative (VSR) is assigned to gather your service treatment records, VA and private medical records, and any other evidence needed.
  3. The VSR orders a Compensation & Pension (C&P) exam if one is needed. Most hernia claims involve one, especially where recurrence, reducibility, or support by a truss needs to be documented, or where a nexus opinion is required for a secondary or aggravation theory.
  4. The C&P exam is conducted. By a VA clinician or a contracted examiner, who completes a Disability Benefits Questionnaire (DBQ) documenting the type of hernia, side, recurrence, reducibility, support, and, where relevant, a nexus opinion.
  5. The file goes to a Rating Veteran Service Representative (RVSR), the "rater." The rater reviews the complete file, including the exam results, and decides whether service connection is warranted and at what percentage.
  6. A senior reviewer may review the decision before it's finalized, depending on the complexity of the claim.
  7. VA issues the decision letter. This states whether the claim is granted or denied, the rating percentage if granted, and the reasons behind the decision.
  8. If you disagree, you choose an appeal lane. Higher-Level Review, Supplemental Claim, or a Board appeal, covered later in this guide.

Who's who: VSO vs. VSR vs. Rater vs. C&P Examiner

Your VSO

An accredited representative from a veterans service organization, or an accredited attorney or claims agent. Not a VA employee. Helps you prepare, gather evidence, and file, and can represent you through an appeal. Has no authority to decide your claim.

VSR (Veteran Service Representative)

VA staff who "develops" your claim: requests records, schedules the C&P exam, and assembles the file. Does not decide the rating.

Rater (RVSR)

VA staff who reviews the completed file and makes the actual decision, service connection or denial, and the percentage. This is the person whose judgment the decision letter reflects.

C&P Examiner

A VA clinician or a contracted medical examiner who conducts the exam and completes the DBQ. Documents findings and, where asked, a nexus opinion. Does not decide the claim.

For the full walkthrough of every stage with more detail, see Inside Your Claim and Claim Stages.

DBQs and Your C&P Exam

The Hernias Disability Benefits Questionnaire (DBQ) is the standardized form an examiner completes for your condition, it structures the exam findings into the specific data points VA's rating schedule requires (for a hernia, that includes the type, side, recurrence, reducibility, and whether it is supported by a truss or belt). See the DBQ Guide for how these forms work, including whether a private DBQ completed by your own doctor can be submitted instead of relying solely on a VA exam.

Before your C&P exam, bring a clear, specific account of your symptoms and history, when you first noticed the hernia, whether it has recurred, and what happens during physical activity. Be consistent with what's already in your medical records and prior statements. For a full walkthrough of what to expect and how to prepare, see the C&P Exam Prep Guide.

Reading Your Decision Letter, and What to Do If Denied

Your decision letter has two parts: a narrative section explaining the reasoning (often called "reasons and bases"), and a codesheet showing the actual rating percentage, the effective date, and the diagnostic code used. See the Reading Your Decision Letter Guide for how to find and interpret each part, or use the Letter Interpreter tool to upload your own letter and get a plain-English breakdown.

If your claim is denied, or the rating is lower than you expected, you have three main lanes:

  • Supplemental Claim: refile with new and relevant evidence, such as a new nexus opinion or updated treatment records. See Supplemental Claim Guide.
  • Higher-Level Review (HLR): a senior reviewer looks at the same evidence again for a difference of opinion, no new evidence is added. See HLR Guide.
  • Board Appeal: your case goes to a Veterans Law Judge at the Board of Veterans' Appeals, with options for a direct review, an evidence docket, or a hearing. See Board Appeal Guide.

Not sure which lane fits your situation? See the Appeals decision guide for a side-by-side comparison of all three.

After You Win: Maintaining Your Rating

Because most hernia appeals end up being about the rating or the effective date rather than whether service connection applies at all, it helps to know how VA treats a rating once it is in place. A hernia that was repaired, with no recurrence and no need for a truss or belt, is usually rated 0 percent, no monthly payment, so a grant at that level is still worth having: it establishes service connection and preserves your ability to file for an increased rating if the hernia later recurs or worsens.

Protect your effective date by filing promptly and continuously pursuing your original claim rather than letting it lapse and starting over later. Once a rating decision becomes final, a freestanding claim asking only for an earlier effective date is generally not available on its own; the recognized ways to reach back are a request for revision based on clear and unmistakable error, or a claim to reopen with new and material evidence (Rudd v. Nicholson, 20 Vet. App. 296 (2006)).

VA cannot simply take service connection away later without proving clear and unmistakable error in the original grant (38 CFR § 3.105). If VA proposes to sever or reduce an existing hernia rating, that is a formal process with its own procedural protections, not something that happens automatically.

Keep your treatment consistent, follow-up exams and records documenting recurrence, pain, or the ongoing need for a truss protect you if VA schedules a future reexamination. Not every rating gets reexamined; understand when a rating becomes protected from future review and what to do if VA proposes to reduce it. See Protect Your Rating and Future Reexaminations for the specifics.

If your hernia worsens after the initial grant, for example becoming recurrent or losing truss support where it did not before, you can file for an increased rating. See the Rating Increase Guide.

