How to Get an 80% VA Rating for GERD (Updated Rating Criteria)

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Gastroesophageal Reflux Disease (GERD) is a serious condition affecting many veterans, often linked to service-related stress, medication use, and dietary changes.

GERD can cause severe symptoms, including chronic acid reflux, difficulty swallowing (dysphagia), weight loss, and esophageal strictures.

As of May 19, 2024, the VA rates GERD under Diagnostic Code (DC) 7206, replacing its previous classification under hiatal hernia (DC 7346).

The VA now provides ratings of 0%, 10%, 30%, 50%, or 80%, based on the severity of symptoms and the level of impairment.

If you are experiencing severe GERD symptoms that significantly impact your health and daily life, you may qualify for an 80% VA disability rating.

In this article, VA disability expert Brian Reese explains how GERD is rated, what evidence you need, how to prove service connection, how to maximize your VA disability rating for GERD, and the most common GERD secondary conditions.

Let’s begin!

Summary of Key Points

• GERD is a Common Veteran Condition: Many veterans develop Gastroesophageal Reflux Disease (GERD) due to service-related stress, prolonged medication use, environmental exposures, and dietary changes. GERD can lead to chronic acid reflux, difficulty swallowing (dysphagia), weight loss, and esophageal strictures.

• Updated VA Rating Criteria for GERD: As of May 19, 2024, GERD is rated under Diagnostic Code (DC) 7206, replacing its previous classification under hiatal hernia (DC 7346). The VA assigns ratings of 0%, 10%, 30%, 50%, or 80% based on symptom severity, frequency of medical intervention, and impact on a veteran’s health and daily life.

• How to Get a Higher GERD VA Rating: Veterans seeking a higher disability rating must provide strong medical evidence, including diagnostic tests, treatment history (e.g., esophageal dilations), weight loss documentation, and hospitalization records for aspiration pneumonia or malnutrition. A Nexus Letter can strengthen claims, especially for secondary service connection.

• Common Secondary Conditions Linked to GERD: Veterans may qualify for secondary service connection if GERD is caused or worsened by a primary service-connected condition, such as PTSD, anxiety, depression, asthma, medication side effects, or obesity due to service-related disabilities. Proper documentation and a strong medical opinion are essential for approval.

Identifying GERD and Its Impact on Veterans

GERD occurs when stomach acid repeatedly flows back into the esophagus, causing irritation and inflammation.

Many veterans develop GERD due to service-related factors:

• High-stress environments during deployment or training

• Long-term use of NSAIDs, antidepressants, or other medications

• Exposure to environmental toxins (burn pits, contaminated water)

• Poor dietary options during service, including frequent MRE consumption

• Sleep disturbances and disrupted circadian rhythms

Common Symptoms of GERD in veterans:

• Persistent heartburn and acid reflux

• Regurgitation of stomach acid or food

• Chest pain resembling heart attack symptoms

• Difficulty swallowing (dysphagia)

• Chronic coughing or hoarseness

• Sensation of food getting stuck in the throat

• Unintentional weight loss due to swallowing difficulties

If GERD symptoms become severe and require frequent medical intervention, you may qualify for a higher VA rating.

VA Disability Ratings for GERD (NEW Rating Criteria – DC 7206)

The VA now assigns disability ratings for GERD based on how it impacts a veteran’s ability to swallow, eat, and maintain proper nutrition.

80% VA Rating for GERD – Severe Impairment

Criteria: A documented history of recurrent or refractory esophageal strictures causing dysphagia, with at least one of the following:

• Aspiration pneumonia due to food or liquid entering the lungs

• Undernutrition caused by an inability to eat properly

• Substantial weight loss, as defined by § 4.112(a)

• Requires surgical intervention (e.g., PEG feeding tube, esophageal dilation surgery)

Example: A veteran has severe esophageal strictures, making it nearly impossible to swallow solids or liquids without choking and aspirating food into the lungs. The condition leads to frequent hospitalizations and significant weight loss, requiring a feeding tube for nutrition.

Pro Tip: If you have been hospitalized for aspiration pneumonia or significant weight loss due to GERD, submit those medical records to support your claim.

