Back to BVA DecisionsDENIEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 250519-545172
HIATAL HERNIA
D. SMART · 2026 · Case ID: A26038765
Summary
The veteran, who served from September 1997 to August 2002, appeals the denial of an increased disability rating for gastroesophageal reflux disease (GERD). The claim is for a rating higher than the 10 percent currently assigned. The Board reviewed evidence from August and October 2023, including VA examinations, treatment notes, and lay statements, but limited its review to evidence of record before the December 2024 agency decision. The veteran reported symptoms including heartburn, acid reflux, regurgitation, and a feeling of a lump in his throat, treating with over-the-counter medications. VA examiners noted reflux, regurgitation, substernal pain, and sleep disturbance but found no esophageal strictures and no considerable or severe impairment of health, nor any functional impact on work. The Board found the veteran's GERD manifested with two or more symptoms for the 10 percent evaluation under Diagnostic Code 7346 (hiatal hernia, by analogy) as no esophageal stricture was documented and the symptoms did not meet the criteria for a higher rating. The Board noted that new GERD criteria (Diagnostic Code 7206) became effective May 19, 2024, but applied pre-amendment criteria as the claim was filed before that date. The Board denied the claim for an increased rating.
Rationale
No esophageal stricture documented; Symptoms did not meet criteria for considerable impairment of health; No functional impact on work noted by examiners
Full Decision Text
Citation Nr: A26038765 Decision Date: 04/27/26 Archive Date: 04/27/26 DOCKET NO. 250519-545172 DATE: April 27, 2026 ORDER Entitlement to a disability rating in excess of 10 percent for gastroesophageal reflux disease (GERD) is denied. FINDING OF FACT The Veteran's GERD did not manifest with esophageal stricture or with persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. CONCLUSION OF LAW The criteria for entitlement to a disability rating in excess of 10 percent for GERD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.21, 4.114, Diagnostic Codes 7206, 7346. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from September 1997 to August 2002. The issues are on appeal from a rating decision issued in December 2024. The Veteran submitted a notice of disagreement in May 2025 electing the direct review lane. Therefore, the Board may only consider the evidence of record at the time of the December 2024 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Entitlement to a disability rating in excess of 10 percent for GERD. The Veteran is seeking a higher rating due to the severity of his symptoms. The Veteran's GERD is rated by analogy to 38 C.F.R. § 4.114, Diagnostic Code 7346, for hiatal hernia. Pursuant to Diagnostic Code 7346, a 10 percent disability rating is warranted for two or more of the symptoms for the 30 percent evaluation of less severity. A 30 percent evaluation is warranted for persistently recurring epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A maximum 60 percent evaluation is warranted for symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health. The Board notes that Diagnostic Code 7346 does not provide definitions for the terms "considerable" and "severe." As such, the Board will use general dictionary definitions. "Considerable" is defined as "large in extent or degree." Merriam-Webster's Collegiate Dictionary 267 (11th ed. 2012). "Severe" is defined as "very painful or harmful." Id. at 1140. Effective May 19, 2024, VA amended the schedule of ratings for the digestive system and created Diagnostic Code 7206 for GERD. Prior to May 19, 2024, GERD did not have its own Diagnostic Code and VA often rated it by analogy to hiatal hernia under Diagnostic Code 7346. Further, effective May 19, 2024, VA amended Diagnostic Code 7346 for hiatal hernia, and now directs VA adjudicators to rate such disabilities pursuant under Diagnostic Code 7203 for stricture of the esophagus. Diagnostic Code 7203's rating criteria mirror those presented in the new Diagnostic Code 7206. Under the new criteria, to receive a disability rating in excess of 10 percent, the evidence must show documented history of recurrent esophageal stricture(s) causing dysphagia, which requires dilation no more than 2 times per year. Note (1): Findings must be documented by barium swallow computerized tomography or esophagogastroduodenoscopy. 38 C.F.R. § 4.114, Diagnostic Code 7206. The period on appeal begins , and now directs VA adjudicators to rate such disabilities pursuant under Diagnostic Code 7203 for stricture of the esophagus. Diagnostic Code 7203's rating criteria mirror those presented in the new Diagnostic Code 7206. Under the new criteria, to receive a disability rating in excess of 10 percent, the evidence must show documented history of recurrent esophageal stricture(s) causing dysphagia, which requires dilation no more than 2 times per year. Note (1): Findings must be documented by barium swallow computerized tomography or esophagogastroduodenoscopy. 