HIATAL HERNIA

B.T. KNOPE · 2026 · Case ID: A26039838

DENIED

Summary

The veteran, who served in the Army from April 1998 to March 2005, including service in the Global War on Terrorism, appeals the denial of an increased disability rating for his service-connected gastroesophageal reflux disease (GERD). The veteran was initially granted service connection for GERD in June 2024, rated as noncompensable. In a subsequent April 2025 Higher-Level-Review decision, the Regional Office assigned a 10 percent rating. The veteran contends he is entitled to a rating higher than 10 percent, specifically seeking a 30 percent rating. The Board reviewed medical evidence, including VA examinations from June and October 2024. Both examinations diagnosed GERD and hiatal hernia, noting the veteran's symptoms were not of daily severity and did not require daily medication. The October 2024 examiner opined that the GERD symptoms did not cause considerable or severe impairment of health, nor did they result in recurrent epigastric distress or significant sleep problems. The Board considered the veteran's lay testimony describing burning sensations and stomach pain impacting his life and sleep, but found it did not rise to the level of "considerable impairment" as required for a higher rating. The Board also noted the recent revision to the Schedule for Rating Disabilities, creating Diagnostic Code 7206 specifically for GERD, but found the existing criteria under the older code (DC 7399-7346) were not met. The Board concluded that the evidence did not support a rating in excess of 10 percent, as the veteran's symptoms did not demonstrate considerable impairment of health. Therefore, the appeal for an increased rating for GERD was denied.

Rationale

Veteran's GERD symptoms did not meet criteria for 30% rating.; Examiners noted no daily symptoms or requirement for daily medication.; Symptoms did not result in considerable impairment of health.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250716-566097

Full Decision Text

Citation Nr: A26039838
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 250716-566097
DATE: April 28, 2026

ORDER

Entitlement to a rating in excess of 10 percent for gastroesophageal reflux disease (GERD), is denied.

FINDING OF FACT

The Veteran has two or more symptoms of GERD which do not result in considerable or severe impairment of health, and to date are of less severity that those anticipated by the 30 percent rating.

CONCLUSION OF LAW

The criteria for a disability rating in excess of 10 percent for service-connected GERD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.21, 4.114, DC 7399-7346.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the Army, on active duty from April to August 1998, September 1 to 2, 1998, and from January 2004 to March 2005. His awards include the Global War on Terrorism Expeditionary Medal, among others.

This claim comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 raring decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This decision was issued following the Veteran's submission of a Higher-Level-Review (HLR), following a December 2024 rating decision. As noted in the rating decision on appeal, the evidentiary window closed at the time of the December 2024 rating decision.

In July 2025, the Veteran submitted a timely VA Form 10182, electing the direct review lane. As the April 2025 HLR rating decision on appeal considered the evidence of record as of the December 2024 rating decision, the Board may only consider the available evidence of record at the time of the December 2024 rating decision. If the Veteran submitted any evidence after the December 2024 rating decision, the Board has not considered it in this decision.

Increased Ratings

Disability ratings are determined by the application of a schedule of ratings, which is based on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The Veteran's entire history is reviewed when making disability evaluations. See generally Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 4.1. Where the question for consideration is the propriety of the initial evaluation assigned, consideration of the medical evidence since the effective date of the award of service connection is required. See Fenderson v. West, 12 Vet. App. 199, 125-26 (1999). Where entitlement to compensation already has been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Further, "[w]here there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned." 38 C.F.R. § 4.7.

The terms "mild," "moderate" and "severe" are not defined. Rather than applying a mechanical formula, the Board must evaluate all the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. Use of terminology such as "mild" or "severe" by VA examiners and others, although evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6.

Entitlement to a rating in excess of 10 percent for gastroesophageal reflux disease (GERD)

The Veteran contends that he is entitled to a rating in excess of 10 percent for his service connected GERD. The Board finds that the claim should be denied.

The Veteran was granted service connection for his GERD in a June 2024 rating decision, rated as noncompensable from October 23, 2023, under DC 7399-7346. In the April 2025 HLR rating decision on appeal, the RO granted a 10 percent rating from the date of his service connection claim. As such, the period on appeal begins on that date. Moreover,
.2, 4.6.

Entitlement to a rating in excess of 10 percent for gastroesophageal reflux disease (GERD)

The Veteran contends that he is entitled to a rating in excess of 10 percent for his service connected GERD. The Board finds that the claim should be denied.

Hyphenated Diagnostic Codes are used when a rating under one code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. 38 C.F.R. § 4.27. In this matter, GERD is not specifically addressed by the diagnostic code. However, DC 7399 refers to a disability of the digestive system, and DC 7346 rates by analogy to symptoms associated with a hiatal hernia. Based on the symptoms reported in the record, this is the most appropriate rating criteria allowable under the diagnostic criteria.

Under the applicable rating criteria:

" A 10 percent rating is assigned for two or more symptoms of the 30 percent evaluation of less severity;

" A 30 percent rating is assigned for persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health;

" A 60 percent rating is assigned for symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptoms productive of severe impairment of health.

38 C.F.R. § 4.114, DC 7346.

The criteria under DC 7346 are conjunctive, not disjunctive, thus all criteria must be met. See Melson v. Derwinski, 1 Vet. App. 334, 337 (1991) (use of the conjunctive "and" in a statutory provision meant that all the conditions listed in the provision must be met).

While the term "considerable impairment of health" is not defined in the rating criteria, considerable is generally described as "large in extent or degree." MERRIAM-WEBSTER's COLLEGIATE DICTIONARY 787 (11th ed. 2003). Thus, the Board will review the evidence to determine whether the Veteran's GERD symptoms resulted in a large degree of health impairment.

