Gastroesophageal Reflux Disease (GERD) (DC 7206)

As of a May 2024 overhaul, GERD has its own diagnostic code (previously rated by analogy to hiatal hernia) and is now rated specifically on documented esophageal stricture severity, not general heartburn or regurgitation symptoms.

Common Filing Mistake

This is a significant, easy-to-miss change: under the current code, straightforward heartburn and regurgitation without a documented esophageal stricture may not support any compensable rating at all, even if your GERD is genuinely bothersome day to day. If your GERD hasn't caused a stricture, ask your provider whether that's actually the right diagnosis to test for, or whether your symptoms might fit better under a different digestive code.

Diagnostic Codes

DC 7206Gastroesophageal reflux disease

Rating Criteria

Rating	Criteria
80%	Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of: aspiration, undernutrition, or substantial weight loss, and treatment with either surgical correction of esophageal stricture(s) or a PEG tube
50%	Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia requiring at least one of: dilatation 3+ times per year, dilatation using steroids at least once per year, or esophageal stent placement
30%	Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia requiring dilatation no more than 2 times per year
10%	Documented history of esophageal stricture(s) requiring daily medication to control dysphagia, otherwise asymptomatic
0%	Documented history without daily symptoms or requirement for daily medications

Special Rules

This is the current criteria effective May 19, 2024. Claims decided under the prior hiatal hernia analogy (DC 7346) used a different, broader symptom picture (epigastric distress, dysphagia, pyrosis, regurgitation); if you were rated before this date, ask whether the older or newer criteria are more favorable to your specific case.
Ratings under most digestive diagnostic codes generally cannot be combined with each other, a single rating reflects the predominant disability.

Sourced from 38 CFR §§ 4.71a / 4.130. This is a reference aid, not a rating decision, your actual rating depends on the medical evidence in your specific case and your C&P exam findings. Rules can be amended, verify current text at eCFR.gov or with an accredited VSO before relying on this for a specific claim.