Crohn’s Disease VA Rating and Secondary Conditions

Crohn’s disease is a chronic autoimmune condition that causes inflammation in the gastrointestinal tract. It can severely impact a person’s quality of life, leading to pain, fatigue, digestive issues, and in many cases, permanent complications. Veterans are at increased risk of developing Crohn’s due to both the physical and psychological challenges of military service. 

A 2023 clinical review published in Military Medical Research revealed that veterans face a disproportionately high rate of inflammatory bowel disease (IBD)—which includes both Crohn’s disease and ulcerative colitis—compared to the general U.S. population. According to the study, this trend is likely the result of multiple service-related exposures, including:

• Prolonged psychological stress, especially during deployment and combat 
• Exposure to burn pit emissions 
• Contact with petroleum-based fuels, solvents, and other chemicals 

The review emphasized that environmental exposure was “common among deployed personnel” and that such exposures may interfere with gut barrier function, disrupt the immune response, and trigger long-term inflammation. Veterans who served in Southwest Asia, Afghanistan, and other high-burn-pit-use areas showed a significantly higher risk of developing service-related chronic conditions like IBD. 

VA Disability Requirements for Crohn’s Disease 

The Department of Veterans Affairs allows veterans to file for benefits as either a primary service-connected disability or as a secondary condition resulting from an already established VA-rated disability, such as PTSD, environmental illness, or autoimmune disorders caused by service. This flexibility gives veterans multiple pathways to qualify for compensation. 

To establish direct service connection for Crohn’s, a veteran must provide:

•  A current diagnosis of Crohn’s disease by a qualified medical provider 
• Evidence of an in-service event, illness, or exposure that could reasonably lead to Crohn’s 
• A nexus statement—medical proof that connects the condition to military service 

When filing as a primary condition, a diagnosis alone isn’t enough. The claim must be supported by records showing that gastrointestinal symptoms or exposures are related to military service. These may include unexplained abdominal pain, chronic digestive issues, or documented deployment to hazardous environments, such as areas with open-air burn pits or fuel contamination. 

In other cases, Crohn’s is not directly caused by military service but is instead worsened by another service-connected disability. If a mental health condition like PTSD is already rated by the VA, and there is medical evidence that Crohn’s developed or intensified because of that condition, the disease may qualify as secondary or aggravated by PTSD, which opens an alternate route to compensation. 

The strength of your medical evidence and service history will guide the VA’s decision, and choosing the most accurate connection from the start can help avoid delays or denials. 

Secondary Service Connection for Crohn’s Disease 

Crohn’s disease often doesn’t arise during active duty but develops later, often as a result of other chronic health conditions tied to military service. When that happens, veterans can pursue what’s called a secondary service connection—a type of claim used when an already-recognized disability contributes to, or worsens, a new condition. This approach requires two things:  

• A primary condition that is already service-connected and 
• Medical evidence showing that this primary condition has either caused the onset of Crohn’s disease or has significantly aggravated its severity    

The VA accepts secondary claims as long as there is strong, clinical documentation explaining the relationship between both conditions. The more well-documented, specific, and consistent your medical records are, the stronger your case.  

Service treatment records, civilian medical evaluations, and professional nexus letters all work together to show that your Crohn’s diagnosis is not a coincidence—but rather, part of a larger health picture that stems from your time in service. 

Veterans pursuing a secondary service connection should also be aware that aggravation claims where a primary condition worsens an existing non-service-connected disease are just as valid. For example, if a veteran had minor digestive issues before service, but those issues became more severe due to the strain of managing a service-connected illness, that escalation could warrant VA disability compensation. 

In all cases, the goal is to draw a clear and logical line between what the VA has already acknowledged and the new condition that has appeared or worsened as a result. 

Crohn’s Disease Secondary to PTSD 

A common example involves PTSD, a condition that affects a significant number of veterans. Scientific research has shown a direct connection between PTSD and the development of inflammatory bowel diseases. Stress-related hormone imbalances and immune system disruptions can compromise gut function over time, creating an environment where diseases like Crohn’s are more likely. 

To establish this type of connection, you’ll need supporting medical opinions—such as from a gastroenterologist or psychiatrist—that outline how your PTSD has influenced the development or progression of Crohn’s disease. These statements should be as detailed as possible, noting changes in symptom frequency, flare-up triggers, or medication responses that align with the course of the mental health condition. 

Alcoholism and Crohn’s Disease 

For many veterans, alcohol becomes a way to cope with service-connected conditions like PTSD, depression, or chronic anxiety. But long-term alcohol use can damage the digestive system, making it more vulnerable to inflammatory diseases like Crohn’s. 

Alcohol disrupts gut health by weakening the intestinal lining, altering the balance of bacteria, and triggering inflammation; all factors that can either lead to Crohn’s or make existing symptoms worse. 

If your alcohol use stems from a recognized mental health condition, and you later develop Crohn’s, the VA may consider your claim under secondary service connection. In this case, Crohn’s would be seen as a result of the service-connected condition that led to alcohol dependency. 

