ULCERATIVE COLITIS

DAVID GRATZ · 2026 · Case ID: A26038715

GRANTED

Summary

The veteran, who served in the U.S. Air Force from March 1970 to September 1973, was represented by his surviving spouse following his death in September 2025. The veteran appealed the July 2020 rating decision, electing the Hearing docket, and a Board hearing was held in July 2024. The Board could only consider evidence of record up to the July 2020 decision date. The veteran sought an increased rating for Crohn's disease status post resection of large intestine with peritoneal adhesions and a residual abdominal scar, and entitlement to Total Disability based on Individual Unemployability (TDIU). The Board granted an initial rating of 60 percent for Crohn's disease, finding the severe symptoms with numerous attacks and malnutrition warranted this level, though not the higher 100 percent rating due to lack of marked malnutrition, anemia, debility, or serious complications. The Board also granted a 10 percent rating for the residual abdominal scar, finding it painful based on the veteran's testimony, which aligned with Diagnostic Code 7804, but did not meet criteria for higher ratings due to lack of instability or sufficient size/depth. Finally, entitlement to TDIU was granted, as the veteran's Crohn's disease resulted in frequent medical absences, retirement from employment, and inability to maintain substantially gainful occupation, meeting the schedular criteria with a 60 percent disabling condition.

Rationale

Veteran's Crohn's disease rated 30% under DC 7323 (ulcerative colitis, moderately severe symptoms); 60% rating warranted for severe symptoms with numerous attacks and malnutrition; No marked malnutrition, anemia, debility, or serious complications found to warrant higher rating

Service Branch

AIR FORCE

Special Benefit

TDIU

Docket No.

200929-113355

Full Decision Text

Citation Nr: A26038715
Decision Date: 04/24/26 Archive Date: 04/24/26

DOCKET NO. 200929-113355
DATE: April 24, 2026

ORDER

An initial rating of 60 percent, but no higher, for Crohn's disease status post resection of large intestine with peritoneal adhesions is granted, subject to the rules and regulations governing the payment of VA monetary benefits..

A 10 percent initial rating, but no higher, for a residual abdominal scar secondary to Crohn's disease status post resection of large intestine with peritoneal adhesions is granted, subject to the rules and regulations governing the payment of VA monetary benefits.

Entitlement to total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is granted.

FINDINGS OF FACT

1. The Veteran's Crohn's disease status post resection of large intestine with peritoneal adhesions was manifested by severe ulcerative colitis with numerous attacks a year and malnutrition with health only fair during remissions; and is not manifested by pronounced ulcerative colitis resulting in marked malnutrition, anemia, and general debility, or with serious complication as liver abscess.

2. The Veteran's abdominal scar was painful.

3. The Veteran's service-connected Crohn's disease precluded the Veteran from substantially gainful occupation.

CONCLUSIONS OF LAW

1. The criteria for an initial rating of 60 percent, but no higher, for Crohn's disease status post resection of large intestine with peritoneal adhesions have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.114, Diagnostic Code 7329-7323.

2. The criteria for an initial rating of 10 percent, but no higher, for residual abdominal scar secondary to Crohn's disease status post resection of large intestine with peritoneal adhesions have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.3, 4.7, 4.40, 4.45, 4.59, 4.118, Diagnostic Codes 7801, 7804, 7805.

3. The criteria for a TDIU have been met. 38 C.F.R. § 4.16.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from March 1970 to September 1973. The Veteran died in September 2025, and the Appellant is his surviving spouse. The Appellant has been substituted as the claimant.

The rating decision on appeal was issued in July 2020 and constitutes an initial decision, as the rating decision is implementing the July 2020 Board decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the September 29, 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on July 1, 2024.

Therefore, the Board may only consider the evidence of record at the time of the July 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Appellant would like VA to consider any evidence that was submitted that the Board could not consider, the Appellant may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Increased Rating

Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. The Board should consider only those factors contained in the rating criteria. Massey v. Brown, 7 Vet. App. 204 (1994).

Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

The Board will also consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

1. An initial rating of 60 percent, but no higher, for Crohn's disease status post resection of large intestine with peritoneal adhesion is granted.

The Appellant seeks a disability rating in excess of 30 percent for the Veteran's Crohn's disease status post resection of large intestine with peritoneal adhesion. See September 2020 VA Form 10182 Notice of Disagreement. The Notice of Disagreement stated that VA failed to grant, consider, or apply a higher extraschedular disability rating. As outlined below, the Board finds that an increased initial rating is warranted for the Veteran's Crohn's disease.

The severity of a digestive system disability is ascertained, for VA rating purposes, by application of the criteria set forth in VA's Schedule for Rating Disabilities at 38 C.F.R. § 4.114. Ratings under Diagnostic Codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348, inclusive, will not be combined with each other. A single rating will be assigned under the diagnostic code that reflects the predominant disability picture, with elevation to the next higher rating where the severity of the overall disability warrants such elevation. 38 C.F.R. § 4.114.

The Veteran's Crohn's disease has been rated as 30 percent disabling under Diagnostic Code 7323, which falls under ulcerative colitis, which provides a 30 percent rating for moderately severe symptoms with frequent exacerbations. A 60 percent rating is warranted for severe symptoms, with numerous attacks per year and malnutrition, with only fair health during remissions. A 100 percent rating is warranted for pronounced symptoms, resulting in marked malnutrition, anemia, and general debility, or serious complications, such as liver abscesses.

The Veteran's Crohn's disease can also be rated under diagnostic code 7329 for resection of the large intestine, which provides a 20 percent rating for resection of the large intestine with moderate symptoms. A 40 percent rating is assigned for severe symptoms that are objectively supported by examination findings.

Effective May 19, 2024, VA amended the rating criteria for the digestive system. The revised rating criteria apply to all claims received by VA or that are pending before the AOJ on or after May 19, 2024. Generally, where the rating criteria are amended during the course of the appeal, both the former and the current schedular criteria are considered. Should an increased rating be warranted under the revised criteria, that award may not be made effective before the effective date of the change. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Here, the evidentiary window for the period on appeal closed July 2020, the date of the rating decision on appeal. Therefore, the amended rating criteria do not apply.

On the March 2018 VA intestinal conditions examination, the examiner indicated that the Veteran has a
the AOJ on or after May 19, 2024. Generally, where the rating criteria are amended during the course of the appeal, both the former and the current schedular criteria are considered. Should an increased rating be warranted under the revised criteria, that award may not be made effective before the effective date of the change. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Here, the evidentiary window for the period on appeal closed July 2020, the date of the rating decision on appeal. Therefore, the amended rating criteria do not apply.

On the March 2018 VA intestinal conditions examination, the examiner indicated that the Veteran has a diagnosis of Crohn's disease. The Veteran stated that he has an ileostomy. He stated that his entire colon had been excised. He stated that he has developed adhesions that have been treated. He stated that if he eats too much, he will experience bloating. He stated that he has been hospitalized frequently for small bowel blockages. The Veteran stated that he has lost 25 pounds over the past year and he keeps developing intestinal blockages and can eat less and less.

On examination, the VA examiner indicated that medication is required to control the Veteran's intestinal condition and has had surgical treatment for an intestinal condition. On examination, the examiner found that the Veteran had symptoms of abdominal distension that were described as bloating if the Veteran eats too much, therefore the Veteran can only eat small meals. Also, the examiner indicated that the Veteran experiences frequent nausea. Further, the examiner found that the Veteran experiences frequent episodes of bowel disturbance with abdominal distress and the examiner found that the Veteran experiences seven or more episodes of exacerbations and/or attacks of the intestinal condition in the past 12 months that can be described as abdominal distress with bloating and nausea. Finally, the examiner found that the Veteran had weight loss attributable to an intestinal condition with a baseline weight of 200 pounds and a current weight of 175 points. The examiner did not find the Veteran to have malnutrition, serious complications, or other general health effects attributable to the intestinal condition.

