Rating criteria · 38 CFR §4.114 · §4.112
GERD & Esophageal Conditions: VA Rating Criteria
The exact rating criteria below are quoted from the Code of Federal Regulations as currently in force, not paraphrased. Compensation amounts come from the current VA rate tables.
By Mario Bailey, U.S. Air Force veteran · current Air National Guard member. Data updated 2026-07-24.
Plain-language guide
What this rating actually turns on
Heartburn does not appear anywhere in the rating criteria. Diagnostic Code 7206 rates GERD entirely on documented esophageal stricture: whether scarring has narrowed the esophagus, how hard it is to keep open, and what that does to your ability to swallow. Every tier from 10 to 80 percent is built on stricture history plus treatment burden, from daily medication to control dysphagia (10 percent), to dilatation no more than twice a year (30 percent), to dilatation three or more times a year, dilatation using steroids, or a stent (50 percent), to surgical correction or a feeding tube with aspiration, undernutrition, or substantial weight loss (80 percent). Note (1) sets the evidence rule in one line: findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy. Severe daily reflux with no documented stricture never starts up this ladder at all, however miserable it feels.
Hiatal hernia claims land here too: DC 7346 contains no criteria of its own, just the instruction “Rate as esophagus, stricture of (DC 7203),” whose tiers are quoted on this page and mirror the GERD code almost word for word (the 80 percent rows differ by one phrase, quoted in each table).
A worked example
An Army veteran has service-connected GERD. An esophagogastroduodenoscopy documents a peptic stricture, and his gastroenterologist dilates it. Within a few weeks the narrowing is back, which is exactly what Note (4) means by recurrent: “the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.” Over the next twelve months he needs three dilatations. That record, recurrent stricture causing dysphagia requiring “dilatation 3 or more times per year,” is the 50 percent criterion verbatim. Had he needed only two dilatations that year, the same diagnosis would rate 30 percent, one tier and a meaningful monthly difference lower on the pay table on this page. The 80 percent tier is a different world entirely: it requires surgery or a PEG tube plus aspiration, undernutrition, or substantial weight loss, which 38 CFR 4.112(a), quoted below, defines as involuntary loss greater than 20 percent of baseline weight, sustained for three months, with diminished quality of self-care or work tasks.
If the decision came back lower
Line the decision up against the tiers above. A frequent gap is a rating that counts symptoms instead of documented procedures: if your file already shows three dilatations in a year and VA assigned 30 percent, that is a misreading to raise in a Higher-Level Review. If the procedure record itself is missing, get the imaging or endoscopy report into the file with a Supplemental Claim first, because under Note (1) the criteria simply do not engage without it.
Rating criteria from the CFR
| Rating criteria | Rating |
|---|---|
| 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 of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube) | |
| 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 | |
| Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year | |
| Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic | |
| Documented history without daily symptoms or requirement for daily medications |
Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.
Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
| Rating criteria | Rating |
|---|---|
| Rate as esophagus, stricture of (DC 7203). |
| Rating criteria | Rating |
|---|---|
| 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) | |
| 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 | |
| Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year | |
| Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic | |
| Documented history without daily symptoms or requirement for daily medications |
Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.
Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
SOURCE: eCFR, 38 CFR Part 4 (issue date 2026-07-13, current through 2026-07-24) · retrieved 2026-07-28
Regulation text
38 CFR §4.114, Schedule of ratings—digestive system.
Do not combine ratings under diagnostic codes 7301 through 7329 inclusive, 7331, 7342, 7345 through 7350 inclusive, 7352, and 7355 through 7357 inclusive, with each other. Instead, when more than one rating is warranted under those diagnostic codes, assign a single evaluation under the diagnostic code that reflects the predominant disability picture, and elevate it to the next higher evaluation if warranted by the severity of the overall disability.
38 CFR §4.112, Weight loss and nutrition.
The following terms apply when evaluating conditions in § 4.114:
(a) Weight loss. Substantial weight loss means involuntary loss greater than 20% of an individual's baseline weight sustained for three months with diminished quality of self-care or work tasks. The term minor weight loss means involuntary weight loss between 10% and 20% of an individual's baseline weight sustained for three months with gastrointestinal-related symptoms, involving diminished quality of self-care or work tasks, or decreased food intake. The term inability to gain weight means substantial weight loss with the inability to regain it despite following appropriate therapy.
