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Yes, as of May 19, 2024, veterans can get VA disability for both GERD and IBS.
With the new digestive system VA rating changes, veterans are now eligible for separate VA ratings for GERD and IBS.
Prior to the VA rating updates that went into effect on May 19, 2024, veterans could not get rated for both GERD and IBS; however, that has since changed.
Let’s explore what happened along with some expert tips to get VA ratings for GERD and IBS.
Pro Tip: The new Diagnostic Code (DC) for GERD is 7206 while the new DC for IBS is 7319. There is no longer a prohibition against pyramiding for assigning separate VA ratings for GERD and IBS. Why? Because GERD and IBS are very different conditions. For example, GERD primarily affects the esophagus and stomach while IBS affects the intestines. GERD symptoms are mostly related to acid reflux and esophageal irritation, including difficulty swallowing. IBS symptoms are related to bowel habits and abdominal discomfort. As long as symptoms don’t pyramid in accordance with 38 CFR 4.14, you can get rated separately for GERD and IBS.
Table of Contents
Summary of Key Points
- VA Rating Changes for Digestive Conditions: As of May 19, 2024, veterans are now eligible for separate VA ratings for GERD (DC 7206) and IBS (DC 7319), removing the previous prohibition against pyramiding for these two conditions.
- Prior Restrictions: Before the VA rating updates, veterans could not receive separate ratings for GERD and IBS due to the prohibition against pyramiding within the digestive system’s diagnostic codes, but this has now changed.
- Distinct Conditions: GERD and IBS are recognized as separate conditions with different primary symptoms and affected areas. GERD primarily affects the esophagus and stomach with symptoms like acid reflux, while IBS affects the intestines and is associated with bowel habit changes and abdominal discomfort.
- Pro Tip: Separate ratings are now permissible because GERD (DC 7206) and IBS (DC 7319) do not overlap in symptomatology. Ensure that your medical records clearly differentiate the symptoms of each condition to avoid pyramiding under 38 CFR 4.14.
VA Disability for GERD vs IBS Explained
DC 7206, Gastroesophageal Reflux Disease (GERD):
GERD is a chronic digestive disorder where stomach acid or bile irritates the food pipe lining. Symptoms include heartburn, regurgitation of food or sour liquid, chest pain, difficulty swallowing, chronic cough, laryngitis, and disrupted sleep, among others.
The new VA disability ratings for GERD under DC 7206 range from 0% to 80% with breaks at 10%, 30%, and 50%, depending on the frequency, severity, and duration of symptoms and how those symptoms negatively impact your work, life, and social functioning.
DC 7319, Irritable Bowel Syndrome (IBS):
IBS is a chronic functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits. Symptoms include abdominal pain or cramping, bloating, gas, diarrhea, constipation, or both, and mucus in stool, among others.
The new VA ratings for IBS under DC 7319 range from 10% to 30% with a break at 20% depending on the frequency, severity, and duration of symptoms and how those symptoms negatively impact your work, life, and social functioning.
Key Differences Between GERD and IBS:
Location of Symptoms: GERD primarily affects the esophagus and stomach whereas IBS affects the intestines.
Symptoms: GERD symptoms are mostly related to acid reflux and esophageal irritation to include difficulty swallowing. IBS symptoms are related to bowel habits and abdominal discomfort.
Can I Get a VA Rating for GERD and IBS?
Yes, veterans can get separate VA ratings for both GERD and IBS under the new DC 7206 and DC 7319, respectively.
For example, you could get a VA rating for GERD at 50% under DC 7206 for esophageal stricture with acid reflux and a VA rating for IBS at 20% under DC 7319.
What changed?
Prior to May 19, 2024, veterans were not eligible to receive separate ratings for GERD and IBS because of the prohibition against pyramiding in the DC 7300 series for digestive system conditions.
GERD used to be rated analogous to Hiatal Hernia under DC 7346 and IBS was rated analogous to Irritable Colen Syndrome under the old DC 7319 – both were 7300 series DCs.
Prohibition Against Pyramiding VA Digestive System Conditions
Prohibition against Pyramiding is a principle used by the VA to ensure that veterans do not receive multiple disability ratings for the same disability or same manifestation of a disability.
The goal is to avoid overcompensation for a single impairment, which is referred to as “pyramiding.”
38 CFR 4.114 prohibits assigning separate evaluations for certain coexisting digestive disabilities.
The purpose of the prohibition, as is further explained in 38 CFR 4.113 and 38 CFR 4.14, is so that digestive disabilities, particularly within the abdomen, with closely related overlapping manifestations will not be combined under 38 CFR 4.25, resulting in extra compensation for the same disability or facet of disability.
