GERD VA Rating 2026: DC 7206 Criteria

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) 7206, Gastroesophageal reflux disease, per 38 CFR § 4.114, Schedule of Ratings — Digestive System.

Before May 19, 2024, the VA had no code for GERD and rated it by analogy to hiatal hernia (DC 7346). The digestive system update that took effect May 19, 2024 created DC 7206 for GERD. Hiatal hernia still has its own code, DC 7346, which is now rated as esophageal stricture (DC 7203). If you see an older decision that lists GERD as “7399-7346” or “7346,” that reflects the pre-2024 rules.

DC 7206 rates GERD based on esophageal stricture (a narrowing of the esophagus) and the treatment it needs, not on heartburn or general health. The notes to DC 7206 say:

• Note (1): Findings must be documented by barium swallow, computerized tomography (CT), or esophagogastroduodenoscopy (EGD).
• Note (2): Non-gastrointestinal complications of procedures are rated under the appropriate body system.
• Note (3): The code also applies to (but is not limited to) mechanical, chemical, drug-induced, infectious, eosinophilic, lymphocytic, and radiation esophagitis, esophagitis due to peptic stricture, Mallory-Weiss syndrome due to caustic ingestion, and any esophageal condition that requires treatment with sclerotherapy.
• Note (4): A recurrent stricture is the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
• Note (5): A refractory stricture is the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.

Rating criteria for GERD

The VA assigns GERD ratings at five possible levels under DC 7206:

0% rating

Criteria: Documented history without daily symptoms or requirement for daily medications.

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

10% rating — $180.42/month

Criteria: Documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic.

What this looks like: Imaging or endoscopy has documented a stricture, and you take a daily medication (for example, a proton pump inhibitor) to keep swallowing problems under control. Without a documented stricture, daily heartburn medication alone does not match this wording.

30% rating — $552.47/month

Criteria: Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year.

What this looks like: Your stricture keeps coming back and causes difficulty swallowing. A gastroenterologist stretches (dilates) the esophagus once or twice a year to keep it open.

50% rating — $1,132.90/month

Criteria: 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.

What this looks like: Your stricture needs frequent dilatation, steroid injections during dilatation, or a stent to keep the esophagus open.

80% rating — $2,102.15/month

Criteria: Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the following present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a), and treatment with either surgical correction of esophageal stricture(s) or a percutaneous esophago-gastrointestinal tube (PEG tube).

What this looks like: Swallowing problems have led to food or liquid entering the airway, malnutrition, or major weight loss, and you needed surgery on the stricture or a feeding tube. Under § 4.112(a), “substantial weight loss” means involuntary loss greater than 20% of your baseline weight sustained for three months with diminished quality of self-care or work tasks.

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
• Barium swallow, CT, or upper endoscopy (EGD) reports documenting any esophageal stricture (Note (1) to DC 7206 requires one of these)
• Procedure records for every dilatation, including dates, whether steroids were used, and any stent placement
• pH monitoring test results if performed (these support the diagnosis, but the rating turns on stricture findings)
• Treatment records showing ongoing symptoms and medication management
• Prescription records showing daily medication (PPIs, H2 blockers, or others) and that it is taken to control swallowing problems
• Documentation of weight changes, aspiration events, or undernutrition if applicable
• Records of stricture surgery or PEG tube placement 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

DC 7206 rates GERD on stricture findings and treatment, so the examiner’s report needs to capture those facts. Expect questions focused on the esophagus rather than on heartburn alone:

• Confirmation of the GERD diagnosis
• Stricture evidence: whether a barium swallow, CT, or EGD has documented esophageal stricture(s), and the date and result of each study
• Dysphagia: whether you have difficulty swallowing, how often, and with what (solids, liquids, or both)
• Daily medication: whether you need a medication every day to control swallowing symptoms, and what it is
• Dilatation history: how many dilatations you have had in the past year, whether steroids were used, and whether a stent was placed
• Recurrent or refractory status: whether the stricture returns within 4 weeks of reaching target diameter, or has not reached target diameter despite at least 5 dilatations at 2-week intervals
• Severe complications: aspiration, undernutrition, or substantial weight loss, and any stricture surgery or PEG tube
• If secondary: the connection to the primary condition

How to prepare

1. Bring your imaging and endoscopy reports. The 10% and higher ratings depend on a documented stricture. If you’ve had an EGD, barium swallow, or CT, bring the reports, not just a summary.
2. List every dilatation. Write down the date of each esophageal dilatation in the past year, and note whether steroids were injected or a stent was placed. Procedure notes from your gastroenterologist are the best proof.
3. Describe your swallowing honestly. Explain whether food sticks, how often, and what you do about it. Describe your worst days, not only your average day.
4. List all medications. Bring a complete list of current medications for GERD and for the primary condition (if claiming secondary), and note which ones you take every day to control swallowing symptoms.
5. Track your weight and any aspiration. If you have lost weight, choked, or developed pneumonia from aspiration, bring medical records that document it.

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 10% 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.