What is the VA Rating for Barrett’s Esophagus?

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Effective May 19, 2024, under the new Diagnostic Code (DC) 7207, veterans are now eligible for a VA rating for Barrett’s esophagus with or without esophageal stricture (narrowing of the esophagus, which makes it difficult to swallow).

• If you have Barrett’s esophagus with esophageal stricture, the new VA ratings are 0%, 10%, 30%, 50%, or 80%.

• If you have Barrett’s esophagus without esophageal stricture, the new VA ratings are either 10% or 30%.

Your final Barrett’s esophagus VA rating depends on the frequency (how often), severity (how bad), and duration (how long) of symptoms and how those symptoms negatively impact your work, life, and social functioning.

>> Learn about the VA digestive system rating changes in detail here.  

Summary of Main Points

• Barrett’s esophagus now has its own DC 7207 under CFR Title 38, Part 4, the Schedule for Rating Disabilities.

• Barrett’s esophagus with esophageal stricture (rate under DC 7203) has VA ratings of 0%, 10%, 30%, 50%, or 80% while Barrett’s esophagus without esophageal stricture (rate under the new DC 7207) has VA ratings of either 10% or 30%.

• If you already have a VA rating for Barrett’s esophagus, there will be no change to your current VA rating—you are “grandfathered” in under the old rating criteria.

What is Barrett’s Esophagus?

Barrett’s esophagus is a condition where the lining of the esophagus, the tube that carries food from the throat to the stomach, undergoes changes.

Normally, the esophagus is lined with squamous epithelial cells, but in Barrett’s esophagus, these cells are replaced by cells that resemble those found in the lining of the intestine.

This change is believed to be a response to chronic irritation from gastroesophageal reflux disease (GERD), where stomach acid flows back into the esophagus, causing inflammation.

Barrett’s esophagus is considered a precancerous condition because it increases the risk of developing a type of esophageal cancer called adenocarcinoma.

However, not everyone with Barrett’s esophagus will develop cancer, and the majority of people with the condition do not progress to cancer.

Nevertheless, regular monitoring and treatment of GERD are recommended for veterans with Barrett’s esophagus to reduce the risk of cancer and manage symptoms.

Symptoms of Barrett’s Esophagus in Veterans

Barrett’s esophagus by itself typically does not cause symptoms.

Instead, symptoms are more commonly associated with gastroesophageal reflux disease (GERD), which often precedes the development of Barrett’s esophagus.

However, some veterans with Barrett’s esophagus may experience symptoms such as:

• Heartburn: A burning sensation in the chest, often after eating, which may worsen when lying down or bending over.

• Regurgitation: Sour-tasting fluid backing up into the throat or mouth, especially after eating or when lying down.

• Difficulty swallowing (called dysphagia): A sensation of food getting stuck in the throat or chest.

• Chest pain: Discomfort or pain in the chest, which may be confused with heart-related issues.

• Chronic cough: A persistent cough, particularly at night or after eating, due to irritation from stomach acid.

• Hoarseness or sore throat: Irritation of the throat caused by stomach acid reflux.

• Weight loss: Although less common, significant weight loss may occur in some cases.

• Symptoms of anemia: If bleeding occurs in the esophagus due to irritation or damage, it may lead to symptoms such as fatigue, weakness, or shortness of breath.

Note that not everyone with Barrett’s esophagus experiences symptoms, and symptoms can vary in severity among veterans.

Additionally, some symptoms, such as difficulty swallowing or unintentional weight loss, may indicate complications or progression of the condition and should be evaluated by a doctor.

VA Rating for Barrett’s Esophagus

The VA rates Barrett’s esophagus under either DC 7203 (with esophageal stricture) or DC 7207 (without esophageal stricture).

DC 7203, Barrett’s Esophagus “with” Esophageal Stricture:

• 80% VA Disability Rating for Barrett’s esophagus: with 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).

• 50% VA Disability Rating for Barrett’s esophagus: with documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement.

• 30% VA Disability Rating for Barrett’s esophagus: with documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year.

• 10% VA Disability Rating for Barrett’s esophagus: with documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic.

• 0% VA Disability Rating for Barrett’s esophagus: with documented history without daily symptoms or requirement for daily medications.

Definitions and Meanings of Key Terms for DC 7203, Barrett’s Esophagus

Recurrent or Refractory Esophageal Stricture(s): Esophageal stricture refers to the narrowing of the esophagus, often due to scar tissue formation. Recurrent or refractory strictures are those that repeatedly occur or are resistant to treatment, leading to ongoing difficulty in swallowing (dysphagia).