50% VA Rating for GERD – Moderate to Severe Impairment

Criteria: A documented history of recurrent esophageal strictures causing dysphagia that requires at least one of the following:

• Dilation procedures three or more times per year

• Dilation using steroids at least once per year

• Esophageal stent placement to keep the esophagus open

Example: A veteran requires four dilation procedures per year to prevent the esophagus from closing, making it difficult to swallow both solids and liquids. Without regular intervention, they risk choking and severe malnutrition.

Pro Tip: Keep detailed medical records of all dilation procedures and treatments, as frequent medical intervention is a key factor for a 50% rating.

30% VA Rating for GERD – Moderate Impairment

Criteria: A documented history of esophageal strictures causing dysphagia, requiring dilation procedures two times per year or less.

Example: A veteran undergoes esophageal dilation twice per year to manage difficulty swallowing, but symptoms are still persistent. Solid foods are difficult to eat, and they rely on soft or pureed foods.

Pro Tip: If you require frequent medication adjustments or struggle with diet restrictions due to GERD, make sure your medical provider documents these limitations in your records.

10% VA Rating for GERD – Mild Impairment

Criteria: A documented history of esophageal strictures requiring daily medication to control GERD symptoms, but no evidence of severe dysphagia or weight loss.

Example: A veteran takes daily proton pump inhibitors (PPIs) like Omeprazole or Nexium to manage GERD. While the medication controls symptoms, stopping it would cause a severe flare-up.

Pro Tip: If your GERD symptoms persist despite daily medication, you should seek a higher rating by providing evidence of worsening symptoms.

0% VA Rating for GERD – Non-Compensable

Criteria: A documented history of GERD without daily symptoms or the need for continuous medication.

Example: A veteran experiences occasional heartburn but does not require daily medication or medical intervention.

Pro Tip: Even with a 0% rating, you establish a service connection, which is critical if your condition worsens in the future.

NEW: Diagnostic Testing is NOT Required to Establish Service Connection for GERD

Veterans seeking a VA disability rating for Gastroesophageal Reflux Disease (GERD) are not required to undergo medical imaging to establish service connection.

According to M21-1, Part V, Subpart iii, Chapter 6 – Digestive Disabilities, a formal diagnosis of GERD does not depend on diagnostic imaging such as barium swallow, computed tomography (CT), or esophagogastroduodenoscopy (EGD).

However, 38 CFR 4.114, Diagnostic Code (DC) 7206, Note (1) states that documented “findings” must be supported by one of these imaging tests when evaluating the presence of esophageal strictures—which is a key factor in determining a veteran’s GERD disability rating.

It’s important to note that this requirement applies to the evaluation of esophageal strictures, not to the initial service connection for GERD.

A veteran can be awarded a 10% disability rating for GERD without imaging confirmation of esophageal strictures, if they require daily medication to manage their symptoms (38 CFR 4.7).

Pro Tip: If you take proton pump inhibitors (PPIs) or other prescribed medications daily such as Prilosec (Omeprazole) to control GERD symptoms, but do not have imaging evidence of esophageal strictures, you may still qualify for a 10% VA disability rating. Be sure to provide medical records documenting your prescribed treatment plan and symptom management.

How to Establish VA Service Connection for GERD

To qualify for VA disability compensation for GERD, you must first establish service connection.

This requires four key elements:

#1. Current Medical Diagnosis

GERD must be diagnosed by a doctor in a medical record.  

The VA will not service-connect or rate GERD without an official diagnosis from a medical provider.

#2. In-Service Event, Injury, Disease, or Aggravation

You must show that GERD began during service or was aggravated by service-related factors.

• Military medical records showing heartburn, acid reflux, or indigestion

• Service treatment records documenting medications prescribed for GI symptoms

• Deployment records indicating exposure to toxins, poor diet, or high-stress environments

• Personal statements in support of a claim, journals, and buddy letters

#3. Nexus Letter (Medical Opinion Linking GERD to Service)

A nexus letter from a private doctor can strengthen your claim by explaining how your military service caused or aggravated GERD.

Pro Tip: If your GERD is secondary to PTSD, anxiety, or sleep apnea, you can file for secondary service connection to increase your overall VA rating. Get a Nexus Letter for a secondary condition!

#4. Severity of Symptoms

In general, the more severe your symptoms are, the higher the VA rating you’ll receive for GERD.

The VA considers the frequency, severity, and duration of your symptoms over time, as well as how they negatively impact your work, life, and social functioning.

