GERD (Gastroesophageal Reflux Disease)
GERD is chronic acid reflux from the stomach into the esophagus, causing heartburn, regurgitation, and sometimes difficulty swallowing. Since May 19, 2024 it has its own diagnostic code (7206) and is rated on esophageal stricture criteria - how badly documented narrowing of the esophagus affects swallowing and what treatment it requires.
How the VA rates it
GERD received its own diagnostic code (7206) in the May 19, 2024 digestive system revision. It is now rated using the same criteria as esophageal stricture (DC 7203): ratings turn on documented strictures causing dysphagia (difficulty swallowing) and how often dilation procedures, stents, surgery, or a feeding tube are needed, with findings confirmed by barium swallow, CT, or endoscopy. Before May 2024, GERD had no code of its own and was rated by analogy to hiatal hernia (old DC 7346) at 10, 30, or 60 percent based on symptom combinations like persistently recurrent epigastric distress, pyrosis (heartburn), regurgitation, and arm/shoulder pain; claims already rated under the old criteria keep their protected evaluations, and claims pending on the change date get whichever version is more favorable.
Rating criteria by percentage
Rated up to 80%Documented history of recurrent or refractory esophageal strictures causing difficulty swallowing, with aspiration, undernutrition, or substantial weight loss, treated with surgical correction or a percutaneous feeding tube (PEG tube).
Documented recurrent or refractory strictures causing dysphagia requiring dilation 3 or more times per year, dilation using steroids at least once per year, or esophageal stent placement.
Documented recurrent strictures causing dysphagia requiring dilation no more than 2 times per year.
Documented history of esophageal stricture that requires daily medication to control difficulty swallowing, otherwise asymptomatic.
Documented history of stricture without daily symptoms and without need for daily medication.
What those terms mean
- stricture
- — A narrowing of the esophagus that makes food hard to swallow. Documented strictures are what drive the higher GERD ratings.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Barrett's Esophagus — Long-standing GERD can progress to Barrett's esophagus (DC 7207), which is rated separately based on dysplasia grade or stricture.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- PTSD — GERD is commonly claimed secondary to PTSD via the medication pathway - SSRIs, other psychiatric medications, and NSAIDs taken for service-connected conditions can cause or aggravate reflux, and chronic stress worsens acid symptoms.
Evidence that strengthens this claim
- Under the post-2024 criteria, the compensable tiers all require a documented esophageal stricture - get a barium swallow, CT, or endoscopy (EGD) into your file. Daily PPI use alone, without documented stricture findings, generally supports only a 0 percent rating under the new criteria.
- Keep records of every dilation procedure with dates - the difference between 30 and 50 percent is dilation frequency (2 or fewer vs. 3 or more per year) or steroid dilation/stent placement.
- If claiming secondary to PTSD, provide pharmacy records showing your psychiatric or pain medications and a medical opinion linking the medication or condition to your reflux.
- Document weight loss, aspiration events, or nutrition problems - these drive the 80 percent level.
Filing notes
If your claim was pending before May 19, 2024, VA must apply whichever criteria (old hiatal hernia analogy or new stricture-based) are more favorable to you. Existing ratings under the old criteria are not reduced solely because of the criteria change.
Rating rules to know
GERD, hiatal hernia, and other esophageal conditions rated on the same stricture criteria are rated as a single disability, not stacked (38 CFR 4.14). Esophageal codes are outside the digestive 'no combining' list, so a GERD rating can be combined with intestinal condition ratings such as IBS.
Related diagnostic codes
More digestive conditions
Irritable Bowel Syndrome (IBS)
IBS is a functional bowel disorder causing abdominal pain tied to bowel movements, with diarrhea, constipation, bloating, or urgency. Since the May 2024 revision it is rated 10, 20, or 30 percent based on how often pain related to defecation occurs.
Rated up to 30%
Hemorrhoids
Hemorrhoids are swollen veins in the rectum or anus that can bleed, prolapse, or form painful clots (thrombosis). Under the May 2024 criteria they are rated 10 or 20 percent based on bleeding with anemia, prolapse, and how many thrombosis episodes occur per year.
Rated up to 20%
Inguinal Hernia
An inguinal hernia is tissue bulging through a weak spot in the groin wall. Since May 2024, DC 7338 covers all abdominal wall hernias (inguinal, femoral, umbilical, ventral, incisional - but not hiatal) and rates 0 to 100 percent based on whether the hernia is irreparable, its size, and pain during daily activities.
Rated up to 100%
Peptic Ulcer Disease
Peptic ulcer disease is open sores in the stomach or duodenum causing abdominal pain, nausea, and sometimes bleeding. The May 2024 revision consolidated the old separate gastric, duodenal, and marginal ulcer codes into a single DC 7304 rated on episode frequency, bleeding, and hospitalization.
Rated up to 100%
Gallbladder Disease (Chronic Biliary Tract Disease)
Chronic gallbladder and biliary tract disease causes recurring attacks of right-upper-abdominal pain with nausea and vomiting. Since May 2024, DC 7314 covers chronic biliary tract disease broadly and rates 0, 10, or 30 percent based on documented attack frequency over the past 12 months.
Rated up to 30%
Diverticulitis
Diverticulitis is inflammation or infection of small pouches (diverticula) in the colon wall, causing attacks of abdominal pain, fever, and elevated white counts. Since May 2024, DC 7327 has its own criteria rated 0, 20, or 30 percent based on hospitalizations and complications.
Rated up to 30%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.