GERD VA Rating and Diagnostic Code 7206 Criteria

Detailed breakdown of each GERD rating tier

Each percentage tier under Diagnostic Code 7206 requires specific clinical findings and treatment history in your medical records.

0 percent noncompensable rating

A 0% rating applies when a veteran has a documented history of GERD without daily symptoms or a requirement for daily medication, or has service-connected GERD without the documented esophageal stricture and dysphagia needed for the 10% tier. While a 0% rating pays no monthly compensation, it establishes service connection, provides no-cost VA health care and medications for the condition, and allows the veteran to file for an increased evaluation if endoscopic or imaging studies later confirm a stricture.

10 percent disability rating

A 10% rating requires a documented history of esophageal stricture(s) requiring daily medications—such as proton pump inhibitors (omeprazole, pantoprazole, esomeprazole) or H2 blockers (famotidine)—to control dysphagia, even if otherwise asymptomatic on medication. Under the rate schedule effective 2025-12-01, a standalone 10% rating pays $180.42 per month for a veteran with no dependents.

30 percent disability rating

A 30% rating requires a documented history of recurrent esophageal stricture(s) causing dysphagia that requires esophageal dilatation (an endoscopic procedure using a balloon or bougie dilator to stretch the narrowed esophagus) no more than two times per year. At 30%, a veteran without dependents receives $552.47 per month, and veterans at 30% or higher qualify for additional allowances for eligible dependents.

50 percent disability rating

A 50% evaluation requires a documented history of recurrent or refractory esophageal stricture(s) causing dysphagia that requires at least one of three intensive treatments:

1. Dilatation 3 or more times per year.
2. Dilatation using steroids at least once per year to reduce scar reformation.
3. Esophageal stent placement to keep the esophageal lumen open.

A 50% disability rating pays $1,132.90 per month for a veteran without dependents.

80 percent disability rating

The maximum schedular rating under Diagnostic Code 7206 is 80%, which requires all three of the following:

1. Recurrent or refractory stricture with dysphagia: Documented history of recurrent or refractory esophageal stricture(s) causing difficulty swallowing.
2. Systemic or pulmonary complication: At least one of the following: (1) aspiration of food or liquid into the airway, (2) undernutrition as defined in 38 CFR 4.112(c), and/or (3) substantial weight loss as defined in 38 CFR 4.112(a).
3. Surgical or tube-feeding intervention: Treatment with either surgical correction of the esophageal stricture(s) or a percutaneous esophago-gastrointestinal tube (PEG tube).

A standalone 80% evaluation pays $2,102.15 per month for a veteran with no dependents.

Mandatory notes and definitions under 38 CFR 4.114 and 4.112

Diagnostic Code 7206 includes five binding notes in 38 CFR 4.114 and incorporates the weight loss and nutrition definitions in 38 CFR 4.112.

The five regulatory notes to Diagnostic Code 7206

• Note (1) — Objective diagnostic proof: Findings must be documented by barium swallow, computerized tomography (CT), or esophagogastroduodenoscopy (EGD). Self-reported reflux symptoms cannot substitute for one of these three diagnostic studies when proving an esophageal stricture.
• Note (2) — Non-gastrointestinal complications: Non-gastrointestinal complications of procedures must be rated separately under the appropriate body system.
• Note (3) — Covered esophagitis conditions: This code applies, but is not limited to, mechanical or chemical esophagitis; Mallory-Weiss syndrome (bleeding at the gastroesophageal junction from mucosal tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organisms; idiopathic eosinophilic or lymphocytic esophagitis; radiation esophagitis; peptic stricture esophagitis; and any esophageal condition requiring sclerotherapy.
• Note (4) — Recurrent stricture definition: Inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
• Note (5) — Refractory stricture definition: Inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.

Weight loss and nutrition standards in 38 CFR 4.112

For the 80% tier, adjudicators apply the exact definitions in 38 CFR 4.112:

• Substantial weight loss (38 CFR 4.112(a)): Involuntary loss greater than 20% of baseline weight sustained for three months with diminished quality of self-care or work tasks.
• Baseline weight (38 CFR 4.112(b)): Clinically documented average weight for the two-year period preceding onset of illness or, if relevant, the weight recorded at the most recent discharge physical. If neither is available or relevant, the VA uses ideal body weight under the Hamwi formula or Body Mass Index (BMI) tables, whichever is most favorable to the veteran.
• Undernutrition (38 CFR 4.112(c)): A deficiency from insufficient intake or inability to absorb, utilize, or retain essential nutrients, characterized by failure to maintain normal organ functions and healthy tissues (signs may include loss of subcutaneous tissue, edema, peripheral neuropathy, muscle wasting, weakness, abdominal distention, ascites, and below-normal BMI).
• PEG tube nutrition (38 CFR 4.112(d)(2)): Assisted enteral nutrition delivers liquid proteins, carbohydrates, fats, vitamins, and minerals through a flexible tube inserted through the abdominal wall into the stomach.