On the March 2018 VA intestinal surgery examination, the examiner indicated that the Veteran has a diagnosis of resection of the large intestine and peritoneal adhesions attributable to resection of the large intestine, due to Crohn's disease and adhesions, respectively. The examiner stated that the Veteran has a permanent ostomy and uses glucerna, protein drinks, and baby food to maintain adequate nutrition. The examiner explained that these nutritional supplementations are required to control the Veteran's Crohn's disease. The examiner found that the Veteran has abdominal pain and/or colic pain that is described as mild discomfort all of the time and frequent bloating. The examiner found that the Veteran's weight loss from 200 pounds to 175 pounds was attributable to the intestinal surgery. The examiner also found that the Veteran's weight loss had been sustained for three months or longer and has been unable to regain weight despite appropriate therapy. With regard to any interference with absorption and nutrition, the examiner did not find this to be applicable. The examiner confirmed that the Veteran's intestinal condition required an ileostomy or colostomy.

In a March 2018 statement, the Veteran stated that he experiences constant symptoms of adhesion.

In an April 2018 private treatment record, the Veteran presented to the hospital with abdominal pain for five days. On examination, the Veteran was observed to have distension and right lower quadrant pain. While admitted to the hospital, the Veteran was observed to have increased abdominal distension in a May 2018 treatment note.

In an April 2018 private treatment record the Veteran sought treatment for abdominal bloating, pain, dry heaves, and decreased output in his ileostomy. The Veteran reported that he has not eaten for five days. The medical provider noted that this is the Veteran's third admission since January for these same symptoms.

In an October 2018 private treatment letter, the medical provider stated that the Veteran presented numerous times with obstructive symptoms and flares of his colitis and was treated by the gastroenterology team as well as the surgical team. The medical provider stated that the Veteran presently has a full colectomy with a functional ostomy. The medical provider stated that the Veteran still gets some obstructive symptoms from adhesions.

In an April 2019 private treatment record, the medical provider stated that the Veteran is clearly obstructed and continues to have abdominal pain. The medical provider stated that the obstruction is clearly not resolving with bowel rest.

In a June 2019 private treatment record, the Veteran was admitted to the hospital for abdominal pain and was observed to have fecoprulent drainage from abscess opening towards the stoma.

In a July 2019 private treatment record the
his colitis and was treated by the gastroenterology team as well as the surgical team. The medical provider stated that the Veteran presently has a full colectomy with a functional ostomy. The medical provider stated that the Veteran still gets some obstructive symptoms from adhesions.

In a June 2019 private treatment record, the Veteran was admitted to the hospital for abdominal pain and was observed to have fecoprulent drainage from abscess opening towards the stoma.

In a July 2019 private treatment record the Veteran was admitted to the hospital for persistent drainage of his peristomal abscess, dehydration, and malnutrition.

At the July 2020 Board hearing, the Veteran testified that in 2019 he underwent five surgical procedures due to his Crohn's disease. T. at 12. The Veteran's wife testified that she was a nurse for 45 years and testified to the Veteran's symptoms that she has observed. T. at 13-14.

In a December 2020 private treatment record, the Veteran was found to have malnutrition related to abdominal pain. The medical provider stated that the Veteran had inadequate protein-energy intake related to chronic abdominal pain as evidenced by pain with diet trial.

In a December 2020 private treatment record, the Veteran reported abdominal distension and right sided periumbilical abdominal pain after eating pie and ham on Christmas Day. The Veteran stated he has worsening pain when eating solids, but tolerates liquids well. The Veteran was observed to have bloating, abdominal pain, and vomiting.

In a March 2021 private treatment record, the Veteran sought treatment for abdominal pain, nausea, vomiting, and decreased ostomy output.

