VA Ratings and Service Connection for Gallbladder and Biliary Tract Diseases

Does your gallbladder or biliary tract condition qualify for VA disability compensation? These health issues can cause pain, digestive problems, and even serious infections. Our guide explains how the VA rates gallbladder and biliary diseases, and how veterans can prove their conditions are service-connected. 

The VA Rating for Biliary Tract Diseases 

Biliary tract diseases affect the bile ducts and how bile flows through the liver, gallbladder, and small intestine. The VA uses Diagnostic Code 7314 to rate chronic biliary tract diseases from 0% to 80% and ratings can go as high as 100% for primary sclerosing cholangitis under DC 7345 (chronic liver disease without cirrhosis). Conditions rated under DC 7314 include:

• Cholangitis – inflammation or infection of the bile ducts 
• Biliary strictures – narrowing of the bile ducts that makes bile drainage difficult 
• Sphincter of Oddi dysfunction – a muscle valve that doesn’t open properly to release bile 
• Bile duct injuries – damage caused during surgery or by trauma 
• Choledochal cysts – abnormal growths in the bile duct that can lead to blockages or cancer 

These disorders can be painful and often require medical treatment, including surgery, stent placement, or endoscopic procedures. 

Veterans who’ve undergone gallbladder surgery may be rated differently depending on what causes their symptoms. If pain or digestive issues are more related to internal scar tissue (called adhesions), then the VA may apply DC 7301 instead of 7314. This allows the VA to rate based on what most affects the veteran’s day-to-day life. 

Cholangitis (Bile Duct Inflammation)

Cholangitis is a serious and potentially life-threatening infection in the bile ducts. Acute cholangitis or ascending cholangitis happens when bile cannot flow normally due to blockage, typically from gallstones. Once blocked, bacteria grows quickly, leading to an infection that may spread to the liver or bloodstream. 

The most common causes of cholangitis include:

• Gallstones stuck in the bile duct 
• Strictures (narrowing) from previous surgery or inflammation 
• Tumors 
• Complications from procedures like ERCP (Endoscopic Retrograde Cholangiopancreatography) 

Cholangitis often comes with a group of symptoms known as Charcot’s triad:

• Fever with chills 
• Jaundice (yellowing of the skin and eyes) 
• Pain in the upper right part of the abdomen 

Severe cases may also include confusion and low blood pressure, which can require emergency treatment. 

The VA rates cholangitis at 0%, 10% or 30% under Diagnostic Code 7314, which also covers other chronic biliary tract diseases. The rating depends on how often you’ve had flare-ups and how severe your symptoms have been in the last 12 months.

DC 7314 VA Ratings for Cholangitis and Other Biliary Tract Diseases

• 30% rating – Severe cases: You must have had at least three or more documented attacks of pain with nausea and vomiting during the past year. The VA may also assign this rating if you’ve needed dilatation of a bile duct stricture at least once in that time.
• 10% rating – Moderate cases: This applies if you’ve had one or two attacks of these symptoms in the past year, with medical documentation showing treatment was needed.
• 0% rating – Asymptomatic: If you haven’t had an attack in the past 12 months, you may receive a 0% rating, meaning the condition is recognized but not currently disabling. 

Because cholangitis is often caused by gallstones or bile duct injury, it can also occur after military-related procedures or injuries. If you experienced digestive issues during service or shortly afterward, and now suffer from cholangitis, that history may help support your claim. 

VA Ratings for Primary Sclerosing Cholangitis

Primary sclerosing cholangitis is rated as chronic liver disease without cirrhosis under Diagnostic Code 7345. If the veteran has cirrhosis, primary sclerosing cholangitis is automatically rated under DC 7312. 

