GERD VA rating
The VA rates gerd under DC 7206, and most ratings land in the 0–80% (0% is common without stricture) range. What decides yours is the criteria below and what your record actually documents.
This code covers GERD - acid reflux.
What the criteria ask for at each level
DC 7206 - 38 CFR §4.114 (own code since the 2024 digestive revision)
| Rating | What the record has to show |
|---|---|
| 0% | Documented history without daily symptoms or a requirement for daily medication. Service connection is granted; the payment is not. |
| 10% | Documented history of esophageal stricture requiring daily medication to control dysphagia, otherwise asymptomatic. |
| 30% | Recurrent esophageal stricture causing dysphagia, requiring dilatation no more than twice a year. |
| 50% | Recurrent or refractory stricture causing dysphagia requiring dilatation three or more times a year, dilatation with steroids at least once a year, or a stent. |
| 80% | Recurrent or refractory stricture causing dysphagia with aspiration, undernutrition, or substantial weight loss (more than 20% of baseline, held three months or longer, per 38 CFR 4.112), plus either surgical correction or a PEG tube. 80% is the ceiling on this code - there is no 100%. |
What the C&P exam actually measures
This code changed in the 2024 digestive revision, and it now measures something narrower than most people expect. GERD used to be rated by analogy to hiatal hernia, where heartburn and epigastric distress were the terms. DC 7206 rates esophageal stricture and difficulty swallowing.
- Whether an endoscopy or barium swallow documents a stricture. This is the finding the entire code turns on.
- Difficulty swallowing - whether it happens, and what it happens with.
- Dilatation procedures and their dates, because frequency is what separates the levels.
- Weight over time, and any aspiration, which belong to the top of the scale.
An examiner cannot produce this finding at the exam. It comes from a procedure done somewhere else, and if that procedure has never happened there is generally nothing for the criteria to measure.
Our C&P Prepwalks through what this exam covers, in the schedule's own terms.
Two records, read against the criteria
Two records, both describing years of reflux.
| Outcome | What the record held | How the criteria read it |
|---|---|---|
| Read at 30% | Endoscopy documenting a stricture. Difficulty swallowing recorded. Dilatation twice in the past year, both dated. | Recurrent stricture causing dysphagia and requiring dilatation no more than twice a year is the 30% level. The dates are what place it there rather than at 50%. |
| Read at 0% | Fifteen years of daily reflux, continuous medication, and treatment notes describing burning after meals. No endoscopy. | Under the current code, classic reflux with no documented stricture is the 0% level. The condition is service-connected and the payment is not - which is a real outcome, not an error. |
This is the change that catches people out. Guidance written before 2024 - including plenty still online - describes criteria the schedule no longer uses. These are general illustrations of how the criteria are written, not a prediction about any particular claim - only the VA decides that, on your own record.
The schedule's own words
Ratings turn on specific terms, and a record that describes the same reality in different language often reads as a lower rating. These are the words this code measures:
- esophageal stricture
- dysphagia
- dilatation
- refractory
- aspiration
Evidence that moves this rating
- Endoscopy or barium swallow documenting stricture - this is the finding the whole code turns on
- Dilatation records with dates, since frequency separates 30% from 50%
- Pharmacy records showing continuous medication
- Weight recorded over time, for the top of the scale
What your statement has to cover
Doctors chart symptoms; they rarely chart consequences. That part is yours, and it is usually what separates a documented rating from a reported one.
- Dysphagia is the word the schedule measures - difficulty swallowing, food sticking, having to wash food down. Heartburn alone is not what this code rates.
- Every dilatation, with dates. The gap between 30% and 50% is how many you have had in a year.
- Weight change over time, and any episode of aspiration or choking at night.
- If secondary: name the connection (NSAIDs for an orthopedic condition, SSRIs, CPAP, the gut-brain axis with a mental health condition).
Our Statement Builderwalks through the questions that produce that kind of statement, in the schedule's own terms.
Where records for this condition fall short
Where GERD records commonly come up short:
- Relying on criteria that no longer apply
Pages describing 10% for persistent heartburn are quoting the old hiatal hernia code. That route closed when GERD got its own.
- No endoscopy or barium swallow
Stricture is the finding the levels are built on, and it is documented by a procedure rather than by an examination.
- Dilatations recorded without dates
Twice a year and three or more times a year are different levels. Without dates, frequency cannot be established.
- Treating a 0% as a loss
A 0% is still service connection. It anchors an increase later if the condition progresses, and it is the connection a secondary claim runs through.
What gerd can lead to 4 documented pathways
A secondary claim runs through a condition the VA already accepts, so the argument about your service is already won. What is left is the medical link - and a nexus opinion has to name the mechanism, not just the pair.
| Can lead to | The mechanism a nexus has to state |
|---|---|
| Chronic sinusitis / rhinitis | Acid reaching the upper airway inflames nasal and sinus tissue. |
| Depression | Chronic pain, regurgitation, and sleep disruption from severe GERD degrade mental health. |
| Sleep apnea | Acid aspiration irritates the airway. |
| Asthma / COPD | Acid aspiration inflames the bronchial tubes. |
A pathway existing in the literature is not the same as your claim being granted - your records and the VA decide that. How secondary claims work covers the argument.
Before you spend money on this claim
VA ratings do not add. Each new rating applies only to the part of you the VA still counts as unimpaired, then rounds to the nearest ten - so from 70%, a new 10% condition leaves you at exactly 70% and changes your payment by nothing.
That does not make the claim worthless; it can still matter for TDIU, for SMC, or later when something else is added. But it is worth knowing before you pay for a nexus letter rather than after. Check what one more condition does at your rating - it takes a minute.