Diagnostic Code 7340 · 38 CFR §4.114
A femoral hernia is a bulge of abdominal contents through the femoral canal — a narrow opening in the lower groin where the femoral artery and vein pass from the abdomen down into the upper thigh. Compared with the much more common inguinal hernia (DC 7338), the femoral hernia sits lower, is smaller, and is far more likely to become incarcerated or strangulated because the femoral canal is narrow and rigid. Women develop femoral hernias more often than men, but in the veteran population the trigger is usually a heavy lifting injury, sustained intra-abdominal pressure from chronic cough, or post-surgical weakness in the lower abdominal wall. Symptoms include a small lump or fullness just below the inguinal crease, a dragging sensation in the groin, and pain that worsens with standing, lifting, or coughing. Because of the high incarceration risk, surgical repair is usually recommended once the hernia is identified.
| Rating | Criteria |
|---|---|
| 0% | Mild hernia not requiring surgical repair, well controlled by ordinary activity, or status post-repair with no current recurrence and no functional limitation. |
| 30% | Hernia recurrent after surgical repair, OR not operable, OR not well supported by a truss or belt under ordinary conditions. |
| 60% | Inoperable hernia not well supported by truss or belt, with severe symptoms — chronic pain, frequent partial incarceration episodes, or significant functional limitation in standing, walking, or working. |
| 100% | Massive recurrent hernia with severe symptoms that cannot be controlled by any conservative measures, OR persistent strangulation/incarceration requiring repeated emergency intervention, OR extensive abdominal wall destruction that renders the defect inoperable and produces total functional impairment. |
A current physical examination by a general surgeon documenting the hernia location, reducibility, size, and whether a truss or belt provides adequate control is the centerpiece. Ultrasound or CT imaging of the groin characterizes the defect and distinguishes femoral from inguinal hernia — the distinction matters because the rating codes differ and the natural history is different. Records of any surgical repair, any recurrence, mesh complications, and any incarceration or strangulation episodes document the disease course. A history of in-service heavy lifting, sustained physical demands, or post-surgical groin weakness establishes the nexus when service treatment records show the inciting event. Photographs taken under Valsalva can capture the bulge for the record.
Both involve a bulge through the lower abdominal wall, but the anatomy differs. Inguinal hernias (DC 7338) come through the inguinal canal above the inguinal ligament; femoral hernias (DC 7340) come through the femoral canal below it, in the upper thigh area. The femoral canal is narrower and more rigid, which is why femoral hernias incarcerate and strangulate at a much higher rate than inguinal hernias. The rating codes are different and the rating outcome can vary significantly, so getting the diagnosis right matters.
Surgical repair is generally recommended for any confirmed femoral hernia because of the high incarceration risk. This is medical advice that comes from the surgical literature, not VA rating policy — but the rating consequences of a surgical decision matter. A clean repair with no recurrence usually moves the rating to 0% (or non-compensable status); a recurrence or post-operative complications can move the rating back up.
Recurrence after surgical repair is specifically listed in the 30% tier criteria. Multiple repairs strengthen the case for the higher tiers because they establish a pattern of severe, persistent disease that conservative measures cannot fully control. Bring the full surgical history — every operative report, every recurrence, every mesh complication — to the C&P exam.