DC 7345 Ratings for Chronic Liver Disease Without Cirrhosis

• 100% rating – Progressive chronic liver disease requiring use of both parenteral antiviral therapy (direct antiviral agents), and parenteral immunomodulatory therapy (interferon and other); and for six months following discontinuance of treatment 
• 60% rating – Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia 
• 40% rating – Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia 
• 20% rating – Chronic liver disease with at least one of the following: (1) intermittent fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, or (5) pruritus 
• 0% rating – Previous history of liver disease, currently asymptomatic 

This diagnostic code is used for primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune liver disease, Wilson’s disease, Alpha-1-antitrypsin deficiency, hemochromatosis, drug-induced hepatitis, and non-alcoholic steatohepatitis (NASH).

DC 7312 Ratings for Cirrhosis of the Liver

• 100% rating – Liver disease with Model for End-Stage Liver Disease score greater than or equal to 15; or with continuous daily debilitating symptoms, generalized weakness and at least one of the following: (1) ascites (fluid in the abdomen), or (2) a history of spontaneous bacterial peritonitis, or (3) hepatic encephalopathy, or (4) variceal hemorrhage, or (5) coagulopathy, or (6) portal gastropathy, or (7) hepatopulmonary or hepatorenal syndrome 
• 60% rating – Liver disease with Model for End-Stage Liver Disease score greater than 11 but less than 15; or with daily fatigue and at least one episode in the last year of either (1) variceal hemorrhage, or (2) portal gastropathy or hepatic encephalopathy 
• 30% rating – Liver disease with Model for End-Stage Liver Disease score of 10 or 11; or with signs of portal hypertension such as splenomegaly or ascites (fluid in the abdomen) and either weakness, anorexia, abdominal pain, or malaise 
• 10% rating – Liver disease with Model for End-Stage Liver Disease score greater than 6 but less than 10; or with evidence of either anorexia, weakness, abdominal pain or malaise 
• 0% rating – Asymptomatic, but with a history of liver disease 

VA Ratings for Gallbladder Diseases

The VA rates gallbladder diseases based on the condition, symptoms, and treatments received. Since gallbladder issues can appear in different forms like infection, blockage, or after surgery, the VA uses several diagnostic codes to properly evaluate them. They are: 

• DC 7314 – Chronic Biliary Tract Disease 
• DC 7318 – Gallbladder Removal (Cholecystectomy) 
• DC 7301 – Peritoneal Adhesions 

If you had a gallbladder infection that required surgery and later developed complications like adhesions or digestive pain, the VA will choose the diagnostic code that reflects your most disabling symptoms. 

Cholecystitis (Inflammation of the Gallbladder) 

Cholecystitis happens when bile gets trapped in the gallbladder. This often occurs because a gallstone blocks the cystic duct, the small tube that drains bile from the gallbladder. When bile can’t flow out, it builds up, causing the gallbladder to swell and become inflamed. 

Most cases of acute cholecystitis are caused by gallstones that become stuck in the neck of the gallbladder or cystic duct, stopping the normal flow of bile. This blockage can lead to sudden pain, fever, and digestive problems. 

If the condition keeps coming back or lasts a long time, it becomes chronic cholecystitis. Repeated inflammation can cause long-term digestive issues and complications like scar tissue. 

In some situations, especially after gallbladder surgery, the VA may rate chronic or recurring cholecystitis under Diagnostic Code (DC) 7301, which covers peritoneal adhesions. This applies when internal scar tissue or post-surgical complications affect digestion more than the gallbladder itself.

DC 7301 VA Ratings 

This code applies when gallbladder surgery or chronic inflammation causes internal scar tissue (adhesions). The adhesions can lead to bowel problems, pain, and other digestive symptoms. 

Ratings under DC 7301 range from 10% to 80%, based on how often symptoms occur, whether there’s a partial bowel obstruction, and if hospital care or a restricted diet is needed:

• 80% rating – Persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition (TPN) for obstructive symptoms 
• 50% rating – Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and clinical evidence of recurrent obstruction requiring hospitalization at least once a year; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea 
• 30% rating – Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea 
• 10% rating – Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider, and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea 

These ratings apply only if a healthcare provider confirms the symptoms are caused by adhesions related to surgery, trauma, chronic cholecystitis, or a similar condition. 

