GERD VA Disability Rating & Claims Guide
Last updated: October 2026
Heartburn doesn't sound like a disability, so many veterans never think to claim it. If you live with GERD, though, you know it can mean daily pills, food that won't go down right, nights spent propped up on pillows, and meals you plan around how your stomach will react. You may also have heard that VA changed how it rates GERD and wondered what that means for your claim.
VA does rate GERD. Since 2024 it has its own diagnostic code, and the rating criteria are more specific than many veterans expect. This guide covers how VA defines and rates GERD, the ways to get it service-connected, the evidence that matters, what happens at the C&P exam, common reasons for denial, secondary conditions, and when TDIU might apply.
I'm not an attorney or a VSO (Veterans Service Organization, an accredited group that helps veterans with claims for free), and this post isn't legal advice. It's general education based on VA's published rules and my own experience. For help with your specific claim, a VA-accredited VSO representative can help you for free.
GERD at a Glance
Diagnostic code: Diagnostic Code (DC) 7206, Gastroesophageal reflux disease, under 38 CFR § 4.114. It took effect May 19, 2024. For rating periods before that date, VA rated GERD "by analogy" under DC 7346 (hiatal hernia), often written as 7399-7346.
Rating levels: 0%, 10%, 30%, 50%, and 80% under DC 7206.
Common paths to service connection: Direct, meaning GERD started in service and continued. Secondary, meaning a service-connected condition or the medication you take for it caused or worsened your GERD.
Key evidence: Treatment records showing symptoms and especially any trouble swallowing, test results from a barium swallow, CT scan, or EGD, your medication history, and lay statements from you and people who know you.
Main exam: The Disability Benefits Questionnaire (DBQ), a standard form VA examiners use to record findings, for esophageal conditions.
Official criteria: 38 CFR § 4.114 on eCFR.
How the VA Defines GERD
GERD stands for gastroesophageal reflux disease. Stomach acid and stomach contents back up into your esophagus, the tube that carries food from your mouth to your stomach. Over time that can cause heartburn, regurgitation, inflammation, and dysphagia, which is the medical word for difficulty swallowing. Repeated acid damage can also cause scarring that narrows the esophagus. That narrowing is called a stricture, and it matters a lot for your rating.
VA rates GERD under the digestive system section of the rating schedule, 38 CFR § 4.114. For years GERD didn't have its own diagnostic code. VA rated it by analogy, which means borrowing the criteria for a similar condition. In GERD's case that was the hiatal hernia code, DC 7346.
That changed with a final rule VA published in the Federal Register on March 20, 2024, which took effect May 19, 2024. The rule overhauled the digestive system schedule and created DC 7206 specifically for GERD. GERD's criteria now mirror those for esophageal stricture (DC 7203), and hiatal hernia (DC 7346) is now rated the same way.
On diagnosis, the rating schedule doesn't name one specific test you must have before VA will accept that you have GERD. A doctor's diagnosis in your treatment records is the starting point. Where the schedule does get specific is stricture. It requires stricture findings to be documented by a barium swallow (an X-ray taken while you swallow a contrast liquid), a CT scan, or an EGD. EGD stands for esophagogastroduodenoscopy, the scope procedure where a doctor looks at your esophagus and stomach with a camera.
The practical takeaway: a diagnosis gets you in the door, but if your symptoms go beyond heartburn, you'll want those imaging or scope results in your file.
How the VA Rates GERD
The GERD criteria focus on one thing above all: documented esophageal stricture causing dysphagia, and how much treatment it takes to keep you swallowing. Heartburn alone, however miserable, doesn't drive the higher levels. Here's an overview of each level.
| Rating | What it generally means |
|---|---|
| 0% | Documented history of GERD without daily symptoms and without needing daily medication |
| 10% | Documented history of esophageal stricture that needs daily medication to control dysphagia, with no other symptoms |
| 30% | Documented history of recurrent stricture causing dysphagia that needs dilatation no more than twice a year |
| 50% | Documented history of recurrent or refractory stricture causing dysphagia that needs dilatation 3 or more times a year, dilatation with steroids at least once a year, or an esophageal stent |
| 80% | Documented history of recurrent or refractory stricture causing dysphagia with aspiration, undernutrition, or substantial weight loss, treated with surgical correction or a PEG feeding tube |
Read the full rating criteria on eCFR.
