GERD VA disability rating: the 2024 rules changed it

If you were rated for GERD before May 2024 and someone tells you the rules have changed, they are right, and the change is bigger than it sounds. It is not a threshold that moved a few points. The code stopped measuring the thing you have and started measuring something else.

What changed, in one paragraph

Before 2024, GERD had no code of its own. It was rated by analogy to hiatal hernia under DC 7346, where the criteria were about persistently recurrent epigastric distress, pyrosis and regurgitation. Reflux severity earned percentages.

Effective 19 May 2024, the digestive schedule was amended. GERD got its own code, DC 7206. What that code rates is esophageal stricture and dysphagia. Stricture is a narrowing of the esophagus. Dysphagia is difficulty swallowing.

Heartburn is not in the criteria. Neither is regurgitation, nor how many antacids you take.

The criteria as they stand

80 percent is the ceiling on this code. There is no 100 percent for GERD, which is worth knowing before anyone plans around one.

"Substantial weight loss" is defined at 38 CFR 4.112 as a loss of more than 20 percent of your baseline weight, held for three months or longer. It is a specific number rather than a judgment.

Why so many GERD ratings now read 0 percent

Look at the 0 percent row again. Documented history, without daily symptoms or a daily medication requirement.

A veteran with well-managed reflux on a daily proton pump inhibitor and no stricture is service connected and paid nothing. That is the schedule working as written, and it is a genuinely hard thing to read in a letter.

0 percent is not a denial. It is a granted condition at a noncompensable level, and it still does real work: it is on the books, it can be increased if the condition progresses, and it opens the secondary pathways that run from it.

If your rating predates the change

Two things protect you.

Claims filed before May 2024 are considered under both versions of the criteria, and the VA applies whichever is more favorable.

An existing rating is not reduced because the schedule was rewritten. A rewrite of the criteria is not itself evidence of improvement.

What the record needs now

The evidence that mattered under the old code and the evidence that matters under the new one are almost entirely different documents.

• An endoscopy or barium swallow. Stricture is a structural finding, and it lives in an imaging or scope report rather than in a symptom note.
• Dilation procedures, dated. The gap between 30 percent and 50 percent is whether dilation happened up to twice a year or three or more times.
• A dysphagia complaint in the notes. Difficulty swallowing, described plainly, and how often.
• Weight over time, if loss is part of the picture, because the 80 percent route needs the 20 percent figure.
• Medication history, which is what separates 0 percent from 10 percent where stricture is documented.

Symptom diaries about heartburn severity were the right evidence for the old code. They are not what the current one reads.

The service connection question is separate

None of the above is about whether GERD is service connected, only about the percentage.

Medication-caused reflux remains one of the better-documented secondary routes. NSAIDs prescribed for a service-connected back or knee, and some psychiatric medications, are documented causes. GERD secondary to medications covers the mechanism a nexus opinion has to name, and how secondary claims work covers the general shape.

A secondary grant that lands at 0 percent under the current criteria is still a grant, and still worth having on the record.

Bottom line

The code changed under everyone in May 2024, and it now measures the esophagus rather than the reflux. If your file is full of heartburn notes but holds no scope report and no record of a dilation, it is documenting the old criteria.

The GERD condition page holds the full criteria and the evidence list. Our free scan reads your conditions and flags what each one needs: start the free scan.

Sources: 38 CFR 4.114 - schedule of ratings, digestive system, 38 CFR 4.112 - weight loss definitions, Federal Register - Schedule for Rating Disabilities: The Digestive System, effective 19 May 2024.