Cholelithiasis (Gallstones)

Cholelithiasis is the medical term for gallstones, hard clumps that form when bile inside the gallbladder solidifies. These stones can be small like grains of sand or as large as golf balls. Many people with gallstones don’t have symptoms, but when stones block the bile ducts, they can cause severe pain and complications when: 

• Bile contains too much cholesterol or waste 
• The gallbladder doesn’t empty properly 
• There’s inflammation in the gallbladder or bile ducts 

Gallstones may also contribute to more serious conditions like cholecystitis or cholangitis. 

There is no specific diagnostic code for cholelithiasis. The VA bases your rating on how gallstones affect your health especially if they lead to complications, surgery, or other chronic symptoms. For example: 

• If gallstones cause repeated biliary colic (painful gallbladder attacks), the VA might rate the condition under DC 7314. 
• If they result in surgery, such as gallbladder removal, the rating may fall under DC 7318. 
• If gallstones lead to adhesions or digestive problems after surgery, the VA could use DC 7301. 

Biliary Colic 

Veterans may still receive VA disability benefits even if their medical conditions existed before service. The key factor is proving that military service aggravated (made worse) these pre-existing conditions. Two legal presumptions help veterans establish claims for aggravated conditions:

Biliary colic is a sharp, cramping pain that happens when a gallstone temporarily blocks the flow of bile. The pain occurs when the gallbladder contracts forcefully to push bile past the blockage, creating pressure and discomfort. 

Unlike constant pain from inflammation, biliary colic comes in waves. It often starts suddenly and goes away once the stone moves. However, repeated attacks can damage the gallbladder or lead to other serious conditions. 

The VA does not rate biliary colic by itself. Instead, it is considered a symptom that may be part of a larger condition, such as chronic gallbladder disease or post-surgical complications. 

Biliary colic may be rated as a symptom under DC 7301, particularly if related to internal scar tissue from gallbladder surgery, chronic inflammation or other abdominal complications. DC 7301 VA ratings for biliary colic range from 10% to 30%, 50% and up to 80% for persistent partial bowel obstruction.

DC 7301 VA Ratings (Including Biliary Colic) 

10% rating – Occasional colic, abdominal pain, nausea, constipation, or diarrhea, related to gallbladder or bile duct complications. No dietary restrictions or hospital stays are required for this level. 

30% rating – Symptomatic peritoneal adhesions that continue or come back after surgery or inflammation. You must also follow a medically-directed diet (not IV feeding), and experience at least one of the following: 

• Abdominal pain 
• Nausea 
• Vomiting 
• Colic 
• Constipation 
• Diarrhea 

50% rating – You have all of the symptoms listed under the 30% rating plus hospitalization at least once a year for bowel obstruction caused by the adhesions. The need for a doctor-prescribed diet must still be present, along with at least one listed symptom. 

80% rating – You have a persistent partial bowel obstruction that can’t be treated with surgery or doesn’t respond to treatment. You must also require total parenteral nutrition (TPN)—being fed through an IV. 

Cholecystectomy (Gallbladder Removal)

A cholecystectomy is the surgical removal of the gallbladder, most commonly done to treat repeated gallstone attacks, cholecystitis, or biliary colic. While surgery often provides relief, complications like adhesions or bile duct damage can still occur and lead to long-term digestive issues. 

In some cases, complications such as scar tissue (adhesions) or damage to bile ducts can occur, causing additional issues that may require long-term care or further treatment. 

The VA rates gallbladder removal at 0%, 10% or 30% under Diagnostic Code 7318, depending on how often symptoms appear and how disruptive they are after the surgery. 

DC 7318 Gallbladder Removal VA Ratings

•  30% rating – You have recurring abdominal pain (especially after meals or at night) and chronic diarrhea, defined as three or more watery bowel movements per day. These symptoms must be persistent and documented by a healthcare provider. 
• 10% rating – You have intermittent abdominal pain and diarrhea, with one to two watery bowel movements per day. The condition flares up but may not happen every day. 
• 0% rating – You’ve had a cholecystectomy, but you have no current symptoms. There’s no pain or digestive trouble caused by the surgery. 