In an April 2021 private treatment record, the Veteran presented with poor oral intake (PO) for two weeks with minimal stool output. The Veteran reported an ability to drink water but is unable to eat and is positive for chills, nausea, and vomiting (N/V).

In a June 2021 private treatment record the Veteran complained of abdominal pain. The Veteran reported six admissions in 2021 for acute pain flareups.

In a March 2022 and April 2022 private treatment records, the Veteran complained of abdominal pain and distension.

In a June 2022 private treatment record, the Veteran presented with abdominal pain that radiates to the stoma. He also stated he had multiple small bowel obstructions (SBOs) present for two days with abdominal pain and low colostomy output.

In an August 2022 private treatment record, the Veteran sought treatment for pain around the stoma.

In a December 2022 private treatment record, the Veteran complained of stoma pain with intermittent abdominal bloating and pain. The Veteran denied bloody or "mucousy" stools. He stated that if he eats bulky foods, he will have pain. The medical provider stated that the Veteran's weight is stable. The Veteran reported that he has small obstructive episodes. He stated that if he eats certain foods, such as noodles or chocolate containing nuts, he will have pain.

The Veteran was sought treatment at the emergency room in June 2023 and complained of pain around his stoma for months.

In a December 2023 private treatment record, the Veteran complained of abdominal pain at the site of his ostomy and progressive ostomy output for one month. The medical record shows the Veteran to have malnutrition related to loose watery stool and burning sensation at the stoma site as evidenced by a 2.3 percent weight loss prior to admission.

In a January 2024 private treatment record the Veteran complained of abdominal pain and decreased ostomy output. The medical provider also indicated a differential diagnosis of bowel obstruction and ostomy dysfunction.

At the July 2024 Board hearing, the Veteran's representative asserted that the Veteran experiences constant abdominal pain with abdominal bloating and distension, steady weight loss, and malnutrition due to subsisting on protein shakes and baby food due to an inability to eat. Board Hearing Transcript (T.) at 3. The representative contends that the Veteran's disability more nearly approximates a 60 percent or 100 percent rating under Diagnostic Code 7323. Id.

At the July 2024 Board hearing, the Veteran testified that when he goes to the hospital for Crohn's disease, he is admitted for blockages, pain, and bloating. T. at 8. He stated that he is usually admitted to the hospital for five to seven days. Id. The Veteran stated that he experiences constant abdominal pain between hospitalization. T. at 9. The Veteran stated that he currently weighs 153 pounds. T.
subsisting on protein shakes and baby food due to an inability to eat. Board Hearing Transcript (T.) at 3. The representative contends that the Veteran's disability more nearly approximates a 60 percent or 100 percent rating under Diagnostic Code 7323. Id.

At the July 2024 Board hearing, the Veteran testified that when he goes to the hospital for Crohn's disease, he is admitted for blockages, pain, and bloating. T. at 8. He stated that he is usually admitted to the hospital for five to seven days. Id. The Veteran stated that he experiences constant abdominal pain between hospitalization. T. at 9. The Veteran stated that he currently weighs 153 pounds. T. at 11. He stated that he has distension every time he eats. Id. He testified that his intestines process food very slowly. Id. He stated that experiences diarrhea, that is sometimes pure water. T. at 12. He stated that he was treated for blood in his ostomy bag prior to Christmas, unfortunately, two weeks after Christmas he had to return for the same symptoms. Id.

At the July 2024 Board hearing, the Veteran's wife stated that when the Veteran is admitted to the hospital, it is usually for bowel rest and to revamp the diet. T. at 8. She stated that sometimes there are concerns for malnutrition, however, he is mostly treated for dehydration. Id. She stated that the Veteran manages with supplemental drinks to maintain calories. Id. She also testified that the Veteran had lost 50 pounds. T. at 9.