A few terms in that table are worth defining:
Dilatation: A procedure that stretches a narrowed esophagus so food can pass.
Recurrent stricture: VA defines this as being unable to keep the target width of the esophagus for more than 4 weeks after reaching it.
Refractory stricture: VA defines this as being unable to reach the target width even after at least 5 dilatation sessions done 2 weeks apart.
Aspiration: Food or liquid going into your airway or lungs instead of your stomach.
PEG tube: A feeding tube placed through the abdomen into the stomach.
Two other notes in the regulation are worth knowing. Stricture findings must be documented by barium swallow, CT, or EGD. And if a procedure causes a complication outside the digestive system, VA rates that complication under the body system it affects.
One thing that may surprise you: medication counts here. Jones v. Shinseki (2012) held that VA generally can't lower your rating because medication improves your symptoms, unless the criteria for that condition mention medication. The GERD criteria do. Daily medication is literally part of the line between 0% and 10%, so tell VA exactly what you take and how often.
Claims That Cover Time Before May 19, 2024
If your claim or appeal covers a period before May 19, 2024, VA may use the old analogy-based criteria under DC 7346 for that time. Board of Veterans' Appeals decisions show judges applying the old code to rating periods that ended before the change, and looking at both versions when a claim spans it. Board decisions aren't precedential, meaning they apply only to the case decided, but they show how the rule works in practice. If your claim straddles that date, ask a VSO which criteria apply to each period instead of guessing.
When GERD Overlaps With Other Digestive Conditions
Section 4.114 has a non-combination rule covering diagnostic codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357. Hiatal hernia (DC 7346) falls in that range. VA can't rate those codes separately alongside each other; instead it assigns one rating under whichever code reflects the "predominant disability picture," meaning whichever condition causes the bigger problem, and can raise that rating one level if the overall picture is more severe. DC 7206 (GERD) and DC 7203 (esophageal stricture) are not on that list, so this specific non-combination rule doesn't apply to them directly.
A broader rule still applies, though. Pyramiding, under 38 CFR 4.14, means VA can't rate the same symptoms twice under different diagnoses. If your GERD and your hiatal hernia both show up as the same swallowing problem, VA won't pay for that dysphagia twice. Under Esteban v. Brown (1994), though, symptoms that are truly distinct and don't overlap can be rated separately. If you have more than one digestive diagnosis, make sure your records describe what each one actually does to you.
Getting GERD Service Connected
Direct Service Connection
Direct service connection under 38 CFR 3.303 needs three things: a current diagnosis, an illness, injury, or event during service, and a medical link between the two. That link is called a nexus, which is a medical opinion explaining why your current condition is connected to service.
Picture a veteran whose service treatment records show repeated sick call visits for heartburn and a prescription for acid reducers during their last enlistment. After separation, they keep refilling that prescription through a civilian doctor and later get diagnosed with GERD. That's a clean story: symptoms in service, a continuous pattern afterward, and a current diagnosis.
Many of us never went to sick call for heartburn. We bought antacids at the exchange and kept going. If that's you, your own statement and statements from people who saw it still count. Under Buchanan v. Nicholson (2006), VA can't reject lay evidence just because there are no medical records from the same time.
Secondary Service Connection
Secondary service connection under 38 CFR 3.310(a)-(b) covers a condition that was caused or made worse by a condition that's already service-connected. This is one of the most common ways GERD gets connected.