The May 19, 2024 schedule revision and grandfathering protections

Before May 19, 2024, GERD was rated by analogy under Diagnostic Code 7346 (Hernia hiatal) at 10%, 30%, or 60%:

• 10% (pre-May 2024 DC 7346): Two or more of the symptoms for the 30% evaluation of less severity.
• 30% (pre-May 2024 DC 7346): Persistently recurrent epigastric distress with dysphagia, pyrosis (heartburn), and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.
• 60% (pre-May 2024 DC 7346): Symptoms of pain, vomiting, material weight loss, and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.

Under 38 U.S.C. 1155 and 38 CFR 3.951(a), a readjustment to the rating schedule cannot be grounds for reducing a disability rating in effect on the date of the readjustment unless medical evidence establishes that the condition has actually improved. Veterans who held a 10%, 30%, or 60% GERD evaluation before May 19, 2024 keep their protected rating. For claims filed before May 19, 2024 and still pending on or after that date, the VA evaluates the pre-revision period under both old DC 7346 and new DC 7206 and assigns whichever evaluation is more favorable.

Related esophageal diagnostic codes and anti-pyramiding rules

Under revised 38 CFR 4.114, several esophageal codes overlap with Diagnostic Code 7206:

• Diagnostic Code 7203 (Esophagus, stricture of): Rated at 0%, 10%, 30%, 50%, and 80% using the same criteria and Notes (1)–(5) as DC 7206.
• Diagnostic Code 7346 (Hiatal hernia and paraesophageal hernia) and Diagnostic Code 7204 (Esophageal motility disorder): Both are now rated as stricture of the esophagus under DC 7203.
• Diagnostic Code 7207 (Barrett’s esophagus): Rated under DC 7203 if stricture is present. Without esophageal stricture, it is rated at 30% when documented by pathologic diagnosis with high-grade dysplasia, or 10% with low-grade dysplasia (or 100% under DC 7343 if malignancy develops).

Under the anti-pyramiding rule in 38 CFR 4.14, the VA cannot assign separate ratings for GERD (DC 7206) and a hiatal hernia (DC 7346) when both produce the same dysphagia and stricture manifestations.

Direct and secondary service connection for GERD

Direct service connection (38 CFR 3.303)

Under 38 CFR 3.303, direct service connection requires a current GERD diagnosis, evidence of in-service reflux symptoms or treatment in service medical records, and a medical nexus. Note that while functional gastrointestinal disorders are presumptive for Gulf War veterans under 38 CFR 3.317(a)(2)(i)(B)(3), structural gastrointestinal conditions diagnosed by endoscopy or radiography—such as GERD with mucosal pathology or stricture—are excluded from that presumption and require direct or secondary proof.

Secondary service connection (38 CFR 3.310)

Under 38 CFR 3.310(a), a disability proximately due to or aggravated by an existing service-connected condition may receive secondary service connection. Common secondary claims include:

• NSAID and medication side effects: Long-term prescription nonsteroidal anti-inflammatory drugs (such as meloxicam, ibuprofen, or naproxen) taken for service-connected back pain or knee pain may erode mucosal defenses and cause or aggravate drug-induced esophagitis and GERD.
• PTSD and mental health conditions: Service-connected PTSD or depressive disorders may cause or aggravate GERD through autonomic nervous system changes, stress-induced acid production, or psychiatric medication side effects.
• Obstructive sleep apnea: Service-connected sleep apnea creates negative intrathoracic pressure during nocturnal airway obstruction, which may pull gastric contents into the esophagus.

How the C&P exam and Esophageal Disorders DBQ measure GERD

During a C&P examination, the clinician completes the Esophageal Disorders Disability Benefits Questionnaire (DBQ) (verified on the VA Public DBQs page). Rather than performing an endoscopy during the exam, the examiner reviews your existing medical records to record:

1. Confirmed esophageal diagnoses (GERD, stricture, hiatal hernia, Barrett’s esophagus).
2. Presence of dysphagia and whether strictures are recurrent or refractory under Notes 4 and 5.
3. Daily medication requirements, annual frequency of dilatation procedures, steroid dilatations, stents, surgeries, or PEG tube use.
4. Evidence of aspiration, undernutrition, or substantial weight loss under 38 CFR 4.112.
5. Objective findings from prior EGD, barium swallow, or CT studies as required by Note 1.

Combining ratings and getting accredited help

GERD evaluations combine with other service-connected ratings using the whole-person formula in 38 CFR 4.25. You can calculate your combined evaluation with our VA combined rating calculator and estimate retroactive compensation from your effective date with our VA back pay calculator.

If you need help gathering endoscopic evidence or filing a secondary claim or appeal, consider working with a VA-accredited representative. Accredited Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide free representation, and accredited claims agents or attorneys assist with complex appeals. No representative can guarantee an outcome; verify credentials through the VA Office of General Counsel Accreditation Search.