Diagnostic Code 7339 · 38 CFR §4.114
A ventral hernia is a bulge of abdominal contents through a weakness in the front wall of the abdomen. The most common version is the postoperative or incisional hernia, where the muscle layer never fully heals along a previous surgical scar and abdominal contents push through the gap. For veterans, the typical history is an abdominal procedure during or after service — appendectomy, exploratory laparotomy, trauma surgery, or hernia repair — followed by a slowly enlarging bulge over months or years. Symptoms range from mild discomfort and a visible bulge that softens when lying down to severe pain, bowel obstruction, or strangulation when contents become trapped. The VA rating under DC 7339 turns on size, whether a support belt provides adequate control, and the structural state of the abdominal wall.
| Rating | Criteria |
|---|---|
| 0% | Wound healed, no current disability, abdominal support belt not indicated. |
| 20% | Small hernia not well supported by belt under ordinary conditions, OR a healed surgical wound with weakening of abdominal wall and indication for a supporting belt. |
| 40% | Large hernia not well supported by belt under ordinary conditions. |
| 100% | Massive, persistent hernia with severe diastasis of the recti muscles or extensive diffuse destruction or weakening of the muscular and fascial support of the abdominal wall, such that the hernia is inoperable. |
A current physical examination by a general surgeon documenting hernia size, reducibility, and the state of the surrounding muscle and fascia is the centerpiece. Cross-sectional imaging (CT or MRI of the abdomen) characterizes the defect more precisely — particularly important for large or recurrent hernias. Photographs taken with the abdomen relaxed and then tensed (Valsalva) show how the hernia presents in daily life. Records from the original surgery establish the postoperative connection. Records of any repair attempts, recurrence, mesh complications, or revisions document the progressive nature. A prescription for or note about an abdominal support belt is directly relevant to the rating language.
Not automatically, but the path is short. If the original abdominal surgery was performed during active duty or on a service-connected condition, an incisional hernia at that surgical site is generally a direct continuation of the service event. The connection runs through the surgical history; a surgeon's opinion linking the current hernia to the original incision closes the nexus.
It is a functional question, not a binary one. A belt is considered to provide adequate support if it keeps the hernia reduced (flat) under routine activity — walking, light lifting, normal daily movement. If the hernia bulges back through despite the belt, if the belt causes its own skin or back problems, or if you need progressively tighter belts or multiple layers, the support is not adequate and the rating should reflect that.
Yes, when they produce their own functional impairment. Mesh infection, mesh erosion into the bowel or skin, chronic mesh pain, and adhesions from the original repair are recognized complications and can support separate ratings or higher tiers depending on their nature. Documentation from the surgeon who placed or revised the mesh is essential.