For the period on appeal, the Board finds that the Veteran's disability picture more nearly approximated the criteria for a disability rating of 60 percent. In this regard, the March 2018 VA intestinal examiner indicated that the Veteran experienced numerous attacks a year with seven or more exacerbations or attacks in the past 12 months. Also, the private treatment records show the Veteran required hospital admission for exacerbations or attacks of the intestinal condition numerous times a year from 2018 thought 2024. Further, the private treatment records show the Veteran to have malnutrition. See July 2019, December 2020, and December 2023 private treatment records. Finally, the Appellant, a nurse, testified at the July 2024 Board hearing that the Veteran was treated for malnutrition when admitted to the hospital. The VA examinations, private treatment records, and Appellant's testimony show the Veteran had weight loss as a result of the intestinal condition. See March 2018 VA examination, December 2023 private treatment record, and July 2024 Board hearing testimony. Taken together, the Board finds that these symptoms demonstrate severe ulcerative colitis with numerous attacks a year and malnutrition with the health only fair during remissions.

The Board does not find that the Veteran's Crohn's disease warrants a rating in excess of 60 percent. To warrant a higher rating, the evidence must show the Veteran to have pronounced ulcerative colitis resulting in marked malnutrition, anemia, and general debility, or with serious complication as liver abscess. Here, although the Veteran's Crohn's disease was severe, the numerous hospital admissions or treatment show no findings of marked malnutrition, anemia, or a serious complication as liver abscess. Further, there are no complaints in the record, from the Veteran or Appellant of any debility. As a result, a rating in excess of 60 percent is not warranted.

The Board also finds that the examinations upon which it has relied in making this determination to be adequate and probative for rating purposes. The records contain all information required for the Board to make an informed decision.

Based on the record, the Board finds that the Veteran's symptomatology for the period on appeal most closely approximated the criteria for a 60 percent rating.

2. An initial rating of 10 percent, but no higher, for residual abdominal scar secondary to Crohn's disease status post resection of large intestine with peritoneal adhesions is granted.

The Appellant asserts that the Veteran's residual abdominal scar warrants an initial compensable rating. As outlined below, the Board finds that a compensable rating is warranted for the period on appeal.

Scars are rated under 38 C.F.R. § 4.118. The relevant scar is not on the head, face, or neck, therefore Diagnostic Code (DC) 7800 is not applicable.

Under DC 7801, a 10 percent rating is warranted for burn scars or scars due to other causes, not of the head, face, or neck, that are deep and nonlinear, at least 6 square inches (39 square centimeters (cm.)). Id. Higher ratings are available for deep and linear scars that affect a larger area, measuring at least 12
abdominal scar warrants an initial compensable rating. As outlined below, the Board finds that a compensable rating is warranted for the period on appeal.

Scars are rated under 38 C.F.R. § 4.118. The relevant scar is not on the head, face, or neck, therefore Diagnostic Code (DC) 7800 is not applicable.

Under DC 7801, a 10 percent rating is warranted for burn scars or scars due to other causes, not of the head, face, or neck, that are deep and nonlinear, at least 6 square inches (39 square centimeters (cm.)). Id. Higher ratings are available for deep and linear scars that affect a larger area, measuring at least 12 square inches. A deep scar is one associated with underlying soft tissue damage. 38 C.F.R. § 4.118, Diagnostic Code 7801, Note (1).

Diagnostic Code 7802 was for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that were superficial and nonlinear. Under these criteria, a scar with an area or areas of 144 square inches (929 sq. cm.) or greater warrants a 10 percent rating. 38 C.F.R. § 4.118. Note 1 to DC 7802 instructed that a superficial scar was one not associated with underlying soft tissue damage. Id.

Under DC 7804, one or two scars that are unstable or painful scars warrants a 10 percent rating. Three or four scars that are unstable or painful scars warrants a 20 percent rating. Five or more scars that are unstable or painful warrants a 30 percent rating. 38 C.F.R. § 4.118. Note 1 to DC 7804 instructs that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id.

