Getting an Ulcerative Colitis VA Rating, Plus Ways to Increase Compensation

Ulcerative colitis doesn’t just bring pain—it can derail your entire life. For many veterans, it means frequent bathroom trips, constant fatigue, and missing out on work, relationships, and even just a good night’s sleep. If you’re dealing with ulcerative colitis as a veteran, you might be eligible for monthly compensation from the VA. 

According to the VA, ulcerative colitis affects approximately 202 out of every 100,000 individuals in the U.S. military population. Women in the military are particularly at higher risk. While it’s classified as an inflammatory bowel disease (IBD), it’s often misunderstood or mistaken for irritable bowel syndrome, leading to misdiagnoses and delayed treatment. 

This guide will walk you through how the VA rates ulcerative colitis, how to prove your condition is service-connected, which secondary conditions can raise your ulcerative colitis rating, and how to fight back if the VA lowballs or denies your claim altogether. 

What is the VA Rating for Ulcerative Colitis? 

Ulcerative colitis is rated by the VA from 10% to 100% under Diagnostic Code 7323, based on the frequency, severity, and impact of the disease on your health and daily life. 

• 100%: 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   
• 60%: Moderate inflammatory bowel disease that is managed on an outpatient basis with immunosuppressants or other biologic agents; and is characterized by recurrent abdominal pain, four to five daily episodes of diarrhea; and intermittent signs of toxicity such as fever, tachycardia, or anemia 
• 30%: 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 
• 10%: Minimal to mild symptomatic inflammatory bowel disease that 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 

If you’re experiencing frequent flare-ups, weight loss or signs of malnutrition, or chronic fatigue and anemia, you may qualify for a high VA rating, especially if these symptoms interfere with your ability to work or function normally. Get a free evaluation of your claim here.

Keep in mind that the VA uses the same diagnostic code for Crohn’s disease and ulcerative colitis, so it’s important to ensure your specific symptoms and complications are well documented. This includes hospitalizations, bloodwork showing anemia, documented weight loss, and physician notes on how often you have flare-ups or relapses. 

If you’re unsure where your symptoms fit into this scale, a medical nexus letter and thorough medical documentation can help the VA properly assess your condition and assign the correct rating. 

How Can I Get VA Disability for Ulcerative Colitis? 

Ulcerative colitis is an autoimmune disorder, meaning your immune system mistakenly attacks the healthy tissue lining your colon and rectum. The exact cause is still unclear, but researchers believe it can be triggered by a mix of genetics, infections, medications, and environmental exposures. 

If you’re a veteran, that last factor—exposure during service—may be the key to winning your VA claim. Known triggers include:  

• Bacterial or viral infections 
• Anti-inflammatory medications (like NSAIDs) 
• Antibiotic use 
• Environmental toxins and chemical exposures during military service   

The VA may deny claims that appear to be strictly genetic, but if you can show that your ulcerative colitis developed or worsened due to a service-related exposure, you may still qualify for service-connected disability. The VA uses a three-part test to determine if your condition is directly tied to your military service. You’ll need:  

• Evidence of an in-service event, illness, or injury. This could be anything from a stomach infection during deployment to long-term use of military-prescribed medications or documented chemical exposure. 
• A current medical diagnosis of ulcerative colitis 
• A nexus statement—a medical opinion that your current condition is “at least as likely as not” linked to your military service   

Even if your diagnosis didn’t come until after you left the military, that doesn’t necessarily disqualify you. If your medical records or a doctor’s opinion show the onset of symptoms during or soon after service, it can still be enough to prove your case. 

Claiming Ulcerative Colitis Caused by PFAS 

One of the most critical factors for today’s veterans is exposure to PFAS chemicals—also known as “forever chemicals.” These are toxic substances found in firefighting foam (AFFF) and certain industrial and cleaning products used on military bases. Many military installations across the U.S. have been flagged for high levels of PFAS contamination, including Camp Lejeune, where waterborne exposure has already led to multiple health-related lawsuits and VA claims. 

Although the VA does not recognize ulcerative colitis as a presumptive condition, current medical research links PFAS to autoimmune diseases, digestive issues, and chronic inflammation—all of which can contribute to the development of ulcerative colitis. 

If you served at a contaminated base, it’s critical to list your exposure to PFAS in your claim and provide documentation, such as base assignments, duration of exposure, and any environmental studies or public health notices. Your doctor can also include PFAS exposure as a possible contributing factor in the medical nexus letter. 

