Home › Conditions › GERD (Acid Reflux)
Gastroesophageal reflux disease — chronic heartburn and regurgitation — is now rated by esophageal stricture and swallowing difficulty under the 2024 digestive schedule. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 7206, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates gerd (acid reflux) in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.114). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 7206 — Gastroesophageal reflux disease (rated on esophageal stricture)
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 80% | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of: aspiration, undernutrition, and/or substantial weight loss as defined by § 4.112(a), and treatment with either surgical correction of esophageal stricture(s) or PEG tube |
| 50% | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires dilatation 3 or more times per year, dilatation using steroids at least one time per year, or esophageal stent placement |
| 30% | Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year |
| 10% | Documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic |
| 0% | Documented history without daily symptoms or requirement for daily medications |
Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy (EGD).
Since the May 2024 digestive-system rewrite, GERD is rated by stricture/dysphagia, not by heartburn frequency. Hiatal hernia is rated under DC 7346; symptoms that are really IBS or functional dyspepsia go to DC 7319.
Honest ceiling: 30% for persistent symptoms with weight loss or anemia.
What the C&P examiner measures
The 2024 esophageal DBQ asks about dysphagia (trouble swallowing), documented strictures, dilatation procedures, aspiration, weight loss and daily medication. If you have had an EGD or barium swallow, bring the report — the rating turns on documented findings.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Do you ever get that burning that comes up the back of your throat?
- Do you sleep propped up, or does lying flat make it worse?
Service connection: presumptive, direct, or secondary
No presumption. GERD is most often claimed secondary to long-term NSAID use for a service-connected orthopedic condition, to psychiatric medications, or to PTSD/anxiety itself; direct claims rest on in-service treatment for reflux or gastritis.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.
What the medical literature says
Bjarnason I. et al., Gastroenterology 154(3):500-14 (2018) — Mechanisms of damage to the gastrointestinal tract from NSAIDs
NSAIDs damage the upper GI tract through well-described mechanisms. Why it matters: GERD secondary to NSAIDs taken for a service-connected condition.
Ing A.J. et al., American Journal of Medicine 108(4a):120S-125S (2000) — Obstructive sleep apnea and gastroesophageal reflux
OSA patients show higher GER prevalence; most reflux episodes were temporally related to apneas. Why it matters: GERD secondary to service-connected OSA.
Why gerd (acid reflux) claims get denied — and the fix
- Rated 0 or 10 percent under the 2024 stricture-based criteria because no EGD/barium swallow documents a stricture — the findings must be documented.
- Secondary-to-medication claim without a pharmacy record showing years of NSAID or SSRI use.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for gerd (acid reflux)?
GERD (Acid Reflux) is rated under diagnostic code 7206 (§ 4.114) at 0%, 10%, 30%, 50%, 80%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for gerd (acid reflux)?
The highest schedular rating available is 80%. Typical grants land around 10%, but every case is decided on its own evidence.
Is gerd (acid reflux) a presumptive condition?
No presumption. GERD is most often claimed secondary to long-term NSAID use for a service-connected orthopedic condition, to psychiatric medications, or to PTSD/anxiety itself; direct claims rest on in-service treatment for reflux or gastritis.
Do I need a nexus letter for gerd (acid reflux)?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.