Quick Reference

The rating table for DC 7338 (Inguinal hernia) is above in the Rating Criteria section. The tables below summarize the connection pathways and who handles each stage of the claim.

Service Connection Pathways

Pathway Mechanism Evidence Needed
DirectHernia appeared or was repaired in service from heavy lifting or strainingService treatment records + current diagnosis or residuals + nexus
Residuals of in-service repairRecurrence, or lasting pain/numbness/weakness at the surgical siteRecords of the in-service repair + current exam documenting the residual
Secondary (DC 7338)Caused or worsened by an already service-connected condition (e.g. chronic cough, bowel condition)Nexus opinion linking the service-connected condition to the hernia
Aggravation of preexisting herniaPreexisting hernia worsened beyond its natural course by serviceBaseline severity + nexus opinion addressing the worsening
Toxic exposureNot presumptive; requires a specific medical mechanismNexus opinion explicitly linking the exposure to the hernia

From Filing to Decision: Who Does What

Role Does Decides your rating?
VSO / accredited representativeHelps prepare, gather evidence, and file; represents you on appealNo
VSRDevelops the claim: orders records and the C&P examNo
C&P ExaminerConducts the exam, completes the DBQ, may give a nexus opinionNo / but has a strong impact
Rater (RVSR)Reviews the full file and decides service connection and percentageYes

Frequently Asked Questions

My hernia was fixed. Can I still get a rating?
Sometimes. A well-repaired hernia with no recurrence often rates 0 percent, but if it came back, or you have lasting pain, numbness, or weakness at the surgical site, that can be service-connected and rated as a residual.
What gets a hernia to a higher rating?
Recurrence after surgery, being unable to push it back in (not readily reducible), and not being controlled by a truss or belt. A large recurrent hernia that cannot be supported and is considered inoperable is the top level.
Is a hiatal hernia rated the same way?
No. A hiatal hernia is rated under the GERD and esophagus criteria because its disability is acid reflux, not a bulge that needs support. It is not scored under DC 7338.
I have hernias on both sides. How does that work?
The VA rates the more disabling side and adds 10 percent for the second, as long as the second side would itself be compensable. Claim it as a bilateral condition so the add-on is applied.
My hernia was repaired in service years ago. Is it too late?
No. A later recurrence or residual symptoms at the repair site can be service-connected as residuals of the in-service surgery, even long afterward, with a current diagnosis and a link to the original repair.
What if I only connected my hernia to service many years after discharge?
A long gap between service and the first time you raised or documented the connection can work against you, published decisions have denied claims for exactly this reason. It is not automatically fatal, but it makes a clear, well-reasoned nexus opinion more important, not less.
Can VA take away my hernia service connection later?
Not without proving clear and unmistakable error in the original decision. Severance is a formal process with its own procedural protections; VA cannot simply reverse a grant because a later reviewer would have decided it differently.
Disclaimer. This guide is educational information, not legal advice, and it does not create any attorney relationship or constitute representation. It describes how the VA's rules and regulations work in general and shows patterns from published Board decisions, not promises about any individual claim. Individual claims have unique facts, and outcomes depend on the specific evidence presented. Veterans seeking help with their claims should work with a VA-accredited VSO representative, claims agent, or attorney; confirm current fees and availability directly before you commit. The laws, regulations, and rating criteria referenced in this guide are current as of July 2026. Rating criteria change; verify current details at VA.gov or in 38 CFR § 4.114. Find a VA-accredited representative →

Sources

  1. 38 CFR § 4.114, Diagnostic Codes 7338 and 7339, Schedule of Ratings, Digestive System (Hernia)
  2. 38 CFR § 3.303, basic requirements for service connection, including § 3.303(d), disease diagnosed after discharge
  3. 38 CFR § 3.310, Secondary Service Connection
  4. 38 CFR § 3.304(b) and 38 U.S.C. § 1111, presumption of soundness at entry and aggravation of a preexisting condition
  5. 38 CFR § 3.102, reasonable doubt, and 38 U.S.C. § 5107(b), benefit of the doubt
  6. 38 U.S.C. § 1110 and 38 U.S.C. § 1131, compensation for a service-connected disability
  7. 38 CFR § 3.105, severance of service connection and clear and unmistakable error
  8. 38 CFR § 3.400 and 38 U.S.C. § 5110, effective dates; 38 CFR § 3.2501, supplemental claims and new and relevant evidence
  9. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004), the current-disability, in-service-event, and nexus elements of service connection
  10. Brammer v. Derwinski, 3 Vet. App. 223 (1992), no current disability means no valid claim for service connection
  11. McClain v. Nicholson, 21 Vet. App. 319 (2007), a disability present at the time the claim was filed or during its pendency satisfies the current-disability requirement even if it later resolves
  12. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021), the benefit-of-the-doubt standard under 38 U.S.C. § 5107(b)
  13. Rudd v. Nicholson, 20 Vet. App. 296 (2006), freestanding earlier-effective-date claims are not available once a rating decision is final
  14. CCK Law, "VA Disability Ratings for Hernias"
  15. Hill & Ponton, "VA Disability Ratings for Hernias"