VA rates GERD (gastroesophageal reflux disease) under Diagnostic Code 7206 — and this changed in 2024. After VA's digestive-schedule revision, GERD is rated by esophageal stricture / dysphagia criteria (0, 10, 30, 50, 80%), not by analogy to a hiatal hernia (the old DC 7346 path). It's frequently claimed as a secondary to another condition or its medication.
Straight talk first
If you read older guides, they'll tell you GERD is rated like a hiatal hernia. That's outdated. The 2024 rule moved GERD to DC 7206 and ties the rating to documented stricture and the dysphagia (trouble swallowing) it causes — how severe it is and how often it needs treatment. Two takeaways: make sure your evidence speaks to those findings, and if you were rated under the old criteria, the rule change is a legitimate reason to revisit. A lot of GERD claims also belong in the secondary lane — reflux from the medications you take for a service-connected condition.
This is the GERD cut of how VA rates conditions.
How the rating works now (DC 7206)
| Rating | Criteria (paraphrased) |
|---|---|
| 80% | Recurrent/refractory stricture causing dysphagia with aspiration, undernutrition, and/or substantial weight loss (with surgical correction or PEG tube) |
| 50% | Recurrent/refractory stricture causing dysphagia requiring dilatation ≥3×/yr, dilatation with steroids ≥1×/yr, or stent placement |
| 30% | Recurrent stricture causing dysphagia requiring dilatation ≤2×/yr |
| 10% | Stricture requiring daily medication to control dysphagia, otherwise asymptomatic |
| 0% | Documented history without daily symptoms or daily medication |
Denied or rated under the old rules?
If your GERD was evaluated under the hiatal-hernia analogy before 2024, the new DC 7206 framework is a real reason to take another look — the change in law, not re-arguing the old decision, is the basis. See the after-a-denial lanes.
Direct or secondary?
- Secondary — very common: GERD secondary to a service-connected condition or to medications (e.g., NSAIDs for a service-connected musculoskeletal condition), under 38 CFR 3.310.
- Direct — onset or link to service.
You'll need a current diagnosis, the service link or primary, and a nexus. See how to file your own claim, then check the combined effect in the VA Combined Rating Calculator.
Key takeaways
- GERD is now rated under DC 7206 (esophageal stricture criteria) after the 2024 digestive revision — not as a hiatal hernia.
- Ratings run 0/10/30/50/80 by stricture + dysphagia severity and treatment frequency.
- Rated under the old rules? The change is grounds to revisit.
- It's frequently a secondary to another condition or its medication.
Frequently asked questions
- How does VA rate GERD now?
- After VA's 2024 digestive-schedule revision, GERD is rated under Diagnostic Code 7206 using esophageal stricture criteria, rather than analogous to a hiatal hernia (DC 7346) as before. Ratings run 0, 10, 30, 50, and 80% based on documented stricture, the dysphagia it causes, and how often it needs treatment like dilatation.
- What changed about GERD ratings in 2024?
- Previously GERD was rated by analogy to hiatal hernia (DC 7346). The 2024 revision moved GERD to DC 7206 and tied the rating to documented esophageal stricture and dysphagia severity. If your GERD was rated under the old criteria, the change in rules can be worth a fresh look.
- Can GERD be a secondary condition?
- Yes, commonly. GERD is often claimed as secondary to a service-connected condition or to medications taken for one (for example, NSAIDs for a service-connected musculoskeletal condition), under 38 CFR 3.310. It can also be a direct claim if it began in or is linked to service.
- What evidence does a GERD claim need?
- A current diagnosis and documentation of your symptoms and any treatment — ideally findings like esophageal stricture, dysphagia, dilatation history, or medication needs, since the rating now keys off those. Plus the link to service or to a service-connected primary condition.
Sources
- 38 CFR 4.114 — schedule of ratings, digestive system (DC 7206): https://www.law.cornell.edu/cfr/text/38/4.114
- 38 CFR 3.310 — secondary service connection: https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/section-3.310
- VA — How VA decides service connection: https://www.va.gov/disability/eligibility/
- 38 CFR 4.25 — combined ratings table: https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-A/section-4.25
