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Acid reflux (GERD)

GERD (acid reflux) and hiatal hernia

What it is

GERD means stomach acid keeps coming back up into the tube that carries food to your stomach (the esophagus).

VA's code numbers for this: 7206, 7203, 7346

What the examiner will do

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

  • Usually a VA or contract doctor, NP, or PA. Often 15-30 minutes.
  • They ask about heartburn, food sticking, vomiting, weight loss, medicines, and any scopes or stretching you've had. They may check your weight and belly.
  • They look for a test report (barium swallow, CT, or EGD) that shows a stricture.

Tests, in plain words

Stricture
A narrow spot in the esophagus, often from scarring by acid. It makes food feel stuck.
Dysphagia
Trouble swallowing.
Proof tests (required)
The stricture must be shown by one of: a barium swallow (you drink chalky liquid and they take X-rays), a CT scan, or an EGD (a doctor looks down your throat with a thin camera while you're sedated).
Dilatation
A doctor stretches the narrow spot open, usually during an EGD.

The examiner fills out a form called a DBQ. You can read it ahead of time: Esophageal Disorders DBQ (opens VA's site).

The rating levels, in plain words

VA picks the level that best matches how often and how badly the condition affects you.

  • 0%

    Records show a narrowing of the esophagus (a 'stricture') in the past, but you have no daily symptoms and don't need daily medicine. Note: since May 19, 2024, plain heartburn with no documented stricture usually rates 0%.

    VA's exact words

    Documented history without daily symptoms or requirement for daily medications

    Rule: 38 CFR 4.114, DC 7206 (rated with the DC 7203 criteria)

  • 10%

    A documented stricture, and you need daily medicine to control trouble swallowing. Otherwise no symptoms.

    VA's exact words

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

    Rule: 38 CFR 4.114, DC 7206 (rated with the DC 7203 criteria)

  • 30%

    The narrowing keeps coming back and causes trouble swallowing. You need it stretched open (dilated) up to 2 times a year.

    VA's exact words

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

    Rule: 38 CFR 4.114, DC 7206 (rated with the DC 7203 criteria)

  • 50%

    Trouble swallowing that needs: stretching 3+ times a year, OR stretching with steroid medicine at least once a year, OR a stent (a small tube placed to hold it open).

    VA's exact words

    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

    Rule: 38 CFR 4.114, DC 7206 (rated with the DC 7203 criteria)

  • 80%

    Trouble swallowing with food or liquid going into your lungs, poor nutrition, or big weight loss (over 20% of your normal weight for 3 months), AND you needed surgery or a feeding tube.

    VA's exact words

    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)

    Rule: 38 CFR 4.114, DC 7206 (rated with the DC 7203 criteria); 38 CFR 4.112(a)

What to track before your exam

What to write down: Swallowing trouble, food getting stuck, choking or coughing when eating, daily medicines, weight, and any stretching procedures.

How: Get copies of any EGD, barium swallow, or CT reports. List every dilation with the date. For 30 days, log swallowing symptoms and weigh yourself weekly.

Your log: what to write each time

  1. Date
  2. Food got stuck? (Y/N) what food
  3. Choked or coughed while eating?
  4. Heartburn/regurgitation (0-10)
  5. Daily reflux medicine taken?
  6. Weight (weekly)
  7. Procedures this month (EGD, dilation)

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

Honest exam rules

  • Tell the whole truth. Don't add to it. Don't shrink it.
  • Describe a normal day AND your worst days. Say how often the worst days happen.
  • Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
  • It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
  • Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
  • If something hurts or makes you worse during the exam, say so right then.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.

Common mistakes

  • Not knowing the rules changed May 19, 2024. Daily heartburn pills alone no longer reach 10% unless a stricture is documented.

    Where this comes from: 89 FR 19735 (Mar 20, 2024), effective May 19, 2024; 38 CFR 4.114 DC 7206

  • No test in the file showing a stricture. The rule says findings must be documented by barium swallow, CT, or EGD.

    Where this comes from: 38 CFR 4.114, DC 7203 Note (1)

  • Worrying an older GERD rating will be cut because of the new rule. VA can't lower a rating just because the schedule changed, unless your condition really improved.

    Where this comes from: 38 U.S.C. 1155

  • Not claiming other symptoms. Problems outside the digestive system (like lung trouble from aspiration) are rated under their own system.

    Where this comes from: 38 CFR 4.114, DC 7203 Note (2)

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. Does food ever feel stuck in your throat or chest? How often?
  2. Do you choke or cough when you eat or drink?
  3. Have you had a scope (EGD) or barium swallow? Do we have the report?
  4. Have you had your esophagus stretched? How many times this year?
  5. Have you lost weight without trying?

Rule changes you may hear about

Today's rules (above) are what VA uses unless a change is final.

  • Final: this is now the rule

    The digestive rules were rewritten. GERD now uses the esophageal stricture criteria. Hiatal hernia (7346) is also rated like stricture (7203).

    Where it stands: FINAL. Published Mar 20, 2024; effective May 19, 2024 (eCFR shows a correction dated May 30, 2024).

    89 FR 19735 (Mar 20, 2024), RIN 2900-AQ90

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.