GERD Under 38 CFR: VA Ratings Under DC 7206 and DC 7346

The VA disability rating for GERD runs from 0% to 80% under Diagnostic Code 7206, which took effect on May 19, 2024, and turns almost entirely on whether you have esophageal stricture and how aggressively it has to be treated.¹ Monthly compensation in 2026 ranges from $0 at 0% to $2,102.15 at 80% for a single veteran with no dependents. If your claim was pending when the rule changed, the VA must also consider the older symptom-based criteria under former DC 7346 and apply whichever version gives you the higher rating.

The Rating Levels Under DC 7206

Every level under DC 7206 requires a documented history of the condition in your medical records. The percentages are:¹

0%: Documented history of GERD with no daily symptoms and no need for daily medication. There is no monthly payment at this level, but service connection is established, which preserves eligibility for VA healthcare and for future secondary claims.
10%: Documented history of esophageal stricture requiring daily medication to control difficulty swallowing, otherwise asymptomatic.
30%: Recurrent esophageal stricture causing difficulty swallowing that requires dilation no more than twice per year.
50%: Recurrent or refractory esophageal stricture causing difficulty swallowing that requires dilation three or more times per year, dilation using steroids at least once per year, or esophageal stent placement.
80%: Recurrent or refractory esophageal stricture with difficulty swallowing plus at least one severe complication (aspiration, undernutrition, or substantial weight loss), requiring surgical correction or a percutaneous esophago-gastrointestinal (PEG) tube.

“Substantial weight loss” here means involuntary loss of more than 20% of your baseline weight, sustained for three months, with a noticeable decline in your ability to handle self-care or work.² When your disability picture sits between two levels, the VA assigns the higher one if your overall condition more closely matches the higher criteria.³

When the Older DC 7346 Criteria Still Apply

Before May 19, 2024, the VA had no specific code for GERD and rated it by analogy to hiatal hernia under DC 7346, which focused on heartburn, regurgitation, chest and shoulder pain, and their overall impact on health.⁴ The distinction matters because many veterans have severe daily reflux without stricture. Under the new DC 7206, those symptoms alone produce a 0% rating. Under the old DC 7346, the same picture could support 30% or even 60%.

For any claim or appeal that was pending when the criteria changed, the VA must apply whichever version produces the more favorable result. The old levels were:⁵

10%: Two or more of the symptoms listed at 30%, but at a lesser severity.
30%: Persistent recurring heartburn, difficulty swallowing, and regurgitation, with pain in the chest, arm, or shoulder, causing considerable impairment of health.
60%: Pain, vomiting, material weight loss, and either hematemesis or melena with moderate anemia, or any combination of symptoms producing severe impairment of health.

The 60% level does not require every symptom on the list. Any combination that produces severe health impairment can qualify.

2026 Monthly Compensation Amounts

For a single veteran with no dependents, the 2026 monthly rates at the percentages available under DC 7206 are:⁶

0%: $0 per month (VA healthcare eligibility only)
10%: $180.42
30%: $552.47
50%: $1,132.90
80%: $2,102.15

Rates at 30% and above increase if you have a spouse, children, or dependent parents. When GERD is one of several service-connected conditions, the VA uses combined ratings math rather than simple addition, and the total is usually lower than adding the percentages straight together.

Getting GERD Service-Connected

A rating percentage only matters after the VA agrees your GERD is connected to your service. There are three routes.

Direct connection requires a current GERD diagnosis, an in-service event or illness that could have triggered the condition, and a medical nexus opinion stating your GERD is “at least as likely as not” caused by that in-service event.⁷

Secondary connection covers GERD caused or worsened by another service-connected condition. Common examples are reflux caused by NSAIDs prescribed for a service-connected pain condition, or by certain antidepressants prescribed for PTSD.⁸ If a service-connected condition made pre-existing GERD measurably worse, the VA compensates only the increase above your prior baseline, so medical records from before the aggravation began are important.

Gulf War presumptive connection covers certain functional gastrointestinal disorders (irritable bowel syndrome, functional dyspepsia, functional dysphagia) for veterans who served in the Southwest Asia theater.⁹ GERD itself is not on that list, and the presumption excludes structural gastrointestinal diseases, but overlapping functional symptoms may still open this pathway.