Board decisions show GERD granted as secondary to service-connected PTSD and other psychiatric conditions. Veterans and their representatives also frequently argue that medications taken for a service-connected condition caused or worsened GERD. For example, some argue that SSRIs prescribed for PTSD can cause digestive side effects, as CCK Law describes. Some veterans also claim GERD secondary to sleep apnea.
None of these links is automatic. A secondary claim needs a medical opinion that ties your GERD to the specific service-connected condition or medication, with reasoning behind it.
Presumptive Service Connection
There's no presumptive service connection for GERD. A presumptive condition is one VA assumes is connected to service if you served in certain places or times, so you don't have to prove the link. GERD isn't on any of those lists. If you served in a location covered by the PACT Act and have a different digestive diagnosis, such as a gastrointestinal cancer, check whether that condition qualifies on its own.
Evidence That Strengthens Your Claim
Because the rating criteria are so specific, your evidence should be specific too. Here's what tends to matter most for GERD:
Treatment records that mention dysphagia: Dysphagia is the symptom almost every rating level turns on. If food sticks, you choke on pills, or you've changed what you eat, make sure your doctor writes that down, not just "reflux."
Barium swallow, CT, or EGD results: If you've had any of these, get the full reports into your file. The regulation requires stricture findings to come from one of these tests.
Dilatation and procedure history: Dates and number of dilatations, any steroid use during dilatation, stents, surgery, or a feeding tube. The 30%, 50%, and 80% levels are built around these.
Medication history: Pharmacy records or a list from your doctor showing daily medication. Daily use is the dividing line between 0% and 10%.
Weight and nutrition records: If you've lost weight or a provider has noted poor nutrition or aspiration, those records matter at the highest level.
For secondary claims, a medical opinion: A provider who explains why your GERD is "at least as likely as not" (a 50% chance or better) caused or worsened by your service-connected condition or its medication.
Your own words count too. A personal statement can describe what swallowing trouble actually looks like day to day, like cutting food into tiny pieces or avoiding meals out. A buddy statement can come from a spouse who's watched dinner turn into a struggle, or a friend from your unit who remembers you eating antacids like candy on deployment. Use VA Form 21-10210 for these statements.
For a broader walkthrough of records requests and doctor's opinions, see my guide on how to gather medical evidence for your claim. My Evidence Organizer has an evidence checklist for each condition and a secondary conditions worksheet to keep these records in one place.
What to Expect at Your C&P Exam
A C&P (Compensation and Pension) exam is an appointment VA orders to gather medical facts for your claim. For GERD, the examiner typically fills out a DBQ covering esophageal conditions. A DBQ, or Disability Benefits Questionnaire, is a standard form that tells the examiner what to record for a type of condition.
Expect questions about when you were diagnosed, what treatment you've had, and what medications you take now. The examiner will also look for anything related to dysphagia and stricture: whether you've had a barium swallow, CT, or EGD, how many dilatations you've had, and whether you've had weight loss or trouble getting enough nutrition. The exam isn't treatment, and the examiner can't tell you how your claim will turn out. My post on what to expect at a C&P exam covers the general process.
Come ready to answer in concrete terms. "Food gets stuck about four times a week, mostly bread and meat" tells the examiner far more than "I have trouble swallowing sometimes." Know your medication names and doses, your last procedure date, and whether your weight has changed. My C&P Exam Prep Workbook includes a daily symptom log you can use to track how often swallowing trouble happens before your exam.
Common Reasons GERD Claims Are Denied
No link between service and today: Board decisions show GERD claims denied when the first reflux treatment doesn't appear until years after discharge and nothing explains the gap. If you had symptoms in service and self-treated, say so in a statement and get buddy statements that back it up.
Inconsistent accounts: When a veteran's current description conflicts with what they told providers earlier, the Board has given more weight to the examiner's report. Before you file, review your records so your statement matches what's already there, and explain any differences honestly.
