GERD is a common digestive disorder where stomach contents flow back into the esophagus, causing irritation and heartburn. For veterans, establishing a service-connected disability is the first step toward receiving monthly compensation from the Department of Veterans Affairs (VA). The VA evaluates GERD based on the severity and frequency of symptoms, applying specific rating criteria. The current rating focuses on the functional impairment caused by the disease, particularly how it affects the esophagus and the ability to swallow.
Establishing Service Connection
The foundation of any successful VA disability claim is proving a service connection, which links the current medical condition to military service. This proof requires demonstrating three distinct elements. The first is a current and confirmed diagnosis of GERD from a licensed medical professional.
The second element is evidence of an event, injury, or exposure that occurred during active military service. This could include a documented incident, specific duties, or exposure to environmental hazards, such as those associated with the PACT Act. The third element is a medical link, known as a nexus, between the in-service event and the current GERD diagnosis.
A medical nexus is established through a doctor’s opinion stating it is “at least as likely as not” that GERD was caused or aggravated by military service. This connection can also be established secondarily, such as when GERD develops due to medication for a service-connected mental health condition like PTSD. The VA often requires a Compensation & Pension (C&P) exam to verify current symptoms and the connection to service.
The Symptom-Based Rating Criteria
The VA now rates GERD under Diagnostic Code 7206, focusing primarily on the presence and severity of esophageal strictures (narrowing of the esophagus). Ratings range from 0% to a maximum of 80%, reflecting the degree of functional impairment. This focus on strictures is a change from the prior method, which rated GERD analogously to a Hiatal Hernia (Diagnostic Code 7346) and considered broader symptoms like pain and regurgitation.
A 0% rating is assigned when a veteran has a documented history of GERD but experiences no daily symptoms or does not require daily medication. A 10% rating is warranted for an esophageal stricture requiring daily medication to control difficulty swallowing (dysphagia), but the veteran is otherwise without symptoms. This rating also applies if daily medication is required to control other GERD symptoms, even without evidence of stricture.
The 30% rating is assigned for recurrent esophageal strictures causing dysphagia that requires dilation (stretching of the esophagus) no more than two times per year. This indicates a moderate, manageable degree of obstruction. Moving to a 50% rating requires recurrent or refractory esophageal strictures causing dysphagia, necessitating more frequent intervention.
The criteria for a 50% rating include needing dilation three or more times per year, requiring dilation using steroids at least once annually, or the placement of an esophageal stent. The maximum rating of 80% is reserved for the most severe, recurrent, or refractory esophageal strictures. This level requires strictures to cause dysphagia and be accompanied by at least one severe complication, such as aspiration, undernutrition, or substantial weight loss. The 80% rating is also assigned if the veteran requires surgical correction of the strictures or the use of a percutaneous esophago-gastrointestinal tube (PEG tube) for feeding.
Related Conditions and Total Disability Ratings
GERD frequently occurs alongside or leads to other digestive and systemic conditions that may also be service-connected. For instance, a Hiatal Hernia (where the stomach pushes up through the diaphragm) is a common anatomical cause of GERD symptoms and was the diagnostic code previously used to rate GERD. Barrett’s Esophagus, a precancerous change in the esophageal lining due to chronic acid exposure, develops secondary to long-standing GERD.
The VA applies rules to prevent “pyramiding,” which is rating the same disability or overlapping symptoms twice. When a veteran has multiple conditions like GERD and Hiatal Hernia, the VA evaluates them under the single diagnostic code that provides the highest rating. Barrett’s Esophagus is rated separately based on the presence of high-grade or low-grade dysplasia. However, if an esophageal stricture is present, it is rated under the GERD/Esophageal Stricture criteria to avoid pyramiding.
While the maximum schedular rating for GERD is 80%, a veteran may be eligible for Total Disability based on Individual Unemployability (TDIU), which compensates at the 100% rate. TDIU is considered when GERD symptoms, alone or combined with other service-connected conditions, prevent the veteran from securing gainful employment. To qualify, a veteran needs one service-connected disability rated at 60% or more, or a combined rating of 70% or more with at least one disability rated at 40%.