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VA Disability Rating

VA Disability Rating for GERD / Acid Reflux

GERD and hiatal hernia are rated on symptoms like reflux, regurgitation, and pain, and are a frequent secondary to other conditions and medications.

Diagnostic code 7346 · §4.114 · Digestive system · up to 80%

How the VA rates GERD / Acid Reflux

The VA assigns one of these ratings for Hiatal hernia and paraesophageal hernia, based on the severity of your condition. These criteria are summarized from §4.114:

RatingWhen it applies
80%Symptoms with severe impairment of health. Per § 4.114 (post-2024 revision).
50%Symptoms persistent despite continuous medication, with significant impact on daily living.
30%Symptoms interfere with daily living.
10%Symptoms not controlled, do not interfere with daily living.
0%Symptoms controlled with medication.

Good to know

Rate as esophagus, stricture of (DC 7203)

How to strengthen a GERD / Acid Reflux claim

The rating you receive depends almost entirely on your evidence and your C&P exam. To put your best claim forward:

Peer-Reviewed Research on GERD / Acid Reflux

14 peer-reviewed studies linked to GERD / Acid Reflux (diagnostic code 7346) in the VA Ready app, sourced from PubMed and the U.S. National Library of Medicine. Every citation is real and links to the source — bring them to your C&P exam or hand them to your VSO.

  1. Meta-analysisPrimary2025
    Post-traumatic stress disorder, attention deficit and hyperactivity disorder, and 24 gastrointestinal diseases: Evidence from Mendelian randomization analysis
    Medicine (Baltimore) · 2025
    • Causal effect of PTSD on GERD demonstrated via MR
    • PTSD increases risk of multiple GI conditions including GERD and IBS
    • Robust to sensitivity analyses

    Why it matters: Strengthens causal argument for PTSD-secondary GERD

    View on PubMed ↗
  2. Cohort studyPrimary2024
    Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome
    Biological Psychiatry Global Open Science · 2024
    • GERD ranks among most strongly elevated comorbidities in PTSD
    • Cross-system comorbidity confirmed across multiple EHR networks
    • Effect persists after demographic adjustment

    Why it matters: Population-level support for PTSD-secondary GERD claims

    View on PubMed ↗
  3. Case seriesPrimary2024
    Updates to the modern diagnosis of GERD: Lyon consensus 2.0.
    Gut · 2024
    • Lyon Consensus 2.0 establishes Los Angeles grade B esophagitis as conclusive objective evidence of GERD.
    • Defines diagnostic pathways separating 'unproven' GERD (tested off antisecretory therapy with prolonged wireless or catheter pH monitoring) from 'proven' GERD with persisting symptoms (evaluated with pH-impedance on optimized therapy).
    • Provides updated thresholds for prolonged wireless pH monitoring and parameters for diagnosing refractory GERD; poorly performing criteria were retired.

    Why it matters: Defines the current objective diagnostic standard and severity grading for GERD, useful for substantiating a documented, medically confirmed diagnosis rather than self-reported symptoms.

    View on PubMed ↗
  4. Cohort studyPrimary2023
    Assessment of Post-traumatic Stress Disorder Among Objective Esophageal Motility and Reflux Phenotypes in Symptomatic Veterans
    Journal of Clinical Psychology in Medical Settings · 2023
    • PTSD significantly associated with functional esophageal disorders in veterans
    • Veterans with PTSD more likely to have reflux hypersensitivity and functional heartburn than true GERD
    • Symptom severity overlapped between true GERD and functional phenotypes with PTSD

    Why it matters: Supports service connection linkage between PTSD and GERD-spectrum esophageal disease

    View on PubMed ↗
  5. Cross-sectionalPrimary2023
    Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases
    Neurogastroenterology and Motility · 2023
    • Medical PTSD symptoms prevalent in chronic esophageal disease including GERD
    • Esophageal symptom flares correlate with traumatic stress responses
    • Bidirectional mind-gut relationship documented

    Why it matters: Peer-reviewed nexus between trauma-related stress and chronic GERD

    View on PubMed ↗
  6. Meta-analysisPrimary2023
    Investigating the shared genetic architecture of post-traumatic stress disorder and gastrointestinal tract disorders: a genome-wide cross-trait analysis
    Psychological Medicine · 2023
    • Significant shared genetic architecture between PTSD and GERD
    • Mendelian randomization supports causal effect of PTSD on GERD risk
    • Shared loci identified across PTSD and multiple GI disorders

    Why it matters: Provides biological mechanism for PTSD-GERD secondary service connection

    View on PubMed ↗
  7. Cross-sectionalPrimary2021
    Prevalence of gastrointestinal disease in US Military Veterans under outpatient care at the Veterans Health Administration.
    SAGE Open Med · 2021
    • Retrospective VA patient-record analysis examined the prevalence of common GI diseases (including GERD, peptic ulcer disease, IBS, functional dyspepsia) among US veterans in VHA outpatient settings.
    • GI disease prevalence among veterans varied by their period of military service.
    • Study notes no prior reliable estimates existed for GI disease prevalence in US veterans and calls for further comparison to the general population.

    Why it matters: Directly documents that GERD is among the common GI conditions treated in the VA outpatient system, supporting how frequently veterans present with this condition.

    View on PubMed ↗
  8. Meta-analysisPrimary2020
    Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis.
    Sci Rep · 2020
    • Global pooled prevalence of GERD was 13.98%, estimated at approximately 1.03 billion people worldwide.
    • Prevalence varied by region, highest in North America (19.55%) and lowest in Latin America/Caribbean (12.88%), and by country (4.16% China to 22.40% Turkey).
    • Multiple risk factors associated with significantly increased GERD risk were identified across the pooled studies.