If the VA sees credible evidence tying your ulcerative colitis to chemical exposures during service, they may be more likely to approve your claim even if the condition appeared later in life. Learn more about VA claims for AFFF exposure.

Establishing Secondary Service Connection 

If you can’t prove that your ulcerative colitis began during service—or wasn’t diagnosed until after you separated—you may still qualify for benefits under a secondary service connection. 

A secondary condition is one that develops as a direct result of another disability that the VA has already linked to your time in service. In other words, if a service-connected condition caused or worsened your ulcerative colitis, you may still be eligible for monthly compensation. For the VA to approve a secondary service connection, you’ll need: 

• A current diagnosis of ulcerative colitis 
• An existing service-connected condition (such as PTSD) 
• A medical nexus letter showing that your ulcerative colitis is “at least as likely as not” caused or aggravated by the primary condition   

This type of claim still follows the same basic rules as a direct service connection—but instead of tying your colitis directly to military service, you’re tying it to another condition that is already recognized as service-related. 

Ulcerative Colitis Secondary to PTSD 

One of the most common—and well-supported—secondary claims is ulcerative colitis linked to post-traumatic stress disorder (PTSD). This is because PTSD is known to affect the gut. Studies have shown a connection between psychological stress and chronic inflammation in the gastrointestinal (GI) tract and veterans with PTSD are at higher risk of developing IBD-related disorders, including ulcerative colitis.

The VA has acknowledged this link before. For example, in a 2022 Board of Veterans’ Appeals case, the VA granted service connection for ulcerative colitis as secondary to PTSD. The key was a medical opinion that stated it was “as likely as not” that the veteran’s PTSD contributed to the development of their digestive condition.

• Ask your treating physician or a private medical provider to write a nexus letter linking your ulcerative colitis to your PTSD or another service-connected condition. 
• Be sure the letter uses the phrase “at least as likely as not”—this is the legal standard the VA uses. 
• Submit medical studies, lay statements, or expert opinions that explain how stress, trauma, or medication use may have triggered or worsened your digestive issues.   

Filing the VA Claim 

Making a VA claim for ulcerative colitis can feel overwhelming, but you don’t have to go into it blind. The more evidence you include up front, the better your chances of getting approved with the correct rating. 

Your first step is to file your claim online through VA.gov, by mail, or with the help of a Veterans Service Organization (VSO). Once your claim is submitted, the VA will begin reviewing your military and medical records and may schedule a Compensation & Pension (C&P) exam to assess the severity of your symptoms. 

To support your claim and give it real weight, you’ll want to include: 

• A current medical diagnosis of ulcerative colitis 
• Records showing how often you experience flare-ups or hospital visits 
• Documentation of serious complications like malnutrition, chronic anemia, physical weakness, fatigue, ongoing weight loss 
• Treatment records showing the long-term impact of the disease 
• Lay statements from you, your family, or co-workers describing how the condition affects your ability to work, eat, or function day-to-day   

The VA looks closely at how the condition affects your overall health, not just how often you go to the doctor. If you’ve had to reduce your work hours, miss events, or drastically change your diet and lifestyle because of the symptoms, say that clearly in your supporting materials.

How to Appeal a VA Rating for Ulcerative Colitis

If the VA lowballs your rating—or denies your claim altogether—you don’t have to just accept it. Veterans have the legal right to challenge the VA’s decision through the VA appeals process. There are three paths you can take to appeal a decision.

Higher-Level Review

This option asks a more senior VA adjudicator to take a second look at your file. You cannot submit new evidence, but you can point out errors in the original decision. Best for clear VA mistakes, misread evidence or claims where all supporting documents were already included.

Supplemental Claim

If you have new and relevant evidence—such as updated medical records, a stronger nexus letter, or new research that supports your claim—this is the right path. Best for claims that were denied due to “lack of evidence” and veterans who want to strengthen their case before resubmitting.

Board Appeal

With this route, your case goes to a Veterans Law Judge at the Board of Veterans’ Appeals. You can choose between:

• A direct review (no hearing, no new evidence)
• A hearing with the judge
• A hearing with the option to submit new evidence within 90 days  

This path is best for complex or difficult claims, cases with conflicting medical opinions and veterans who want to testify about their condition.