To qualify, your medical records need to show a clear connection between the mental health diagnosis, alcohol use, and the onset or worsening of Crohn’s. The VA will consider whether alcohol use was a symptom of your condition, rather than a personal choice unrelated to service.

Crohn’s Disease Secondary to Psoriasis

Psoriasis is a chronic autoimmune condition that causes skin cells to build up quickly, leading to red, scaly patches that can itch or hurt. While it is often thought of as a skin condition, psoriasis actually begins in the immune system. This is important for veterans because Crohn’s disease and psoriasis share immune-related roots. 

Medical studies show a strong link between the two. Veterans who have psoriasis are more likely to develop Crohn’s disease later in life. One study found that people with psoriasis had 1.7 times the odds of developing Crohn’s compared to those without it. This connection is believed to exist because both conditions involve the immune system attacking healthy tissue by mistake. 

For veterans, this link may provide another path to VA compensation. If you already have service-connected psoriasis, and you later develop Crohn’s disease, you may be able to file for secondary service connection and ask the VA to recognize your Crohn’s as being caused, or made worse by, your service-connected skin condition. 

This is especially relevant if your psoriasis was caused by military exposures. Veterans who served in areas where they came into contact with toxic chemicals, like those found in fuel, solvents, or burn pits, may have developed psoriasis as a result. Over time, the immune system disruption that causes psoriasis could also lead to Crohn’s disease. 

To support this kind of claim, you will need medical records that show a clear timeline. A strong claim will include details about your psoriasis diagnosis, proof of exposure during service, and medical opinions linking your Crohn’s disease to the immune dysfunction already documented.

Other Conditions Related to Crohn’s Disease 

Crohn’s disease doesn’t just affect the digestive system. It can also cause a variety of complications in other parts of the body. These are known as extraintestinal manifestations, and many of them may qualify as secondary service-connected conditions, increasing your total VA rating. 

Arthritis and Joint Pain 

A significant number of people with Crohn’s disease, up to one-third, experience joint pain or swelling. This type of arthritis is part of a broader group of disorders called spondyloarthritis, which includes inflammation in the spine and large joints. 

The connection between Crohn’s and joint issues lies in the way the immune system behaves. Normally, the gut keeps harmful bacteria contained. But in people with Crohn’s, that barrier is often weakened. As a result, immune cells may respond to bacteria that escape the gut and cause inflammation in the joints. For veterans, this can mean painful swelling in areas like the knees, hips, or back.  

If joint pain begins after a Crohn’s diagnosis, or becomes more intense during flare-ups, it may be part of the disease process and could support an additional claim. There is current research on identifying biomarkers that may help explain why arthritis and Crohn’s often appear together, which could improve diagnosis and treatment in the future. 

Skin Problems 

Skin issues are another common complication. Some people with Crohn’s develop painful rashes, ulcers, or lesions, often around sensitive areas of the body. One of the most severe examples is the development of perianal fistulas. These are infected tunnels that form between the intestines and the skin near the anus. 

Fistulas can drain blood, pus, or stool, and they often require surgical treatment. They can be deeply uncomfortable and may lead to infections or ongoing pain if not treated quickly. About one in three people with Crohn’s experience this complication. 

Veterans who suffer from these skin-related issues as part of their Crohn’s symptoms may be eligible for a higher VA rating or additional benefits under a separate diagnostic code. 

Colorectal Cancer 

Crohn’s disease increases the risk of colorectal cancer, especially for those who have lived with the condition for many years. Ongoing inflammation in the bowel can damage the cells lining the colon and rectum, making it more likely for cancer to develop over time.  

This risk is even higher in cases where Crohn’s affects the large intestine. Veterans with a long history of gastrointestinal flare-ups, strictures, or bowel surgeries should be screened regularly for signs of cancer. If colorectal cancer is diagnosed and linked to chronic inflammation caused by Crohn’s, the VA may consider it a secondary condition. 

Anemia 

Many veterans with Crohn’s disease also develop anemia, which means the body doesn’t have enough healthy red blood cells to carry oxygen effectively. This is usually due to chronic blood loss from the intestinal tract, especially during flare-ups, or from poor absorption of nutrients like iron, vitamin B12, or folate. 

Anemia can cause fatigue, dizziness, shortness of breath, and trouble concentrating. If you’re living with Crohn’s and feel constantly tired or weak, ask your provider to test for this complication. If diagnosed, anemia related to Crohn’s may qualify for a separate rating or be included as part of your total disability picture. 

Mental Health Secondary Conditions 

Living with a lifelong illness like Crohn’s can take a toll on your mental health. Many veterans develop depression, anxiety, or sleep disorders as a result of chronic pain, dietary restrictions, or the fear of sudden flare-ups. 

Sleep issues are particularly common. Pain, cramping, and frequent trips to the bathroom can make it difficult to get consistent rest, which only adds to feelings of exhaustion and stress. 

When mental health symptoms are directly tied to a service-connected physical illness like Crohn’s, veterans may be able to pursue secondary claims for conditions such as major depressive disorder, generalized anxiety, or insomnia. These claims require supporting evidence from a mental health provider who can explain how your physical health is affecting your emotional well-being. 

