Since May 19, 2024, VA rates gastroesophageal reflux disease (GERD) under Diagnostic Code 7206, and every compensable level requires a documented history of esophageal stricture, a narrowing of the esophagus confirmed by barium swallow, CT scan or upper endoscopy. Heartburn and daily medication alone no longer reach 10% under the new code. Before you file for an increase, check whether your records document a stricture. If they do not, an increase claim is unlikely to raise your rating, but your current rating is protected from a reduction caused by the schedule change alone.
Should you file? Three facts to check first
- A claim filed now is rated under the 2024 criteria. VA's announcement said claims pending on May 19, 2024 would be considered under both the old and new criteria, with the more favorable applied. The Board of Veterans' Appeals (the Board) has explained that it cannot apply a regulation before its effective date. An increase claim filed today falls entirely under DC 7206.
- Without a documented stricture, the top rating under DC 7206 is 0%. Each compensable level starts with "documented history of" esophageal stricture, and Note (1) says the findings "must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy." In the decision described below, the Board found daily medication documented but no stricture, and concluded the new code would allow only a noncompensable rating.
- An existing rating is protected from a schedule-change reduction. Under 38 C.F.R. § 3.951(a), a readjustment of the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." VA's announcement says a reduction "will only occur if there is improvement in a disability sufficient to warrant a reduction under the former criteria." Any claim can still lead to an exam, and real improvement can still support a reduction, but the new code by itself cannot.
The DC 7206 levels, in short:
| Rating | Documented esophageal stricture, plus |
|---|---|
| 80% | Recurrent or refractory stricture causing trouble swallowing, with aspiration, undernutrition or substantial weight loss, treated with surgery or a feeding tube (PEG tube) |
| 50% | Recurrent or refractory stricture requiring dilation three or more times a year, dilation with steroids at least once a year, or a stent |
| 30% | Recurrent stricture causing trouble swallowing that requires dilation no more than twice a year |
| 10% | Stricture that requires daily medication to control trouble swallowing, otherwise without symptoms |
| 0% | Documented history without daily symptoms or a need for daily medication |
The GERD condition guide covers service connection. If VA has proposed or made a reduction, that is a different question with its own rules; the GERD reduction case study walks through one.
Separate what you observe from what a clinician found
Write down symptoms you know firsthand, such as regurgitation, burning, disrupted sleep, trouble swallowing or food getting stuck, and when they happen. If swallowing is difficult, tell your clinician promptly rather than waiting to build a claims file. Do not label the cause a stricture yourself; the esophageal conditions DBQ is for a clinician to complete.
| Evidence type | What to find | What it can and cannot show |
|---|---|---|
| Your symptom notes | Dates, frequency, trouble swallowing, meals or sleep affected | Your experience, not a diagnosis |
| Visits and prescriptions | Provider notes, medication names, dose changes, response | Treatment history, not proof of a stricture |
| Imaging or endoscopy | The actual report and date, and the clinician's interpretation | A documented finding, if the report states one |
| Procedures | Dilation, stent, surgery or feeding-tube records, if performed | Procedure type and dates |
| Functional effects | Work or meals interrupted, weight discussed with your clinician | Context for the rating |
Do not seek a test or procedure for the sake of a rating. Treatment decisions belong to you and your clinician.
Build a dated treatment-and-symptom timeline
Copy one line per event: date | symptom or test | clinician finding, if any | treatment | response | source file and page. Leave "clinician finding" blank when there is none, and mark estimates as estimates.
Fictional example: "May 8: told primary care that food sometimes sticks when eating bread; referral ordered. June 12: upper endoscopy report in records, page 6; clinician documented a narrowing and planned follow-up. July 2: medication changed; sleep improved, swallowing concern continued." This is a source trail, not a claim that every narrowing meets DC 7206.
VA's increased-claim guidance calls for current evidence of worsening. A timeline makes it easier to find records and to discuss symptoms with your clinician.
A real decision: daily medication without a documented stricture
In Board decision A25094660, October 31, 2025, treatment records and an April 2024 VA exam documented GERD symptoms and daily omeprazole. The record did not show an esophageal stricture documented by barium swallow, CT or endoscopy. VA had assigned 0% under DC 7206.
Because this initial-rating appeal began before the rule change, the Board compared both versions. Under the old criteria (rated by analogy to hiatal hernia, DC 7346), heartburn and regurgitation met the 10% level. Under DC 7206, the Board found only a noncompensable rating was possible, because "there is not a history of esophageal stricture documented by barium swallow, CT, or EGD." It granted 10%, but no higher, under the older criteria for the whole appeal period. A claim filed today would not have that older code available.
| Record | What to copy accurately |
|---|---|
| Prescription or medication list | Drug, dose, dates and the documented reason for treatment |
| Symptom history | What happened, including trouble swallowing if present, and effects on meals or daily tasks |
| Test or procedure report | The actual finding and the clinician's interpretation; leave a missing finding missing |
What Claim Raven's Board data shows for GERD
In Claim Raven's analysis of 2024 to 2025 Board decisions, GERD was a decided issue in 2,248 condition records: 36.7% favorable, 37.4% denied and 25.9% remanded. Among 433 denied GERD records with a classified reason, the most common were no medical link to service (35.1%) and severity criteria not met (23.8%), followed by service connection not shown and no current diagnosis (15.7% each). These are appeals of already-disputed claims, and the GERD label mixes service-connection and rating issues, so the figures describe patterns, not your odds. Claim Raven's statistics page describes how the records were coded. If VA has denied a GERD increase, this guide to reading an increase denial shows how to line the decision up with the criteria.
If you want to put your observed symptoms in writing without claiming the clinician's findings, the free statement builder on this page can help; Claim Raven, which sells claim-preparation tools, makes it.
Sources and scope
Checked September 23, 2026: 38 C.F.R. § 4.114, Diagnostic Code 7206 and 38 C.F.R. § 3.951 (eCFR, current through August 27, 2026); the 2024 digestive system final rule; VA's announcement; the esophageal conditions DBQ; VA evidence guidance; and Board decision A25094660. Whether to file is your decision; an accredited representative can review a complicated effective-date or reduction question.
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