No medical opinion for a secondary claim: Saying your GERD came from your PTSD medication isn't enough on its own. A secondary claim needs a provider's reasoned opinion connecting the two.
Rating lower than expected: If your records only mention heartburn, VA may not find the dysphagia or stricture history the higher levels require.
These claims are often close calls. Under 38 CFR 3.102 and Gilbert v. Derwinski (1990), when the evidence for and against you is roughly balanced, VA must give you the benefit of the doubt. If your claim was denied, VA's decision reviews page explains your options, and my post on common reasons VA claims get denied walks through how to match the fix to the problem.
Secondary Conditions Linked to GERD
GERD shows up on both sides of secondary claims.
Conditions GERD is often secondary to:
PTSD and other mental health conditions: Board decisions have granted GERD as secondary to service-connected PTSD and other psychiatric conditions.
Medications for other service-connected conditions: Veterans commonly argue that the medications they take for one condition caused or worsened their reflux.
Sleep apnea: Some veterans claim GERD as secondary to sleep apnea, arguing that the breathing disruption makes nighttime reflux worse.
That medication pathway is my own story. My GERD is secondary to migraines, because of the medication I use to manage them. If your migraines are service-connected, my migraines VA disability guide covers how that condition is rated and connected. In my experience, GERD most commonly rated at 10% historically. Recent changes have dropped this rating to 0% on average. Higher ratings are possible, but they depend on documented stricture and how often it needs treatment.
Conditions sometimes claimed as secondary to GERD:
Sleep apnea: The link is sometimes argued in the other direction too, with nighttime reflux said to disrupt breathing and sleep.
Whatever direction your claim runs, the medical opinion carries it. Ask the provider who prescribes the medication, or who treats the primary condition, whether they're willing to explain the connection in writing.
When TDIU May Apply
TDIU (Total Disability based on Individual Unemployability) pays at the 100% rate when your service-connected conditions keep you from holding a substantially gainful job, even if your combined rating is lower. There's no special TDIU rule for GERD. The general rules apply.
Schedular TDIU, meaning you meet VA's rating thresholds, requires one service-connected disability rated at least 60%, or two or more with a combined rating of at least 70% and one rated at least 40%, under 38 CFR 4.16(a). GERD's 80% level would meet the single-disability threshold, but it requires stricture severe enough to need surgery or a feeding tube along with aspiration, undernutrition, or major weight loss. Most veterans with GERD won't be there.
GERD more often plays a supporting role. Disabilities affecting a single body system count as one disability for these thresholds, so several digestive ratings can work together. GERD can also add to the overall picture alongside a mental health or other condition. If you don't meet the thresholds but still can't work, extraschedular TDIU under 4.16(b), a referral process for veterans who don't meet the standard rating percentages but still can't hold a job because of their service-connected conditions, lets VA refer your case for special consideration outside the normal rating rules. See the full TDIU eligibility rules for how to apply.
Conclusion
GERD now has its own diagnostic code, and the rating turns heavily on documented dysphagia, stricture, and the treatment it takes to manage them. Daily medication, test results from a barium swallow, CT, or EGD, and your procedure history all matter. You can connect GERD directly to service or as secondary to a condition, or a medication, that's already service-connected.
Your next step is to pull your treatment and pharmacy records and look for three things: any mention of swallowing trouble, any imaging or scope results, and proof of daily medication. If you're going the secondary route, a VSO is often my first suggestion. They can help you figure out what kind of medical opinion your claim needs and which criteria apply to your timeline. You can find an accredited representative on VA.gov for free.
Wondering how this applies to your condition? Every veteran's situation is a little different. Schedule a free consultation to talk through what you've read and get connected with a VSO who can help with your claim.
Continue Reading
Links already present in the article (medical evidence, C&P exam, migraines, why claims get denied, TDIU eligibility) are excluded since they're already referenced. Here are the remaining relevant posts:
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