Gallbladder Polyps 

Gallbladder polyps are small growths that form on the inner wall of the gallbladder. Most are benign (non-cancerous) and don’t cause any symptoms. In many cases, they’re found during imaging tests for unrelated issues. However, larger polyps or those that grow over time can lead to complications such as: 

• Abdominal pain 
• Digestive discomfort 
• Chronic inflammation 
• Risk of gallbladder cancer (in rare cases) 

If the polyp causes symptoms or is larger than a certain size (typically over 1 centimeter), doctors may recommend surgical removal of the gallbladder as a precaution. 

Because there’s no specific diagnostic code, polyps are rated based on symptoms or required treatment, especially if they cause complications. If the polyp leads to chronic cholecystitis or requires surgical removal, the VA may rate the condition under: 

• DC 7314 – If symptoms like abdominal pain or bile duct issues are present 
• DC 7318 – If the polyp led to gallbladder removal (cholecystectomy) 

If the polyp caused long-term problems or required surgery, it may contribute to a compensable disability rating. 

How to Service Connect Gallbladder Conditions 

To receive VA disability benefits for a gallbladder or biliary tract condition, you must first establish service connection. This means showing the condition is linked to your military service. There are three main types of service connection the VA recognizes: direct, presumptive, and secondary. 

Direct Service Connection 

Most gallbladder-related claims fall under this category. To qualify, you must show: 

• A current diagnosis of a gallbladder condition (such as gallstones, cholecystitis, or bile duct disease) 
• An in-service event, illness, or injury (such as environmental exposure, or a related procedure) 
• A medical nexus, or clear medical evidence linking your current diagnosis to your service 

Some veterans may link gallbladder issues to exposures during service, such as burn pits, though this is not presumed and requires medical proof.  

If the VA denies your claim for direct service connection, you may still qualify on appeal. A free case evaluation can help you figure out what evidence is missing and how to move forward. 

Presumptive Service Connection 

Presumptive service connection means the VA automatically assumes your condition is related to your service if you meet specific criteria. For gallbladder conditions, only a few qualify under this rule. 

Gallstones as a Chronic Disease 

Gallstones are recognized as a chronic condition eligible for presumptive service connection, but only under certain circumstances: 

1. You must have served at least 90 continuous days on active duty, and 
2. Your gallstones must have appeared to a compensable level (10% or more) within one year of your discharge 

Service Connection by Aggravation

Service connection by aggravation applies when a veteran’s condition existed before service but significantly worsened because of active duty. If your pre-existing condition deteriorates beyond its natural progression, the VA may award disability compensation. There are two situations:

1. Known Conditions – If your condition was documented at entry and later worsened, this supports service-connected aggravation.
2. Unknown Conditions – If not noted at entry but symptoms existed, veterans rely on the presumption of soundness. The VA must then prove your condition existed before service and was not aggravated by service.

If these conditions are met, the VA will presume that your gallstones were caused by your military service, even if you didn’t show symptoms while still in uniform. 

Gallbladder Cancer 

The VA considers gallbladder cancer a presumptive condition for veterans exposed to ionizing radiation. If you meet the VA’s criteria for radiation exposure, you may be eligible for benefits without having to prove a direct connection. Qualifying exposure scenarios include:

• Fukushima Nuclear Accident – Service in Japan between March 12, 2011 and May 11, 2011 
• Radiation-Risk Activities – Includes participation in nuclear weapons testing 
• Occupation of Hiroshima or Nagasaki 
• Military Occupational Exposure – Jobs involving direct contact with radiation sources 
• Depleted Uranium Exposure – Especially during the Gulf War, where fragments from munitions entered the body 
• LORAN Stations – Coast Guard duty at Long Range Navigation sites (1942–2010) 
• McMurdo Station (Antarctica) – Exposure from Navy nuclear power operations between 1964–1973 
• Radium Treatments – For barotrauma prevention in pilots, divers, or submariners (1940s–1960s) 
• In-Service Radiation Therapy – Radiation treatments received during military medical care 

