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The VA has announced significant updates to its disability rating system, including the introduction of a new Diagnostic Code (DC) 7206 specifically for Gastroesophageal Reflux Disease (GERD) and related conditions.

Introduction of DC 7206 for GERD Previously, GERD was rated analogously to Hiatal Hernia under DC 7346, with potential ratings of 10%, 30%, or 60%, based on symptom frequency, severity, and duration. Under the new rule, GERD will be rated using DC 7206 and evaluated as Esophageal Stricture under DC 7203, with new rating levels of 0%, 10%, 30%, 50%, or 80%.

Concerns About the New Rating Criteria The new criteria focus on symptoms of esophageal obstruction and irritation. However, this change is controversial. The new ratings for GERD emphasize “esophageal stricture,” or difficulty swallowing, and may not adequately reflect the common symptoms experienced by many veterans with GERD, such as:

  • Heartburn, especially after eating or at night
  • Chest pain
  • Difficulty eating and swallowing
  • Regurgitation of food or sour liquid
  • Sensation of a lump in the throat

Nighttime GERD symptoms might include chronic cough, laryngitis, new or worsening asthma, disrupted sleep, and insomnia. Many veterans are concerned that this shift could lead to lower disability ratings for GERD under the new system.

Effective Date and Implications The new rating criteria for GERD will take effect on May 19, 2024. Veterans are encouraged to submit their GERD claims as soon as possible to be rated under the current system. Importantly, veterans who already have a VA rating for GERD will be “grandfathered in” and will not be affected by these new updates.

Key Takeaways

  • New DC 7206 introduced for GERD, effective May 19, 2024.
  • GERD will now be rated under DC 7203 for Esophageal Stricture.
  • Concerns about the adequacy of the new criteria in reflecting common GERD symptoms.
  • Veterans with existing GERD ratings will not be impacted by the changes.
  • Urgency for new claims to be filed before the effective date to be rated under the old system.

For more detailed information on these changes and how they may affect your VA disability rating, be sure to consult with us by scheduling a free consultation.

Rate GERD Under DC 7203, Esophagus, Stricture of:

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)

80%

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilation 3 or more times per year, (2) dilation using steroids at least one time per year, or (3) esophageal stent placement

50%

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

30%

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

10%

Documented history without daily symptoms or requirement for daily medications

0%

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 dilation sessions performed at 2-week intervals

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[Download] the Official Ruling VA Rating Changes for GERD