If one or more scars are both unstable and painful, 10 percent is added to the evaluation that is based on the total number of unstable or painful scars. 38 C.F.R. § 4.118, Diagnostic Code 7804, Note (2).

Scars can also receive separate evaluations under Diagnostic Codes 7800, 7801, 7802, and 7805, despite also being rated under Diagnostic Code 7804. 38 C.F.R. § 4.118, Diagnostic Code 7804, Note (3).

Under Diagnostic Code 7805, any other scars, including linear scars, are to be rated based on any disabling effects and the appropriate diagnostic code for such effects. Diagnostic Code 7805 directs that any disabling effects not considered in Diagnostic Codes 7801 through 7804 should be evaluated under the appropriate diagnostic code. This instruction essentially directs that scars may be rated for the functional impairment caused by the scar.

The Board notes that the Schedule for Rating Skin Disabilities was amended in August 2018 so that it more clearly reflects VA's policies concerning the evaluation of skin disorders, specifically, 38 C.F.R. § 4.118, Diagnostic Codes 7801, 7802, 7805 7806, 7813, 7815-7817, 7820-7822, and 7824-7829. Although there is no specific effective date provided for ratings issued under the new criteria, there is no specification on whether the regulations are retroactive. Therefore, the new regulations apply to claims filed on or after August 13, 2018 and claims pending on August 13, 2018, if the new regulation is more favorable for the Veteran. 38 C.F.R. § 4.118 (2018). Although the Veteran's application was received by VA before the August 2018 effective date for the revised skin regulations, the Board will consider its application to the Appellant's claim for increased rating.

Since August 13, 2018, DC 7802 is for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. 38 C.F.R. § 4.118. DC 7802 was otherwise unchanged by the August 13, 2018, amendments.

Diagnostic Code 7804 was unchanged by the August 2018 amendments.

Diagnostic Code 7805 instructs that any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 under an appropriate Diagnostic Code. DC 7805 was unchanged by the August 2018 amendments.

On the March 2018 VA intestinal conditions examination, the examiner found the Veteran to have a scar related to his Crohn's disease. The examiner found the scar to not be painful or unstable, or to be equal or greater than 39 square cm (6 square
tissue damage. 38 C.F.R. § 4.118. DC 7802 was otherwise unchanged by the August 13, 2018, amendments.

Diagnostic Code 7804 was unchanged by the August 2018 amendments.

On the March 2018 VA intestinal conditions examination, the examiner found the Veteran to have a scar related to his Crohn's disease. The examiner found the scar to not be painful or unstable, or to be equal or greater than 39 square cm (6 square inches), or are located on the head, face, or neck. The examiner measured the abdominal scar to be 30 cm long and 1 cm wide.

At the July 2024 Board hearing, the Veteran's representative asserted that the Veteran scar is painful and should be assigned a compensable rating under Diagnostic Code 7804. T. at 3.

At the July 2024 Board hearing, the Veteran stated that his stomach scar is painful and is "all bunched together." T. at 14.

Upon review of the record, the Board finds that the Veteran's residual abdominal scar more nearly approximated a 10 percent rating, but no higher. Here, the Veteran testified at the July 2024 Board hearing that the abdominal scar was painful; this warrants a 10 percent rating under Diagnostic Code 7804. However, a still higher rating is not warranted, as the Veteran does not have a scar that is deep and nonlinear, at least 6 square inches (39 square centimeters); superficial and nonlinear with an area or areas of 144 square inches (929 sq. cm.) or greater; or unstable; or three or four scars that are unstable or painful. Here, the March 2018 VA examinations show the Veteran to have one scar that does not have a total area of 6 square inches (39 square centimeters). Also, there is no complaint by the Veteran or Appellant that the scar was unstable. Accordingly, an initial disability rating of 10 percent, but no higher, is warranted for the Veteran's scar.

