55 digestive conditions along with GERD VA disability rating changes are here, and the final rule changes are effective May 19, 2024 as announced by the VA.
The VA has approved adding a new Diagnostic Code (DC) 7206 for rating Gastroesophageal Reflux Disease (GERD), including acid reflux.
Historically, the VA has rated GERD analogous to Hiatal Hernia, DC 7346, with ratings of 10%, 30%, or 60% depending on the frequency, severity, and duration of symptoms.
But, under the new proposal, DC 7206 for GERD will now be rated under Esophageal Stricture, DC 7203, with ratings of 0%, 10%, 30%, 50%, or 80%.
Overall, I think this is a bad change for veterans because the new rating criteria for GERD under “esophageal stricture” doesn’t contain any of the most common symptoms of GERD, which doesn’t make any sense.
I think this change will result in veterans getting lower ratings for GERD than under the previous ratings analogous to Hiatal Hernia.
Okay, let’s explore more details of the new VA ratings for GERD in 2024.
VA Rating for GERD Changes: What You Need to Know
The VA said these changes are “because the new criteria considers symptoms of esophageal obstruction and irritation, which are consistent with the symptoms of GERD.”
Overall, I’m skeptical of this change because GERD will now be rated as DC 7206, Gastroesophageal Reflux Disease, which says to rate as Esophagus, Stricture Of, DC 7203.
The new rating criteria only gives credit for GERD with “esophageal stricture,” which means you have difficulty swallowing.
However, many veterans with GERD experience symptoms such as:
- A burning sensation in your chest (heartburn), usually after eating, which may worsen at night
- Chest pain
- Difficulty eating and swallowing
- Regurgitation of food particles or sour liquid
- Sensation of a lump in your throat
If you have nighttime GERD and acid reflux, you might also experience:
- Chronic cough
- Laryngitis
- New or worsening asthma
- Disrupted sleep and insomnia
GERD VA Disability Rating Changes Effective Date
The new VA rating criteria for GERD is effective May 19, 2024.
What does this mean for you?
GET YOUR GERD VA CLAIM IN ASAP!
You’ve got a very short window to be rated under the old system.
Pro Tip: If you already have a VA rating for GERD, you are “grandfathered in” under the old rating system. These new updates will not impact your current rating.
New VA Rating Criteria for GERD (Effective May 19, 2024)
| Rate GERD Under DC 7203, Esophagus, Stricture of: | VA Rating |
|---|---|
| Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) Aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube) | 80% |
| Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilation 3 or more times per year, (2) dilation using steroids at least one time per year, or (3) esophageal stent placement | 50% |
| Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year | 30% |
| Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic | 10% |
| Documented history without daily symptoms or requirement for daily medications | 0% |
| Note (#1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy | |
| Note (#2): Non-gastrointestinal complications of procedures should be rated under the appropriate system | |
| Note (#3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy | |
| Note (#4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved | |
| Note (#5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilation sessions performed at 2-week intervals |
[Download] the Official Ruling VA Rating Changes for GERD
About the Author
Brian Reese
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).
