On May 19, 2024, the VA initiated a new disability rating schedule for Gastroesophageal Reflux Disease (GERD). Updates to the GERD VA rating criteria include the addition of a new Diagnostic Code 7206 specifically used to evaluate and rate disability claims for GERD within the Veterans Administration system.
These changes will significantly affect the ability of many veterans with this disease to obtain optimum ratings for VA disability compensation.
Read on for our complete summary of the new criteria for evaluating GERD, how they can affect new or pending VA disability claims for this condition, and your path to obtaining the maximum benefits you deserve.
On this page:
- Summary of 2024 GERD VA Rating Changes
- (Old) VA Rating Schedule for GERD
- (New) VA Rating Schedule for GERD
- How Do These Changes Affect My GERD VA Rating and Compensation?
- Under Which GERD VA Rating (Old or New) Will My Claim Be Rated?
- How Do I Prove a VA Claim or Appeal a Decision for GERD On or After 2024?
- Secondary Service Connection for GERD
- What Does the VA Say about the New GERD VA Rating Criteria?
- Contact Us Now about Your GERD Disability Benefits
Summary of 2024 GERD VA Rating Changes
On the downside: VA’s new GERD ratings make it more difficult for veterans to get above 0% ranking without documented esophageal stricture accompanied by dysphagia.
On the upside: Veterans with documented esophageal stricture accompanied by dysphagia may now receive higher ratings, up to 80%. This is a deserved advantage for veterans with these symptoms.
- Esophageal stricture is an abnormal narrowing of the esophagus caused by conditions such as chronic acid reflux. This can lead to inflammation of the esophagus, which causes tissue scarring, often resulting in swallowing difficulties.
- Dysphagia is when someone has difficulty swallowing. A 2020 study reports about 48% of people with GERD symptoms will experience dysphagia.
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(Old) VA Rating Schedule for GERD
Previously, the VA rated GERD using Diagnostic Code 7346, which is the same code used for hiatal hernias. The rating was based on the frequency, duration, and severity of the veteran’s symptoms, and the possible ratings were 10%, 30%, or 60% as follows:
Previous: 7346 Hiatal Hernias (to include GERD): Before May 19, 2024
10%: “With two or more of the symptoms for the 30% rating of less severity” (meaning, the symptoms weren’t severe enough for the total 30% rating);
30%: “Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health”;
60%: “Symptoms of pain, vomiting, material weight loss, and hematemesis or melena with moderate anemia, or other symptom combinations productive of severe impairment of health.”
(New) VA Rating Schedule for GERD
Under the new ratings for DC 7206, a GERD VA disability claim can be rated at 0%, 10%, 30%, 50%, or 80%, depending on your symptoms.
New: 7206 Gastroesophageal reflux disease: Effective as of May 19, 2024
0% “Documented history without daily symptoms or requirement for daily medications”
10% “Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic”
30% “Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year”
50% “Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement”
80% “Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by §4.112(a) and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube)”
7206 GERD VA ratings also include the following criteria:
- Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
- Non-gastrointestinal complications of procedures should be rated under the appropriate system.
- Diagnostic code 7206 pertains to (but is not limited to):
- esophagitis, mechanical or chemical;
- Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid;
- drug-induced or infectious esophagitis due to Candida, virus, or other organism;
- idiopathic eosinophilic, or lymphocytic esophagitis;
- esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
- Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
- Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
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How Do These Changes Affect My GERD VA Rating and Compensation?
The majority of veterans will not be eligible for a GERD rating above 0% for claims submitted after May 19th, 2024, even though these rating changes raise the maximum GERD VA disability rating from 60% to 80%. This is because esophageal stricture is a requirement of the new rating criteria.
Swallowing becomes difficult when the esophageal lumen narrows abnormally, a condition known as esophageal stricture. Not all veterans with GERD have esophageal stricture although it is the most prominent and persistent symptom of the condition. Many people are primarily affected by other severe symptoms like trouble swallowing, laryngitis, chest pain, or chronic cough.
Veterans will not be eligible for a 10% or higher GERD VA rating under DC 7206 unless they have medically authenticated esophageal structure issues. In other words, while other symptoms can help support a claim, without esophageal stricture (permanent impairment), a veteran can only qualify for a 0% rating.
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Under Which GERD VA Rating (Old or New) Will My Claim Be Rated?
How VA rates your GERD claim depends on the timing:
- For a VA decision made before May 19, 2024, the old GERD rating schedule will apply.