Additional Recognized Radiation-Risk Activities (Effective August 10, 2022)

The PACT Act expanded the list of presumptive radiation-risk events. These now include: 

• Cleanup of Enewetak Atoll (Marshall Islands) – From January 1, 1977 to December 31, 1980 
• Nuclear accident in Palomares, Spain – Between January 17, 1966 and March 31, 1967 
• Nuclear accident at Thule AFB, Greenland – Between January 21, 1968 and September 25, 1968 

If you served during any of these times and locations and were later diagnosed with gallbladder cancer, you may qualify for VA compensation without needing a separate nexus opinion. 

Other common gallbladder issues, such as cholecystitis, gallbladder polyps, and biliary colic, are not considered presumptive conditions by the VA. This means veterans must establish service connection through direct evidence, such as in-service documentation or a medical nexus, or through secondary service connection. 

Secondary Service Connection

Secondary service connection applies when a gallbladder or biliary tract condition is caused or worsened by another service-connected disability (or by its medical treatment). If you already receive VA benefits for a separate condition, and that condition contributes to gallbladder problems, you may be eligible for additional compensation. 

What Can Lead to Gallbladder Conditions?

• Medication side effects – Certain medications prescribed for service-connected conditions (like orthopedic injuries or chronic pain) can interfere with gallbladder function. For example, long-term use of opioids or NSAIDs may increase the risk of biliary colic or cholecystitis. 
• Psychiatric conditions – Service-connected mental health issues, such as PTSD or major depression, may lead to poor diet choices, weight gain, or metabolic stress, all of which can aggravate existing gallbladder conditions. 
• Obesity – If a service-connected condition (such as PTSD, joint damage, or limited mobility) causes obesity, and that obesity contributes to the development or worsening of gallbladder disease, the VA may recognize obesity as an “intermediate step” for secondary service connection. 
• Other digestive disorders – Conditions like GERD or Irritable Bowel Syndrome (IBS), if already service-connected, may cause or worsen gallbladder symptoms over time. 
• Diabetes Mellitus (Type 2) – Veterans with service-connected diabetes, especially due to Agent Orange exposure, may experience gallbladder dysfunction, including bile duct problems and gallstones. 
• Cancer treatment – If a veteran is being treated for a service-connected cancer, and radiation or chemotherapy leads to inflammation or damage of the gallbladder, that condition may be secondarily connected. 

For any secondary claim, it’s important to submit medical records and, when possible, a nexus letter from a doctor explaining how your service-connected condition contributed to the gallbladder problem. 

VA Individual Unemployability and Gallbladder Conditions 

Some veterans with gallbladder or biliary tract conditions find that their symptoms make it difficult, or even impossible, to keep a steady job. In these cases, the VA offers Total Disability based on Individual Unemployability (TDIU). This benefit pays at the 100% disability rate, even if your combined rating is below 100%. 

In such cases, your condition may qualify as the basis for a TDIU claim, especially if it contributes significantly to your total combined disability rating. Under Schedular TDIU (38 C.F.R. § 4.16(a)) there are two ways to qualify: 

• You have one condition rated at 60% or higher, or 
• You have one condition rated at 40% and a combined total of 70% or more 

A 30% rating for gallbladder removal, for example, may count toward that total if you have another service-connected condition rated at 40%. 

If you don’t meet the percentage thresholds, but your gallbladder condition still prevents you from holding substantially gainful employment, you may qualify for TDIU under 38 CFR § 4.16b (“Extraschedular”). 

To be approved, you’ll need strong evidence showing how your condition affects your ability to work, such as medical records, doctor’s statements, or employer reports. And if the VA hasn’t rated you correctly, you have options. A TDIU lawyer can greatly increase your chances of success at the appeal.