Ulcerative colitis vs. Crohn’s disease: What veterans need to know regarding VA disability benefits

Ulcerative colitis and Crohn's disease are both inflammatory bowel diseases (IBD) and lifelong gastrointestinal disorders. They have a lot of symptoms in common, but they're not the same – which can make things confusing for veterans who are getting ready to file a claim for VA disability benefits. An estimated 66,000 veterans live with inflammatory bowel diseases, and it's possible to earn benefits for these conditions.

Before filing a claim with the VA, it's important to make sure you have the right diagnosis and enough supporting evidence to prove it to the VA. In this blog, we'll talk about the difference between the two, along with what it means to have a structural condition (both ulcerative colitis and Crohn's are structural) in regards to the VA's rating system.

Here's what veterans need to know about ulcerative colitis, Crohn's disease, and their VA disability benefits claim:

What is ulcerative colitis?

Ulcerative colitis is a type of inflammatory bowel disease that causes ulcers in parts of the digestive tract. It occurs in the large intestines, specifically the colon and rectum, and typically develops over a long period of time. The following are common symptoms of ulcerative colitis:

• Fatigue

• Fever

• Diarrhea

• Rectal pain

• Rectal bleeding

• Blood or pus in stool

• Stomach cramping 

• Stomach pains

• Weight loss

What is Crohn's disease?

Crohn's disease is another type of inflammatory bowel disease, where swelling and irritation occur in the digestive tract, leading to chronic inflammation. Although this inflammation can affect different parts of the digestive tract depending on the individual, it usually has the biggest impact on the end of the small intestine and the beginning of the large intestine. Here are some common symptoms of Crohn's disease:

• Diarrhea

• Fatigue

• Fever

• Stomach cramping

• Stomach pains

• Mouth sores

• Pain or drainage near or around the anus

• Fistulas (tunnels into the skin)

Similarities and differences between ulcerative colitis and Crohn's disease

As you can tell by the descriptions above, ulcerative colitis and Crohn's disease have a lot of similarities – but they're not the same thing. Many of the symptoms overlap, such as diarrhea, stomach pain and cramping, fever and fatigue, but there are some key differences in the conditions.

Someone with Crohn's disease can still have healthy parts of the intestine in between parts of inflammation. By contrast, ulcerative colitis causes inflammation throughout the colon continuously. Another key difference is that Crohn's disease can occur in all different layers of the bowel walls, whereas ulcerative colitis only affects the inner lining of the colon.

The difference between structural and functional conditions

Regarding VA disability benefits, ulcerative colitis, and Crohn's disease, it's important for veterans to understand the differences between structural and functional conditions in regards to how the VA operates.

• Structural conditions have some identifiable medical marker, such as positive lab tests, abnormalities on imaging studies, or visually inflamed bowels on direct inspection during a procedure.

• Functional conditions, such as IBS (irritable bowel syndrome – it's different from IBD) can have symptoms of a gastrointestinal condition, but all the tests come back normal.

Since both ulcerative colitis and Crohn's disease are structural conditions, they do not qualify as presumptive conditions – meaning that veterans are not automatically eligible based on their time in service. This means that you'll need strong medical evidence and supporting competent evidence to prove your condition to the VA.

What about functional conditions like IBS (irritable bowel syndrome)?

Regarding IBS, it's a diagnosis of exclusion. This means that simply having the diagnosis does not guarantee that the VA will award a presumptive service connection.

So, the best path is to be evaluated and have other possible causes for your symptoms ruled out, which might require an evaluation or procedure from a GI specialist. If nothing is found, then the IBS diagnosis is stronger. In our opinion, simply having a provider diagnose IBS without ruling out any other causes is a much weaker claim to file.

Get what you need for your VA disability benefits claim

Start by getting a chart review with us so we can review your medical documentation and decide which documents you need for a compelling claim. Whether you're filing for ulcerative colitis, Crohn's disease, or another claimable condition – we can help. Get a Nexus Letter, DBQ, and more.

Sign up for a chart review and view our other services here.