Whether your claim was denied or underrated, you don’t have to handle the appeals process alone. Hill & Ponton specializes in helping veterans win appeals. Our legal team understands how ulcerative colitis affects daily life and how to fight for the rating (and back pay) you rightfully earned. Call us today on 1-888-477-2363 for a free case evaluation.

Secondary Conditions

Ulcerative colitis doesn’t just affect your digestive system—it can cause widespread complications throughout the body. These complications may qualify as secondary service-connected disabilities, which means you could receive additional compensation on top of your primary ulcerative colitis rating.

To qualify for a secondary rating, you’ll need a medical diagnosis of the secondary condition and a nexus opinion from a doctor stating that the secondary issue was “at least as likely as not” caused or worsened by your ulcerative colitis.

Here are some of the most common and well-documented secondary conditions:

• Arthritis – Chronic inflammation from ulcerative colitis can trigger joint problems, especially in the lower back, hips, and knees. This includes peripheral arthritis, ankylosing spondylitis and other spondyloarthropathies. 
• Osteoporosis, osteopenia or osteomalacia – Bone loss is shockingly common in UC patients—present in as many as 30 to 60% of people with the disease. This happens due to chronic inflammation, poor nutrient absorption, and long-term steroid use. 
• Skin disorders – Up to 15% of UC patients experience skin issues, such as erythema nodosum (painful red nodules), ulcerating skin lesions, psoriasis and eczema flare-ups.
• Anemia – Frequent bleeding during flare-ups can lead to chronic iron-deficiency anemia. This is one of the most common complications and can significantly worsen fatigue and reduce your quality of life. 
• Dry eyes – Dehydration, inflammation, and immune system dysfunction can result in dry eye syndrome, a painful and persistent condition. If you’re already service-connected for ulcerative colitis, you may be able to link this as a secondary condition. 
• Mental disorders – Living with a chronic illness like ulcerative colitis can take a serious toll on your mental health. Depression, anxiety, and PTSD are common among veterans with IBD—and the VA recognizes mental health conditions as valid secondary claims. 
• Colorectal cancer – Long-term inflammation in the colon raises the risk of colorectal cancer. UC patients have a 2 to 3 times higher risk compared to the general population. 
• Kidney stones – Ulcerative colitis can lead to dehydration and nutrient loss. This creates the perfect environment for kidney stones to form, particularly if you’ve had long-term diarrhea or trouble absorbing calcium and oxalate. These stones are not only painful but may require hospitalization or surgical removal. 
• Gallstones – Ulcerative colitis may also increase your risk of developing gallstones, especially if you’ve had weight fluctuations or bile flow disruptions due to long-term inflammation or poor digestion. 
• Liver damage – Some veterans with ulcerative colitis develop primary sclerosing cholangitis (PSC)—a rare but serious liver disease linked to IBD. Even without PSC, chronic inflammation and medication use can strain the liver and lead to fatty liver disease or elevated liver enzymes.

VA Unemployability for Ulcerative Colitis 

Ulcerative colitis can make working nearly impossible—especially if you’re dealing with unpredictable flare-ups, frequent restroom use, fatigue, or complications like anemia and chronic pain. A recent study found that fatigue is one of the most common and disabling symptoms of ulcerative colitis. Veterans with UC report higher levels of disease activity and significantly reduced work productivity. 

That’s where TDIU (Total Disability based on Individual Unemployability) comes in. TDIU allows veterans who can’t maintain substantially gainful employment due to service-connected conditions to receive compensation at the 100% disability rate, even if their combined rating is lower. There are two ways to qualify for TDIU, depending on your current rating.

Schedular TDIU – 38 CFR § 4.16(a)

This is the most common and straightforward path to receiving TDIU. It requires:

• One service-connected disability rated at 60% or higher, OR
• Two or more disabilities that combine to 70%, with one rated at least 40%

Extraschedular TDIU – 38 CFR § 4.16(b)

If you don’t meet the rating thresholds above but still can’t keep substantially gainful employment, you may qualify under this rule. To be approved, you must show that your service-connected condition uniquely interferes with your ability to work. You’ll need documentation such as vocational assessments, medical statements, and employer records.

The goal is to prove that your situation isn’t adequately captured by the standard rating schedule and that the VA should treat your case differently. This can be difficult, but don’t give up: an attorney with experience in TDIU claims may be able to help you win your case. Call us today for a free case evaluation.