What Is the VA Disability Rating for Crohn’s Disease? 

The Department of Veterans Affairs rates Crohn’s disease from 10% to 100% under Diagnostic Code 7326, based on the severity and frequency of the symptoms and on how much the condition limits health, function, and daily life. 

• 10%: This rating applies when the symptoms are minimal to mild, the condition is managed with oral or topical agents (other than immunosuppressants or other biologic agents) and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and no signs of systemic toxicity. 
• 30%: Given for mild to moderate inflammatory bowel disease that is managed with oral and topical agents (other than immunosuppressants or other biologic agents) and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and minimal signs of toxicity such as fever, tachycardia, or anemia. 
• 60%: This rating is for moderate inflammatory bowel disease managed on an outpatient basis with immunosuppressants or other biologic agents and characterized by recurrent abdominal pain, four to five daily episodes of diarrhea; and intermittent signs of toxicity such as fever, tachycardia, or anemia. 
• 100%: The highest rating is reserved for veterans with severe inflammatory bowel disease that is unresponsive to treatment; and requires hospitalization at least once per year; and results in either an inability to work or is characterized by recurrent abdominal pain associated with at least two of the following: (1) six or more episodes per day of diarrhea, (2) six or more episodes per day of rectal bleeding, (3) recurrent episodes of rectal incontinence, or (4) recurrent abdominal distension.    

Note: Inflammation may involve small bowel (ileitis), large bowel (colitis), or inflammation of any component of the gastrointestinal tract from the mouth to the anus. 

Following colectomy/colostomy with persistent or recurrent symptoms, the VA rates Crohn’s disease under DC 7326 or DC 7329 (Intestine, large, resection of), whichever provides the highest rating. 

The VA requires diagnoses under DC 7326 to be confirmed by endoscopy or radiologic studies. You should also include in your claim physician notes detailing symptom patterns, treatment outcomes, and medical history, as well as information on any related complications, such as intestinal blockages or weight loss. 

VA Unemployability: Another Path to 100% VA Disability for Crohn’s disease 

Even if your Crohn’s disease doesn’t qualify for a 100 percent schedular rating under the VA’s guidelines, you may still be eligible for Total Disability based on Individual Unemployability (TDIU). This benefit provides veterans with the same compensation as a 100 percent rating when their condition prevents them from holding substantially gainful employment. 

Crohn’s disease can be unpredictable and disruptive. Many veterans struggle with:

• Frequent and urgent trips to the bathroom 
• Severe abdominal pain and cramping 
• Chronic fatigue that affects focus and stamina 
• Difficulty attending long meetings or working in environments without easy access to a restroom   

In fact, a recent study found that 26 percent of patients with Crohn’s disease experience long-term fatigue, regardless of whether the disease is active. This type of exhaustion can make it nearly impossible to sustain consistent work, especially in jobs that require standing, travel, or strict time schedules. 

To qualify for TDIU, veterans must have a single service-connected disability rated at 60 percent or higher, OR a combined rating of 70 percent, with one condition rated at least 40 percent.

If you meet the above and your Crohn’s disease or related conditions make it difficult to work, you may be able to apply for TDIU. In some cases, veterans with lower ratings may still qualify through an extra-schedular TDIU review, which considers how unique symptoms affect employability, even if the percentage doesn’t meet the standard threshold. 

Veterans applying for TDIU need to submit VA Form 21-8940 (Veteran’s Application for Increased Compensation Based on Unemployability). Supporting documentation should include:

• Medical records showing how symptoms limit your ability to function 
• Statements from your doctor detailing how your condition affects work 
• Evidence of employment history and any efforts to maintain work despite symptoms 
• Personal statements or buddy letters explaining how Crohn’s interferes with daily responsibilities   

In cases where Crohn’s is linked to additional health problems—such as PTSD, arthritis, or chronic pain—those conditions can strengthen your TDIU claim. The VA looks at the full picture, not just one diagnosis. 

For many veterans, TDIU is a vital option when their condition makes daily life and steady employment too difficult to manage. If you are struggling to keep a job because of Crohn’s disease, and your symptoms limit your ability to maintain a regular work schedule, this benefit may help provide financial stability and support. 

Has the VA Denied or Underrated You?

If your Crohn’s disease claim was denied or rated too low, you’re not alone—and you don’t have to accept the VA’s decision as final. 

Many claims are denied due to a missing nexus statement, lack of documented symptom severity, or failure to link the condition to an existing service-connected issue. Others are underrated because secondary complications like arthritis, anemia, or mental health symptoms were never considered. 

The good news? You can appeal. The VA allows veterans to submit new evidence, request a higher rating, or file a supplemental claim if your case wasn’t evaluated correctly. 

At Hill & Ponton, we’ve helped thousands of veterans get the benefits they deserve. If your Crohn’s claim has been denied or underrated, we invite you to request a free case evaluation with our team. We’ll review your situation and help you understand the best next steps.