(b) Baseline weight. Baseline weight means the clinically documented average weight for the two-year period preceding the onset of illness or, if relevant, the weight recorded at the veteran's most recent discharge physical. If neither of these weights is available or currently relevant, then use ideal body weight as determined by either the Hamwi formula or Body Mass Index tables, whichever is most favorable to the veteran.
(c) Undernutrition. Undernutrition means a deficiency resulting from insufficient intake of one or multiple essential nutrients, or the inability of the body to absorb, utilize, or retain such nutrients. Undernutrition is characterized by failure of the body to maintain normal organ functions and healthy tissues. Signs and symptoms may include loss of subcutaneous tissue, edema, peripheral neuropathy, muscle wasting, weakness, abdominal distention, ascites, and Body Mass Index below normal range.
(d) Nutritional support. Paragraphs (d)(1) and (2) of this section describe various nutritional support methods used to treat certain digestive conditions.
(1) Total parenteral nutrition (TPN) or hyperalimentation is a special liquid mixture given into the blood through an intravenous catheter. The mixture contains proteins, carbohydrates (sugars), fats, vitamins, and minerals. TPN bypasses the normal digestion in the stomach and bowel.
(2) Assisted enteral nutrition requires a special liquid mixture (containing proteins, carbohydrates (sugar), fats, vitamins, and minerals) to be delivered into the stomach or bowel through a flexible feeding tube. Percutaneous endoscopic gastrostomy is a type of assisted enteral nutrition in which a flexible feeding tube is inserted through the abdominal wall and into the stomach. Nasogastric or nasoenteral feeding tube is a type of assisted parenteral nutrition in which a flexible feeding tube is inserted through the nose into the stomach or bowel.
Monthly compensation at each rating level
Veteran-alone amounts, effective 2025-12-01. Dependents increase these amounts at 30% and above, use the combined rating calculator for your exact situation, especially if this isn't your only rated condition.
| Rating | Monthly (veteran alone) |
|---|---|
| $2,102.15 | |
| $1,132.90 | |
| $552.47 | |
| $180.42 |
SOURCE: VA compensation rate tables, va.gov · retrieved 2026-07-28 · effective 2025-12-01
Frequently asked questions
What is the highest VA rating for GERD & esophageal conditions?
Under 38 CFR §4.114, §4.112, the highest schedular rating for GERD & esophageal conditions is 80%, which pays $2,102.15 a month for a veteran with no dependents on the current rate tables (effective 2025-12-01). Reaching it means the exam and records actually meet the 80% criteria quoted above, the diagnosis by itself does not set the rating.
What rating levels are possible for GERD & esophageal conditions?
VA can assign 10%, 30%, 50% or 80%, depending on the severity your evidence documents. Every one of those steps has its own test in 38 CFR §4.114, §4.112, quoted in full on this page, so two veterans with the same diagnosis can land at very different levels based on what the exam and records show.
If your rating came back lower than this
A decision that ignores the criteria above is a frequent reason veterans are underpaid. Line your decision up against the levels on this page. If the evidence supports a higher level than VA assigned, you have three ways to challenge it, and the right one depends on why it went wrong:
- Something was missing from the record (an exam finding, a prescription, a flare-up statement, a nexus letter): add it with a Supplemental Claim.
- The evidence was already there and VA misread it: ask for a Higher-Level Review by a more senior rater, with no new evidence needed.
- A legal or judgment error: take it to the Board of Veterans' Appeals.
Line your decision up against the criteria on this page. Which review lane fits depends on why the rating is wrong: new evidence that was missing, a misread of evidence already in the file, or a legal error. All three are laid out in the decision reviews and appeals guide.
Before you file, recombine this rating with your others (VA math does not add ratings), check how long each lane is taking right now, and remember a VA-accredited representative or VSO will help you for free. You can also browse every other condition's criteria to make sure you are claiming everything you are owed.