    Why it matters: Independently corroborates the very high worldwide prevalence of clinically defined GERD, with North America among the highest rates, underscoring how common the condition is in the US veteran-eligible population.

    View on PubMed ↗
  9. Cohort studyPrimary2019
    Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks
    Environmental Health · 2019
    • GERD persistently elevated in trauma-exposed responders and survivors
    • Significant overlap between PTSD and chronic GERD years post-exposure
    • Inhalational and psychological exposures both linked to GERD

    Why it matters: Analog cohort supporting deployment-related chronic GERD

    View on PubMed ↗
  10. ReviewPrimary2019
    Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease.
    Med Clin North Am · 2019
    • PPI-refractory GERD is defined as troublesome GERD symptoms persisting despite optimized PPI therapy for at least 8 weeks with ongoing documented pathologic reflux.
    • It arises from dysfunction in anti-reflux protective systems and propagation of physiologic reflux events.
    • Management requires personalized pharmacologic, invasive, and endoluminal options matched to the patient's mechanistic dysfunction.

    Why it matters: Documents that a defined subset of GERD remains symptomatic despite maximal medication, directly supporting persistence of impairment relevant to higher rating levels.

    View on PubMed ↗
  11. ReviewPrimary2017
    The natural history of gastro-esophageal reflux disease: a comprehensive review.
    Dis Esophagus · 2017
    • GERD comprises two main forms, erosive reflux disease and non-erosive reflux disease (NERD), with NERD making up to 70% of patients.
    • Progression from NERD to erosive disease, from mild to severe erosive disease, and from erosive disease to Barrett's esophagus occurs in a minority of patients (ranging 0-30%, 10-22%, and 1-13% respectively).
    • Natural-history data are strongly influenced by widespread PPI use, and direct/indirect costs of GERD diagnosis, treatment, and surveillance have risen.

    Why it matters: Characterizes the long-term course and complication risk of GERD, including progression to the pre-cancerous Barrett's esophagus, informing prognosis and severity for disability evaluation.

    View on PubMed ↗
  12. Meta-analysisSupporting2024
    A systematic review and meta-analysis of the efficacy of vonoprazan for proton pump inhibitor-resistant gastroesophageal reflux disease.
    J Gastroenterol Hepatol · 2024
    • Up to 40% of GERD patients experience inadequate symptom relief on a proton pump inhibitor (PPI-resistant/refractory GERD).
    • Vonoprazan 20 mg achieved healing of PPI-resistant erosive esophagitis in 91.7% at 4 weeks and 88.5% at 8 weeks, with maintenance up to 93.8% at 48 weeks.
    • Symptom (FSSG) improvement was more modest at 74.6% (week 4) and 51.9% (week 8); no serious adverse events were reported.

    Why it matters: Quantifies that a large share of GERD patients fail standard PPI therapy, supporting that GERD symptoms commonly persist despite treatment and require escalation.

    View on PubMed ↗
  13. Meta-analysisSupporting2023
    Association between obstructive sleep apnea and gastroesophageal reflux disease: A systematic review and meta-analysis.
    J Gastroenterol Hepatol · 2023
    • A statistically significant association exists between obstructive sleep apnea and GERD (OR 1.53, P=0.0001).
    • The association persisted across diagnostic tools and after controlling for gender, BMI, smoking, and alcohol (sensitivity ORs 1.45-1.81).
    • Presence of GERD did not worsen OSA severity metrics (AHI, sleep efficiency, oxygen desaturation, Epworth score).

    Why it matters: Establishes a robust comorbid link between GERD and obstructive sleep apnea, a frequently co-claimed veteran condition, supporting secondary-condition and comorbidity arguments.

    View on PubMed ↗
  14. ReviewSupporting2018
    Chemoprevention of Barrett's Esophagus and Esophageal Adenocarcinoma.
    Dig Dis Sci · 2018
    • Barrett's esophagus is common in Western countries but progression to esophageal adenocarcinoma is uncommon, drawing largely on case-control and cohort data.
    • Once-daily PPI therapy is recommended for Barrett's esophagus patients, with twice-daily PPI reserved for poorly controlled reflux symptoms or esophagitis.
    • Aspirin/NSAID use is inversely associated with esophageal adenocarcinoma by reducing neoplastic progression, but routine use is not warranted given low progression risk and bleeding/stroke harms.

    Why it matters: Frames GERD's most serious downstream complications (Barrett's esophagus and esophageal adenocarcinoma) and their management, relevant to complication-based severity and secondary-condition claims.

    View on PubMed ↗

Citations are provided for general educational use and are not medical advice. The VA Ready app pairs every study with its key findings and a one-tap Claim Summary PDF appendix.

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Common questions

What is the VA rating for GERD / Acid Reflux?

The VA rates Hiatal hernia and paraesophageal hernia under diagnostic code 7346 (§4.114). Ratings run up to 80%, assigned from the criteria in the table above based on the severity of your condition.

What diagnostic code does the VA use for GERD / Acid Reflux?

Diagnostic code 7346, rated under §4.114 of the VA Schedule for Rating Disabilities.

This page is for general informational purposes only and is not legal or medical advice. Rating criteria are summarized from 38 CFR Part 4; the VA determines actual ratings based on your evidence and exam. VA Ready is not affiliated with the U.S. Department of Veterans Affairs. Always verify current criteria at VA.gov and consult a VA-accredited representative.