The Board acknowledges the March 2018 VA examiner findings that the Veteran's scar did not cause pain. However, the Board finds this examination to be less persuasive as no VA examination was provided to the Veteran after service connection was granted in the July 2020 rating decision.

Based on the evidence of record, the Board finds that the Veteran's symptomatology for the period on appeal most closely approximated the criteria for a 10 percent rating.

3. Entitlement to a TDIU is granted.

The Appellant asserts that the Veteran was entitled to a TDIU due to his service-connected Crohn's disease. As outlined below, the Board finds that the evidence establishes a TDIU.

A TDIU may be assigned, where the schedular rating is less than total, where a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). To qualify for schedular consideration of a TDIU, if there is only one such disability, this disability shall be ratable at 60 percent or more, and, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Id.

For the purposes of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting from common etiology or a single accident; (3)disabilities affecting a single body system, e.g., orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric; (4) multiple injuries incurred in action; or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16(a); see Moody v. Wilkie, 30 Vet. App. 329, 339 (2018) (combining disabilities as "one disability" to meet the rating threshold of § 4.16(a) requires the use of the combined rating table).

The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component refers to an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. Id. The noneconomic component requires a determination as to a veteran's ability to secure and follow such employment. Id. Attention should be given to the veteran's history, education, skills, and training; whether the veteran has the physical ability (both exertional and nonexertional) to perform the types of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, as well as auditory and visual limitations); and whether the veteran has the mental ability to perform the activities required by the occupation at issue (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Id.

An award of TDIU is an individualized determination, specific to a veteran's particular circumstances, e.g., their history, education, skills, and training. See Todd v. McDonald, 27 Vet. App. 79, 85 (2014). It does not require a showing of 100 percent unemployability. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The ultimate question is whether they are capable of performing the physical and mental acts required by employment, not whether they can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993).

The Veteran was service connected for Crohn's disease, rated as 60 percent disabling and residual abdominal scar, rated as 10 percent disabling, as a result of this Board decision. Therefore, the Veteran meets the schedular criteria as there is one disability rated as 60 percent disabling.

For the reasons that follow, the Board finds that a TDIU is warranted.

On the March 2018 VA intestinal conditions examination, the examiner found that the Veteran's Crohn's disease impacts the Veteran's ability to work by causing the Veteran to have frequent medical absences. As a result, the Veteran retired from the Post Office in 1998. The examiner noted that the Veteran has been on Social Security Disability since that time. The Veteran attempted to work at Costco, but was frequently absent and could not continue the employment.

At the July 2020 Board hearing, the Veteran stated that his Crohn's disease and related treatment have affected his employment. T. at 12-13. He stated that he worked for the post office for 17 years and he had to take time from work due to Crohn's disease. T. at 13. He stated that for two years he could not work 180 days during the year. Id. He stated that his employment referred him for a physical examination and the examiner concluded that the Veteran was unfit for duty. Id. He stated that he was approved for Social Security Disability. Id.

At the July 2024 Board hearing, the Veteran testified that he was released from working at the post office because he was unable to work due to illness. T. at 15. He stated that the post office retired him in 2020. Id.

At the July 2024 Board hearing, the Veteran's wife testified that the Veteran stopped working 24 years ago. T. at 17.

The Board finds that the Veteran did not have the ability to secure or follow a substantially gainful occupation due to Crohn's disease. The record shows that the Veteran's Crohn's disease caused the Veteran to have frequent medical absences. See March 2018 VA examinations. Also, the Veteran testified that his prior employer retired him as he was unfit for duty due to the Crohn's disease. See July 2024 Board hearing transcript. Further, the private treatment records within this decision show that the Veteran was frequently hospitalized for more than five days numerous times throughout one year from 2018 to 2024. As a result, the frequent medical absences caused by the Veteran's Crohn's disease precluded the Veteran from securing or maintaining any employment.

Accordingly, the Board finds that the Veteran's Crohn's disease

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