38 C.F.R. § 4.114, Diagnostic Code 7206. The period on appeal begins on July 21, 2023, the date of service connection. As the Veteran's claim was filed before May 19, 2024, the Board must apply both the pre- and post-amendment rating criteria, whichever is more favorable to the claimant. However, if the post-amendment criteria are more favorable to the claimant, the award based on the post-amendment criteria may not be made effective before May 19, 2024. For the reasons that follow, the Veteran's GERD manifested with two or more symptoms for the 30 percent evaluation of less severity. The Board notes that it has reviewed all the evidence in the record relevant to the period on review. This includes VA examinations from August 2023 and October 2023, as well as the Veteran's treatment notes and lay statements. Although the Board has an obligation to provide adequate reasons and bases supporting its decision, there is no requirement that the Board discuss every piece of evidence in the record. Hence, the Board will summarize the relevant evidence, as deemed appropriate, and the Board's analysis will focus on what the evidence shows, or fails to show, as to the claims. See Gonzalez v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). The Veteran reported heartburn, acid reflux, regurgitation of stomach contents into his throat, and a feeling like there is a lump in his throat with frequent coughing every other day. He treats his GERD with over-the-counter medication such as Tums, Rolaids, and Prilosec. He avoids certain foods. If he lies down soon after eating, the regurgitation starts and gets worse until he sits up. He also noted pain in the middle of his chest when his GERD flared up. The examiners noted reflux, regurgitation, substernal pain, and sleep disturbance. Persistently recurrent epigastric distress, dysphagia, pyrosis, material weight loss, nausea, vomiting, hematemesis, or melena with moderate anemia. The examiners did not find any symptoms productive of considerable or severe impairment of health. The examiners also found no esophageal strictures. The examiners noted no functional impact on the Veteran's ability to work. The Veteran has reported self-treatment with over the counter medication, burning in his chest and throat, with gagging. The Veteran's treatment records are silent for any additional complaints or treatment of GERD. At no point did any treating doctor find that his GERD was causing impairment of health and at no point did the Veteran require prescription medication or additional treatment for his GERD. The Board notes that the Veteran has reported sleep disturbance due to his GERD. The Board notes that the Veteran's sleep symptoms are addressed and considered under his service-connected sleep apnea and psychiatric disabilities. The sleep symptoms are not addressed in the consideration of his GERD. He noted some weight loss. The Veteran is competent to report readily observable symptoms. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board has acknowledged and addressed the Veteran's lay reports of symptoms of GERD. Even with the Veteran's lay reports, the Veteran did not experience dysphagia and the Veteran's symptoms did not result in considerable impairment of health. Additionally, no treatment or lay records show esophageal stricture. Accordingly, the Veteran's GERD manifested in two or more symptoms for the 30 percent evaluation of less severity throughout the appeal period, corresponding to the criteria for a 10 percent rating under Diagnostic Code 7346. A higher 30 percent rating under Diagnostic 7346 is not warranted unless there is persistently recurring epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A higher rating is also not warranted under Diagnostic Code 7206 not experience dysphagia and the Veteran's symptoms did not result in considerable impairment of health. Additionally, no treatment or lay records show esophageal stricture. Accordingly, the Veteran's GERD manifested in two or more symptoms for the 30 percent evaluation of less severity throughout the appeal period, corresponding to the criteria for a 10 percent rating under Diagnostic Code 7346. A higher 30 percent rating under Diagnostic 7346 is not warranted unless there is persistently recurring epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A higher rating is also not warranted under Diagnostic Code 7206 as no esophageal stricture was shown. Thus, the Veteran's GERD did not more nearly approximate the criteria for a disability rating in excess of 10 percent for his GERD and the claim must be denied. D. SMART Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Veresink, Patricia The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.