How to Get a Higher VA Disability Rating for GERD

If you believe your current VA rating for GERD is too low, follow these steps to request an increase:

• Open an Intent to File on VA.gov and begin gathering new and relevant evidence

• Obtain updated medical records documenting worsening symptoms

• Consider getting a Disability Benefits Questionnaire (DBQ) for GERD from a private healthcare provider that shows more severe symptoms than your current lowball rating

• Schedule new diagnostic tests (endoscopy, barium swallow, CT scan)

• Keep track of weight loss, swallowing difficulties, or aspiration incidents and document in a journal or statement in support of a claim

GERD Secondary Conditions List

GERD is a common secondary claim for secondary service connection.

Here’s a list of the most common GERD secondary conditions:

#1. GERD Secondary to Asthma

Asthma and GERD have a well-documented connection. When stomach acid backs up into the esophagus, it can trigger airway irritation and inflammation, worsening asthma symptoms. Additionally, asthma medications, such as bronchodilators, can relax the lower esophageal sphincter, allowing acid to escape the stomach more easily. Veterans with service-connected asthma who develop GERD may qualify for a secondary service connection.

#2. GERD Secondary to PTSD

Post-Traumatic Stress Disorder (PTSD) is a common condition among veterans and has been linked to digestive issues like GERD. Stress and anxiety from PTSD can lead to an overproduction of stomach acid, increased inflammation, and unhealthy coping mechanisms such as alcohol or caffeine consumption, all of which exacerbate GERD. Additionally, medications prescribed for PTSD, such as antidepressants and anti-anxiety drugs, can contribute to acid reflux symptoms.

#3. GERD Secondary to Depression

Depression affects the body’s autonomic nervous system, which regulates digestion. Veterans with depression often experience changes in appetite, reduced stomach motility, and increased acid production, all of which can lead to GERD. Furthermore, some antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can relax the esophageal sphincter, making acid reflux worse.

#4. GERD Secondary to Anxiety

Anxiety disorders can have a significant impact on the digestive system. Chronic anxiety leads to increased stomach acid production and muscle tension, which can contribute to GERD symptoms. Additionally, individuals with anxiety may develop poor eating habits, such as skipping meals or overeating, which can further exacerbate acid reflux. If a veteran is service-connected for anxiety and later develops GERD, they may be eligible for secondary service connection.

#5. GERD Secondary to Medication Side Effects

Many medications prescribed for service-connected conditions can contribute to GERD.

For example:

• NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) for chronic pain can irritate the stomach lining.

• Opioids slow digestion and cause acid reflux.

• Beta-blockers used for hypertension can relax the esophageal sphincter.

• Antidepressants and anti-anxiety medications can also contribute to GERD symptoms.

If a veteran’s GERD is caused or aggravated by medications taken for a service-connected condition, they may qualify for a secondary VA disability rating.

#6. GERD Secondary to Weight Gain or Obesity as an Interim Link

Obesity is a well-known risk factor for GERD because excess weight increases pressure on the stomach, forcing acid into the esophagus. Many veterans develop weight gain due to limited mobility, chronic pain, or side effects from medications prescribed for service-connected conditions. If a veteran’s service-connected disability leads to weight gain, which then contributes to GERD, they may be able to claim GERD as a secondary condition by establishing the link between obesity and acid reflux.

Pro Tips: To establish GERD as a secondary condition, veterans should gather:

• A current GERD diagnosis from a medical provider (in a medical record).

• Evidence of a service-connected primary condition rated at 0% or higher

• Medical Nexus Letter linking GERD to the primary service-connected condition (cause and effect or aggravation).

• Evidence of symptoms and treatment, including medications, lifestyle adjustments, and impact on daily life.

By properly documenting these connections, veterans can strengthen their VA claim for GERD as a secondary condition.

Final Thoughts: Don’t Settle for a Lowball VA Rating!

GERD can have a serious impact on your health and daily life, and if you are experiencing severe symptoms such as weight loss, aspiration pneumonia, or difficulty swallowing, you deserve a higher VA disability rating.

The new VA rating criteria for GERD allow veterans with severe esophageal strictures or chronic aspiration issues to qualify for up to 80% disability.

If your claim was denied or underrated, file an appeal, submit new evidence, and fight for the compensation you’ve earned.

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