Dysphagia: Difficulty swallowing, which can range from mild discomfort or the sensation of food getting stuck to severe obstruction, making it challenging or impossible to swallow solid foods and liquids.

Aspiration: Inhalation of food or liquids into the airways, which can lead to respiratory complications such as pneumonia or lung infections.

Undernutrition: Inadequate intake of essential nutrients, resulting in malnutrition and related health issues.

Substantial Weight Loss: Significant decrease in body weight, often indicative of malnutrition or underlying health problems.

Surgical Correction: Medical procedures aimed at correcting anatomical abnormalities or pathological conditions through surgery.

Percutaneous Esophago-Gastrointestinal (PEG) Tube: A tube inserted into the stomach through the abdominal wall to provide nutrition and medication when swallowing is impaired.

Dilatation: Medical procedure to widen a narrowed esophagus using dilators or balloons.

Steroids: Medications with anti-inflammatory properties often used to reduce inflammation and swelling in various medical conditions.

Esophageal Stent Placement: Placement of a tube-like device (stent) in the esophagus to maintain its patency and prevent narrowing.

Daily Medications: Medications required on a daily basis to manage symptoms or prevent complications associated with Barrett’s esophagus, such as acid reflux or dysphagia.

DC 7207, Barrett’s Esophagus “without” Esophageal Stricture

• 30% VA Rating for Barrett’s esophagus: without esophageal stricture with documented by pathologic diagnosis with high-grade dysplasia.

• 10% VA Rating for Barrett’s esophagus: without esophageal stricture documented by pathologic diagnosis with low-grade dysplasia.

Definitions and Meanings of Key Terms for DC 7207, Barrett’s Esophagus

High-Grade Dysplasia: Dysplasia refers to abnormal changes in cells or tissues that indicate a pre-cancerous condition. High-grade dysplasia specifically indicates more severe abnormalities in cell appearance and organization, suggesting a higher risk of progression to cancer if left untreated. In the context of Barrett’s esophagus, high-grade dysplasia may be detected through a pathologic diagnosis, typically obtained via biopsy samples taken during an endoscopy.

Low-Grade Dysplasia: Similarly, dysplasia indicating abnormal cellular changes, but in this case, the changes are less severe compared to high-grade dysplasia. Low-grade dysplasia still represents a pre-cancerous condition, but the risk of progression to cancer is lower than with high-grade dysplasia. Pathologic diagnosis with low-grade dysplasia in Barrett’s esophagus suggests the presence of abnormal cellular changes that require monitoring and possibly intervention to prevent progression to cancer.

Esophageal Stricture: An esophageal stricture is a narrowing of the esophagus, the muscular tube that connects the throat to the stomach. Strictures can occur due to various reasons, including inflammation, scarring, or the formation of scar tissue. In Barrett’s esophagus, strictures may develop as a complication of chronic irritation and inflammation caused by gastroesophageal reflux disease (GERD) or as a result of advanced dysplasia or cancer.

Pathologic Diagnosis: This term refers to the diagnosis of a medical condition based on examination of tissue samples (biopsies) under a microscope. In the case of Barrett’s esophagus, a pathologic diagnosis involves examining biopsy samples taken during an endoscopic procedure to assess the cellular changes in the lining of the esophagus. This helps to determine the presence and severity of dysplasia, which is crucial for guiding treatment and monitoring strategies.

What is the VA Disability Rating for GERD with Barrett’s Esophagus?

The VA disability rating for GERD with Barrett’s Esophagus depends on whether you have esophageal stricture.

• If you have GERD with Barrett’s esophagus plus esophageal stricture, the new VA ratings are 0%, 10%, 30%, 50%, or 80% under DC 7206, Gastroesophageal reflux disease (GERD).

• If you have Barrett’s esophagus with GERD symptoms minus esophageal stricture, the new VA ratings are either 10% or 30% under DC 7207, Barrett’s esophagus.

What If I Already Have VA Disability for Barrett’s Esophagus?

If you already get VA disability for Barrett’s esophagus, there will be no change to your current VA disability rating; you are “grandfathered” in under the old rating criteria.

A reduction in your rating will only occur if there is improvement in a disability sufficient to warrant a reduction under the old criteria.

All VA claims related to these digestive systems that were submitted and in “pending” status as of May 19, 2024, will be considered under both the old and new rating criteria, and whichever criteria is more favorable to the veteran will be applied.

In summary, get your VA disability claim submitted ASAP!

Why?

Because the VA rater must consider both the old and new criteria, and select the rating that’s most favorable to you.

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