The C&P Exam and What Drives the Rating

After you file, the VA schedules a Compensation and Pension exam. The examiner reviews your records, asks about symptom onset and severity, and completes a Disability Benefits Questionnaire. Under DC 7206, the examiner pays close attention to documented esophageal stricture, daily medication use, and any procedures such as dilations, stent placements, or surgical correction. Blood work may check for anemia or undernutrition, both relevant at higher levels.

The examiner does not usually perform endoscopy at the exam itself. Your existing endoscopy reports, pH monitoring studies, imaging, and pharmacy records carry the weight. Every rating criterion has a document behind it: endoscopy reports show stricture, procedure notes show dilations and stents, pharmacy records show daily medication, and weight-tracking records show substantial loss. What is not in the medical record generally cannot be rated.

Combining GERD With Other Digestive Conditions

Under 38 CFR 4.114, certain digestive codes (DCs 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357) cannot be combined with one another. When more than one applies, the VA assigns a single rating under the most prominent condition and may bump it one level up if warranted.¹

DC 7206 sits outside that restricted range, and so does DC 7319 for irritable bowel syndrome. Since the May 2024 update, veterans can potentially receive separate ratings for GERD and IBS, provided the symptoms rated under each code are distinct. Rating the same symptom under two different codes is pyramiding and remains prohibited.¹⁰ Records need to draw a clean line between reflux-driven symptoms (acid reflux, esophageal irritation, difficulty swallowing) and IBS-driven symptoms (altered bowel habits, abdominal cramping).

If GERD Has Progressed to Barrett’s Esophagus

Long-standing GERD can cause the esophageal lining changes known as Barrett’s esophagus, which has its own codes. Under the May 2024 criteria, Barrett’s with stricture is rated under DC 7203 and Barrett’s without stricture under DC 7207. If you have that diagnosis, name it specifically in your claim so the rating is not limited to DC 7206 alone.

Protection for Existing Ratings After the 2024 Rule Change

If you already had a GERD rating under DC 7346 before May 19, 2024, the switch to DC 7206 by itself cannot reduce it. A change to the rating schedule is not grounds for reduction unless medical evidence shows your condition actually improved.¹¹ A rating in place continuously for 20 or more years is protected outright and cannot be reduced unless the VA proves fraud. So a 30% rating assigned under the old symptom-based criteria stays at 30% if your symptoms have not improved, even where the same picture would not meet the stricture-focused DC 7206 requirements.

How To File

File on VA Form 21-526EZ through the VA website, by mail, or in person at a VA regional office.¹² Before you file, gather your service treatment records, current medical records showing the GERD diagnosis, reports of endoscopies and any procedures such as dilations, and a nexus letter from a qualified medical professional linking your GERD to service. For secondary claims, include records showing how your service-connected condition caused or worsened your reflux; pharmacy records tying specific medications to symptom onset can be persuasive.

After filing, the VA will schedule your C&P exam and issue a decision. If the claim is denied, you can file a supplemental claim with new evidence, request a higher-level review, or appeal to the Board of Veterans’ Appeals.¹³

1
eCFR. 38 CFR 4.114 – Schedule of Ratings, Digestive System
2
eCFR. 38 CFR 4.112 – Weight Loss
3
eCFR. 38 CFR 4.7 – Higher of Two Evaluations
4
Board of Veterans’ Appeals. Board of Veterans’ Appeals Decision A25020094
5
Board of Veterans’ Appeals. Board of Veterans’ Appeals Decision A25029438
6
Department of Veterans Affairs. Current Veterans Disability Compensation Rates
7
eCFR. 38 CFR 3.303 – Principles Relating to Service Connection
8
eCFR. 38 CFR 3.310 – Proximately Due to or the Result of Service-Connected Disability
9
eCFR. 38 CFR 3.317 – Compensation for Certain Disabilities Occurring in Persian Gulf Veterans
10
eCFR. 38 CFR 4.14 – Avoidance of Pyramiding
11
eCFR. 38 CFR 3.951 – Preservation of Disability Ratings
12
Department of Veterans Affairs. How To File a VA Disability Claim
13
Department of Veterans Affairs. Eligibility for VA Disability Benefits