GERD VA Disability Rating: Criteria, Evidence & Pay

What is GERD and how does it affect veterans?

Gastroesophageal Reflux Disease (GERD) is a chronic digestive condition where stomach acid frequently flows back into the esophagus, causing irritation, pain, and damage over time. The lower esophageal sphincter — a ring of muscle that normally prevents acid from moving upward — weakens or relaxes abnormally, allowing acid to splash into the esophagus and sometimes into the throat and mouth.

Veterans experience GERD at elevated rates for several reasons. The stress of military service and combat increases stomach acid production and disrupts digestive function. Irregular eating schedules, MREs, and the general diet during deployment are hard on the digestive system. Perhaps most significantly, medications commonly prescribed for service-connected conditions — NSAIDs for pain, SSRIs for PTSD and anxiety, and others — are well-documented causes of GERD.

GERD goes beyond occasional heartburn. Chronic acid reflux can cause painful swallowing, persistent chest pain that mimics heart problems, regurgitation of food and acid, disrupted sleep from nighttime reflux, chronic cough, and long-term damage to the esophagus including Barrett’s esophagus (a precancerous condition). It affects your ability to eat comfortably, sleep well, and maintain a normal daily routine.

VA diagnostic code for GERD

GERD is rated under Diagnostic Code (DC) 7346 per 38 CFR § 4.114, Schedule of Ratings — Digestive System.

DC 7346 technically covers hiatal hernia, but the VA uses this code to rate GERD and other esophageal reflux conditions because the symptom criteria align closely. The rating is based on the severity and combination of specific symptoms: dysphagia (difficulty swallowing), pyrosis (heartburn), regurgitation, pain, vomiting, weight loss, and overall health impairment.

Rating criteria for GERD

The VA assigns GERD ratings at four possible levels:

0% rating

Criteria: The condition is diagnosed and service-connected but symptoms are mild and do not meet the criteria for a 10% rating.

Monthly payment: $0 (but establishes service connection, which matters for future increases)

10% rating — $180.42/month

Criteria: Two or more of the symptoms for the 30% evaluation of less severity.

What this looks like: You experience a combination of heartburn, difficulty swallowing, regurgitation, and/or substernal (under the breastbone), arm, or shoulder pain. The symptoms are present and documented but not severe enough to cause considerable impairment of your overall health. You manage with medication and dietary modifications but the condition affects your comfort and daily routine.

30% rating — $552.47/month

Criteria: Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.

What this looks like: You have ongoing upper abdominal distress with difficulty swallowing, heartburn, and regurgitation. You experience pain in your chest, arm, or shoulder area related to the reflux. These symptoms collectively cause considerable impairment to your overall health — meaning they significantly affect your ability to eat normally, sleep well, maintain weight, and function day-to-day despite treatment.

60% rating — $1,435.02/month

Criteria: Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.

What this looks like: Your GERD is severe and causes significant health deterioration. You experience pain and vomiting. You’ve lost meaningful weight because eating is painful or triggers severe symptoms. You may have hematemesis (vomiting blood) or melena (black, tarry stools indicating GI bleeding). You may be anemic from chronic bleeding. Alternatively, you have a combination of symptoms that together produce severe impairment of your health — even without bleeding, if the overall impact is severe enough.

What evidence do you need?

Service records

• Service treatment records showing GI complaints, heartburn, or acid reflux treatment
• Records of medication use during service that could cause GERD (NSAIDs, etc.)
• Deployment records if relevant to stress-related claims
• If claiming secondary: complete records for the primary service-connected condition

Medical evidence

• Current diagnosis of GERD from a gastroenterologist or primary care physician
• Upper GI endoscopy (EGD) results showing esophageal damage, inflammation, or Barrett’s esophagus
• pH monitoring test results if performed
• Treatment records showing ongoing symptoms and medication management
• Prescription records for PPIs (proton pump inhibitors), H2 blockers, or other GERD medications
• Documentation of weight changes if applicable
• Lab results showing anemia if applicable

Nexus letter

A medical opinion connecting your GERD to service. If claiming as secondary to PTSD or anxiety, the nexus letter should explain how chronic stress increases acid production and impairs digestive function, or how medications for the primary condition cause or worsen GERD. The letter should cite relevant medical literature supporting the connection.

Buddy statements

Statements from family members or others who can describe your symptoms — frequent trips to the bathroom, difficulty eating meals, visible weight loss, disrupted sleep from reflux, restrictions on what you can eat, and how GERD affects your daily life and social activities.

C&P exam tips for GERD

What the examiner evaluates

• Confirmation of GERD diagnosis
• Presence and severity of specific symptoms: dysphagia, pyrosis, regurgitation, pain
• Impact on overall health (weight changes, anemia, nutritional deficiencies)
• Evidence of complications (Barrett’s esophagus, esophageal stricture, bleeding)
• Current treatment and its effectiveness
• If secondary: the connection to the primary condition

How to prepare

1. Bring endoscopy and test results. Objective evidence of esophageal damage is powerful. If you’ve had an EGD, pH study, or barium swallow, bring the results.
2. Document your symptoms comprehensively. Before the exam, write down all symptoms you experience: how often you have heartburn, whether you regurgitate food, whether you have trouble swallowing, where you feel pain, and how often symptoms occur.
3. Track your weight. If you’ve lost weight because of GERD (eating less due to pain, avoiding meals), document the weight change with medical records.
4. List all medications. Bring a complete list of current and past medications for GERD and for the primary condition (if claiming secondary). Show that despite treatment, symptoms persist.
5. Describe the daily impact. Explain which foods you can’t eat, how reflux disrupts your sleep, whether you’ve had to change your diet significantly, and how symptoms affect your work and social life.

Common secondary conditions linked to GERD

GERD is often connected to other conditions:

• PTSD and anxiety — GERD is most commonly claimed as secondary to these mental health conditions. The stress-digestive system connection is well-established in medical literature.
• Sleep apnea — GERD and sleep apnea have a bidirectional relationship. Sleep apnea can worsen reflux (due to negative intrathoracic pressure), and GERD disrupts sleep quality.
• Esophageal conditions — Chronic GERD can lead to Barrett’s esophagus, esophageal strictures, and other complications that may be separately ratable.
• Respiratory conditions — Chronic aspiration of stomach acid can cause or worsen asthma, chronic cough, and other respiratory problems.
• Dental erosion — Chronic acid reflux damages tooth enamel, which can be claimed as a dental condition secondary to GERD.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions. GERD at 30% combined with PTSD, tinnitus, and other conditions can produce a significantly higher combined rating.

Use our VA disability calculator to:

• Calculate your combined rating with multiple conditions
• See how VA math combines ratings
• Estimate your monthly payment including dependents

For the full breakdown of payment amounts at every rating level, see our 2026 VA disability pay rates page.

Disclaimer: This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on your VA disability claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent. You can find accredited representatives at VA.gov.