GERD is one of the most commonly claimed digestive conditions among veterans, and one of the most commonly rated at 0%. The condition is real, the diagnosis is usually solid, and the rating still comes back non-compensable. The reason is almost always the same, and it is fixable.
There Is No Diagnostic Code for GERD
Nothing in 38 CFR 4.114 is titled GERD. Under 38 CFR 4.20, a condition without its own code is rated by analogy to a closely related listed condition. Historically the VA used Diagnostic Code 7346 for hiatal hernia. Following the 2024 revision of the digestive system schedule, reflux is rated under Diagnostic Code 7206 for gastroesophageal reflux disease.
The Rating Tiers
| Rating | Criteria | 2026 pay (no dependents) |
|---|---|---|
| 50% | Severe symptoms with documented weight loss, anemia, or hematemesis productive of severe impairment of health | $1,132.90 |
| 30% | Recurrent aspiration, esophageal stricture, or persistently recurrent epigastric distress with substernal pain productive of considerable impairment of health | $552.47 |
| 10% | Recurrent pyrosis, reflux, or regurgitation two or more times per week not controlled by medication | $180.42 |
| 0% | Documented GERD with symptoms controlled and no functional impact | $0 |
The Medication Trap
Read the 10% criterion again: symptoms not controlled by medication. If your treatment notes say reflux is well controlled on omeprazole and nothing else, a rater has a written basis for 0%. Veterans lose compensable ratings here constantly, and the fix is accurate reporting, not stopping treatment.
- Report breakthrough symptoms. How often do you still get reflux despite the PPI?
- Report what happens when you miss a dose or run out between refills.
- Report dietary restriction. Foods you avoid entirely and sleeping propped up are functional impact.
- Report nighttime symptoms, including waking with acid in your throat or coughing.
- Report rescue antacid use layered on top of your prescription.
Under Jones v. Shinseki, the VA generally may not deny a compensable rating solely because medication relieves symptoms where the rating criteria do not mention medication. Where the criteria do mention it, as here, your record must show what the medication does not fix.
Secondary Service Connection: The Main Path In
Most veterans do not get GERD directly service-connected. They get it under 38 CFR 3.310 as secondary to something already rated:
- PTSD, anxiety, and depression. Chronic stress measurably worsens reflux, and this is the most frequently granted GERD secondary claim in the system.
- NSAID use for musculoskeletal pain. Long-term ibuprofen, naproxen, and meloxicam prescribed for a service-connected back, knee, or shoulder condition damage the gastric lining.
- Sleep apnea. Nighttime reflux and airway obstruction reinforce each other, and the relationship runs in both directions.
- IBS and other digestive conditions already service-connected.
Evidence That Actually Wins
Get a real diagnosis rather than self-reported heartburn: an upper endoscopy, EGD, barium swallow, or pH monitoring study. Then build the frequency record, because the criteria are symptom-driven. Weight loss, anemia, dysphagia, and esophageal stricture are what move a file from 10% toward 30% or 50%, so make sure those findings are in your records if they exist.
What GERD Can Support Downstream
Once GERD is service-connected, it opens its own secondary claims: Barrett's esophagus, dental erosion from stomach acid, chronic laryngitis and sinusitis from laryngopharyngeal reflux, and sleep impairment. Each needs its own diagnosis and nexus, but the door is only open once the GERD itself is connected.
See how sleep apnea is rated and how it interacts with reflux.