Assignment of separate evaluations for any combination of the following digestive system DCs is prohibited:
- DC 7301 – Peritoneum, adhesions of
- DC 7302 – Gastrojejunal ulcer
- DC 7303 – Chronic complications of upper gastrointestinal surgery
- DC 7304 – Peptic ulcer disease
- DC 7305 – Gastric ulcer
- DC 7306 – Duodenal ulcer
- DC 7307 – Gastritis, chronic
- DC 7308 – Postgastrectomy syndrome
- DC 7309 – Stomach, stenosis of
- DC 7310 – Stomach, injury of, residuals
- DC 7311 – Residuals of injury of the liver
- DC 7312 – Cirrhosis of the liver
- DC 7313 – Liver, abscess of
- DC 7314 – Chronic biliary tract disease
- DC 7315 – Cholelithiasis, chronic
- DC 7316 – Gallbladder, chronic disease of
- DC 7317 – Gallbladder, injury of
- DC 7318 – Cholecystectomy (gallbladder removal), complications of
- DC 7319 – Irritable bowel syndrome (IBS)
- DC 7320 – Intestinal, tuberculosis of, active
- DC 7321 – Intestinal, tuberculosis of, inactive
- DC 7322 – Dysentery, bacillary
- DC 7323 – Colitis, ulcerative
- DC 7324 – Distomiasis, intestinal or hepatic
- DC 7325 – Enteritis, chronic
- DC 7326 – Crohn’s disease or undifferentiated form of inflammatory bowel disease
- DC 7327 – Diverticulitis and diverticulosis
- DC 7328 – Intestine, small, resection of
- DC 7329 – Intestine, large, resection of
- DC 7331 – Peritonitis, tuberculous, active or inactive
- DC 7342 – Cirrhosis, hypertrophic
- DC 7345 – Chronic liver disease without cirrhosis
- DC 7346 – Hiatal hernia (exceptions apply)
- DC 7347 – Pancreatitis, chronic
- DC 7348 – Vagotomy with pyloroplasty or gastroenterostomy
- DC 7349 – Sarcoidosis
- DC 7350 – Liver abscess
- DC 7352 – Pancreas transplant
- DC 7355 – Celiac disease
- DC 7356 – Gastrointestinal dysmotility syndrome
- DC 7357 – Post pancreatectomy syndrome
Exceptions:
- Effective May 19, 2024, 38 CFR 4.114 does not categorically prohibit evaluating hiatal hernia separately from another condition in the above list, as long as the specific evaluations do not pyramid under 38 CFR 4.14. This is because as of that date, hiatal hernia (38 CFR 4.114, DC 7346) is evaluated using the diagnostic criteria for esophageal stricture (38 CFR 4.114, DC 7203), which is not included in the listed DCs.
- Additionally, some DCs provide instructions to rate residuals not addressed in the diagnostic criteria under another DC. 38 CFR 4.114, DC 7319 (irritable bowel syndrome (IBS)) contains a note that says, “Evaluate other symptoms of a functional digestive disorder, not encompassed by this diagnostic code, under the appropriate diagnostic code, to include gastrointestinal dysmotility syndrome (DC 7356), following the general principles of § 4.14 and this section.”
- When the primary DC for the diagnosis, and a DC for rating other residuals not encompassed in the primary DC are both listed in 38 CFR 4.114, the evaluations can be combined on a case-by-case basis as long as the symptoms used to provide each evaluation do not pyramid under 38 CFR 4.14.
Notes:
- Separately evaluating and combining 7200-series DCs (such as Barrett’s esophagus) with a 7300-series DC (such as IBS or Crohn’s disease) is not categorically prohibited by 38 CFR 4.114.
- Similarly, separately evaluating and combining multiple 7200-series DCs is not categorically prohibited.
- Whenever considering DCs that are not included in the 38 CFR 4.114 list above, always carefully consider whether specific diagnostic criteria will compensate the same facet of disability and therefore violate 38 CFR 4.14.
5 Expert Tips for Your VA Claim for GERD and IBS
- Tip #1: Medical Diagnosis. If you think you have both GERD and IBS, make sure you have a medical diagnosis in a medical record before filing a VA claim. This can be in service treatment records, VA medical records, or private medical records. A current diagnosis within the past 12 months can be helpful although not required.
- Tip #2: Obtain a Nexus Letter. If you’ve been out of the military for more than a year, think about how you’re going to service GERD and IBS. The most common types are direct service connection, secondary service connection, and presumptive service connection.
- Tip #3: Severity of Symptoms. Your VA rating percentage for GERD and IBS depend on the severity of your symptoms and how those symptoms negatively impact your work, life, and social functioning. A symptoms diary can help capture the severity of your GERD and IBS symptoms over time.
- Tip #4: Review DBQs. It’s a good idea to review the GERD DBQ and IBS DBQ before your VA exams. Be prepared to describe the onset and progression of your symptoms over time, as well as any treatments you have pursued and their effectiveness (if any).
- Tip #5: C&P Exam Education. You need to be ready for your C&P exam for GERD as well as your C&P exam for IBS. You’ll likely have the same C&P examiner for both conditions.
About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