In assigning a rating under Diagnostic Code 7346, the Board may not consider the ameliorative effects of medication. See Jones v. Shinseki, 26 Vet. App. 56, 63 (2012).

During the course of this appeal, revisions to the Schedule for Rating Disabilities created a new diagnostic code, Diagnostic Code 7206, specifically for GERD. 89 Fed. Reg. 19,735 (Mar. 20, 2024). In sum, the old and new regulations are both for consideration with regard to rating the Veteran's disability, and the more favorable regulation will be applied, with the exception that if the revised criteria are more favorable to the Veteran and provide for an increased rating, that award may not be made effective before the effective date of the regulatory change. See 38 U.S.C. § 5110 (g); VAOPGCPREC 3-00; Landgraf v. USI Film Products, 511 U.S. 244 (1994); Karnas v. Derwinski, 1 Vet. App. 308 (1991); Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

Under the amended criteria for DC 7206:

" a noncompensable rating is warranted for a documented history of GERD without daily symptoms or requirement for daily medications;

" a 10 percent rating is warranted for documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic;

" a 30 percent rating is warranted for documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilation no more than 2 times per year.

38 C.F.R. § 4.114, DC 7206.

" a 10 percent rating is warranted for documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic;

" a 30 percent rating is warranted for documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilation no more than 2 times per year.

38 C.F.R. § 4.114, DC 7206.

Therefore, the question before the Board is whether the Veteran's GERD symptoms result in either (1) persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health, and/or from May 19, 2024, (2) persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. Either of these findings would result in a higher rating.

Analysis

Turning to the medical evidence of record, the Veteran was afforded a VA examination in June 2024. Here, he was diagnosed with GERD and hiatal hernia. He reported heartburn, and is prescribed omeprazole as needed, which he described as twice per week when he eats spicy food. Upon examination, the VA examiner noted his GERD with hiatal hernia manifested without daily symptoms, and without requirement for daily medication. The examiner noted no tumors, neoplasms or other physical symptoms. Overall, the June 2024 VA examiner opined that his GERD symptoms caused no functional impairment.

Next, the Veteran underwent another VA examination in October 2024. Here, he described a burning sensation when eating spicy foods, especially Taco Bell. Further, he reported occasional burning sensations in his chest. The examiner noted he was prescribed omeprazole everyday as needed for his stomach. However, upon examination, the clinician noted GERD without daily symptoms or requirement for daily medication. Moreover, the clinician noted he exhibited no other physical symptoms. While he had infrequent episodes of burning sensation and rarely had substernal pain, he presented with no recurrent epigastric distress and no sleep problems or weight loss. Overall, the October 2024 VA examiner opined his symptoms were not productive of considerable impairment, nor did they cause functional impairment.

In light of the above, the Board finds that a rating in excess of 10 percent is not supported for GERD during the period on appeal. While the Veteran has shown some symptoms of GERD, there is no evidence that these symptoms have resulted in any considerable or severe impairment of health. Indeed, the October 2024 VA examiner opined that his symptoms did not cause considerable or severe impairment. He has not required hospitalization or surgical treatment due to his condition. While there is some substernal pain and reflux, the Board finds that this is not indicative of "considerable" impairment of health.

In considering the appropriate disability ratings, the Board has also considered the Veteran's statements that his GERD is worse than the rating he currently receives. Specifically, in August 2024 lay testimony, he described feeling burning sensation, something being stuck in his throat and stomach pain that significantly impacts his life. Further, he reported that these symptoms cause him trouble sleeping. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of his disabilities according to the appropriate diagnostic codes. Rucker v. Brown, 10 Vet. App. 67, 74 (1997).

On the other hand, such competent evidence concerning the nature and extent of the Veteran's GERD symptoms have been provided by the medical personnel who have examined him during the current appeal and have rendered pertinent opinions in conjunction with the evaluations. The medical findings, as provided in the examination report, directly address the criteria under which his GERD is evaluated.

Overall, the evidence of record does not indicate that the Veteran's GERD symptoms were of such frequency and severity to warrant a 30 percent rating. Specifically, the Board determines that his symptoms were not productive of considerable impairment of health. In other words, his GERD symptoms did not impair his health to a large extent and/or degree. Moreover, from May 19, 2024, his symptoms did not result in documented history of recurrent esophageal stricture causing dysphagia which requires dilatation no more than two times per year. While the Board acknowledges some impairment, the evidence taken as a whole, does not show considerable health impairment. Indeed, he did not report any nutrient deficiency or weight loss, despite having to monitor his food intake at times. While there was some impact to his sleep hygiene
symptoms were of such frequency and severity to warrant a 30 percent rating. Specifically, the Board determines that his symptoms were not productive of considerable impairment of health. In other words, his GERD symptoms did not impair his health to a large extent and/or degree. Moreover, from May 19, 2024, his symptoms did not result in documented history of recurrent esophageal stricture causing dysphagia which requires dilatation no more than two times per year. While the Board acknowledges some impairment, the evidence taken as a whole, does not show considerable health impairment. Indeed, he did not report any nutrient deficiency or weight loss, despite having to monitor his food intake at times. While there was some impact to his sleep hygiene, his testimony indicates, in the Board's view, that it was not to the frequency and severity that would show it to a large degree. Moreover, his VA treatment records do not contain any significant complaints related to GERD, and there are no reported surgeries or hospitalizations regarding this disorder. As such, the Board finds the evidence is persuasively against finding that his GERD symptoms were productive of considerable impairment of health.

Based on the foregoing, the Board determines that an increased rating for the Veteran's GERD is not warranted, and the appeal is denied. 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.

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board McDonald, Thomas K.

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