Diagnostic Code 5326 · 38 CFR §4.73
A muscle hernia is a protrusion of muscle tissue through a defect in the surrounding fascia — the tough connective sheath that holds the muscle in place. It typically follows direct trauma that tears the fascia: penetrating combat injury, blast injury, surgical incision that did not heal cleanly, or repeated heavy strain on a previously weakened area. The classic presentation is a soft, visible bulge that appears when the muscle is contracted (climbing stairs, lifting, jumping) and disappears when the muscle relaxes. Most muscle hernias produce only minor symptoms; an extensive muscle hernia, the version DC 5326 captures, involves a substantial fascial defect and produces functional limitation, cramping, or pain that interferes with use of the affected muscle group. The lower extremity (anterior thigh, calf) is the most common location for veterans, followed by the abdominal wall and the upper extremity.
| Rating | Criteria |
|---|---|
| 10% | Extensive muscle hernia — substantial fascial defect with muscle protrusion, without other injury to the muscle group. The 10% rating is the schedular maximum under DC 5326. When the muscle hernia coexists with other muscle injury to the same group, the rating is taken under the muscle injury code (DC 5301 through DC 5323) for that group rather than DC 5326 separately, because the muscle injury code captures both findings and the higher rating is taken. |
A physical examination documenting the fascial defect with the muscle relaxed and the protrusion with the muscle contracted is the core evidence. Ultrasound or MRI imaging characterizes the size and location of the defect — particularly useful when the protrusion is subtle on physical exam. Operative reports from any repair attempt document the disease course. Service treatment records establishing the in-service trauma — penetrating wound, blast injury, surgical complication — connect the condition to service. Photographs of the bulge under muscle contraction support the record. If the hernia coexists with muscle injury to the same group, the muscle injury workup (strength testing, EMG, functional assessment) determines whether DC 5326 or the muscle injury code rates higher.
No. An abdominal wall hernia (DC 7338 inguinal, DC 7339 ventral, DC 7340 femoral) involves protrusion of intra-abdominal contents (intestine, omentum) through a defect in the abdominal wall. A muscle hernia (DC 5326) is protrusion of muscle tissue itself through a defect in the fascia around the muscle, most often in the limbs. The codes, the diagnostic workup, and the natural histories differ.
The schedular ceiling reflects the legislative judgment that an isolated extensive muscle hernia, without accompanying muscle group injury, produces relatively modest functional impairment. When the muscle group itself is injured — strength loss, atrophy, denervation, scar tissue restricting motion — the muscle injury codes DC 5301 through DC 5323 apply and the rating ceiling is much higher. The right strategy is usually to claim under both and let the higher rating win, rather than accepting DC 5326 alone.
A clean repair with no recurrence and no functional impairment often drops the rating to 0%. Service connection is preserved, so a later recurrence can be claimed as an increase rather than starting from scratch. Many muscle hernias recur after repair, particularly in active veterans who continue to load the affected muscle group; document any recurrence with imaging and a follow-up surgical consult to support a renewed rating.