- For VA compensation claims still pending a decision on or after May 19, 2024, the old and new GERD VA rating schedules will be considered. By law, the VA must assign the rule that awards the most benefits to the veteran.
- For all VA claims submitted on or after May 19, 2024, the new GERD rating schedule will be used.
How Do I Prove a VA Claim or Appeal a Decision for GERD On or After 2024?
You will need to demonstrate to the VA how GERD affects your life and how it relates to your time in the military. This evidence will include medical findings and testimony from others, including:
Medical Records: Support your claim with a formal GERD diagnosis from your physician, an accounting of prescription drugs, medical history and treatment records, and other correspondence related to your GERD.
Clinical findings: Compile the results of all clinical testing such as blood work, x-ray, pH probe tests, endoscopy, esophagoscopy, esophageal manometry, and other tests.
Service records: Build your case with military service records, including DD214 and medical records.
Statements to Support Your Claim: Obtain and submit buddy statements from fellow soldiers and pertinent lay witness testimony from family, friends, and work colleagues about how GERD symptoms limit daily activities. Competent and credible statements from others on a personal level can prove to be an influential asset, adding context and detail to your disability’s impact. We will guide you through this part of the VA claim process, and you can be confident that best practices are followed.
Nexus Statement – Proof of Service Connection: To qualify for disability benefits, the VA must find that your diagnosis and military service are connected. A well-developed nexus letter can establish that your GERD is linked (1) directly to your military service or (2) secondary to another service-connected condition.
Keep a Daily Journal: Create a chronological log documenting all of your GERD symptoms, detailing the severity, duration, and frequency of episodes and the onset and progression of your disability. Capture the details of how GERD affects your daily functionality, including missed work due to sick leave, pain, sleep loss, stress, nausea, anxiety, and more.
C&P Exam: The VA may request to perform a follow-up physical examination called the Compensation and Pension exam and discuss your symptoms. A VA doctor or a contracted non-VA doctor may perform the exam. It is a final discovery and assessment of evidence proving you are disabled due to your military service.
These exams carry weight in the VA’s assessment of your service-connected disability and GERD VA rating assignment. We can help you prepare for the C&P exam and navigate VA’s process in the best way possible.
Secondary Service Connection for GERD
GERD is a common VA claim for secondary service connection, where GERD is caused or aggravated by another condition that is service-connected.
For example, GERD may qualify as secondary-service connected to various disorders like PTSD, asthma, sleep apnea, or secondary to medications taken for a service-connected disability. Gulf War veterans exposed to environmental hazards, such as Agent Orange or burn pits, may be able to establish a link between their GERD and their service.
Nexus statements are also essential for secondary claims. As your VA disability attorneys, we work extensively with you to obtain effective linkage statements to help prove your claim.
What Does the VA Say about the New GERD VA Rating Criteria?
Before the changed ratings became official, commenters questioned why traditional symptoms of GERD are not considered for disability benefits. Symptoms such as heartburn, regurgitation, sore throat, nausea, chest pain, difficulty swallowing, laryngitis, chronic cough, new or worsening asthma, inflammation of the gums, cavities, bad breath, disrupted sleep, ulceration, erosion or Barrett’s esophagus – all indicative of Gastroesophageal Reflux Disease.
To this, the VA’s responds:
“Even though these symptoms are important in the diagnosis and treatment of GERD, the VA rating schedule bases its evaluations on the permanent impairment due to this condition.
Such permanent impairment of function is based on the scarring due to the chronic irritation of the esophagus by acid reflux and consequent development of scar tissue that causes esophageal stricture.
Therefore, for VA disability compensation purposes, the functional impairment due to GERD will be evaluated and based on the degree of esophageal stricture.”
You can read VA’s entire commentary on the new GERD VA rating criteria in the Federal Register, Schedule for Rating Disabilities: The Digestive System – Final Ruling, 3/20/2024.
Contact Us Now about Your GERD Disability Benefits
If you are a veteran whose claim for disability compensation for GERD was denied or underrated, you need an advocate to fight for your rights. Don’t give up. In addition to helping you get the most compensation possible, our accredited veterans’ lawyers can offer legal guidance on how you may be able to raise your GERD VA rating.
Contact us today at 800-562-9830 for a free legal consultation. We’re here to help you throughout the VA disability claims process for GERD in whatever step of the process you may be.
Call or text 800-562-9830 or complete a Free Case Evaluation form