GASTROESOPHAGEAL REFLUX DISEASE (GERD)

S. HENEKS · 2026 · Case ID: A26040161

DENIED

Summary

The veteran, who served from June 2011 to October 2014, appeals the denial of a higher rating for GERD and a compensable rating for allergic rhinitis. Regarding GERD, the veteran sought an increased rating beyond the 10 percent evaluation. The Board reviewed the criteria under DC 7206, which requires documented recurrent esophageal strictures causing dysphagia for higher ratings. The veteran reported severe GERD symptoms, including indigestion, chest pain, regurgitation, vomiting, sleep disturbance, and difficulty concentrating. VA examinations noted these symptoms and diagnosed GERD, but found no esophageal strictures. The Board concluded that the veteran's GERD did not meet the criteria for a higher rating, as there was no documented history of recurrent esophageal strictures requiring dilatation. For allergic rhinitis, the veteran sought a compensable rating under DC 6522. VA examinations found no nasal polyps, no significant nasal obstruction, and no impact on work. The Board found the veteran did not meet the criteria for a 10 percent rating, as there was no evidence of polyps or significant obstruction. The Board also noted that the benefit-of-the-doubt doctrine did not apply as the evidence was not in approximate balance. Therefore, both claims were denied.

Rationale

No documented history of recurrent esophageal stricture causing dysphagia; Veteran's symptoms did not meet criteria for higher rating; Evidence did not reflect inability to work due to GERD severity

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

7206

Docket No.

251218-615355

Full Decision Text

Citation Nr: A26040161
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 251218-615355
DATE: April 29, 2026

ORDER

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

Entitlement to a compensable disability rating for allergic rhinitis is denied.

FINDINGS OF FACT

1. The Veteran's GERD is not productive of a documented history of recurrent esophageal stricture(s) causing dysphagia.

2. The Veteran is not shown to have polyps, or greater than 50 percent obstruction of the nasal passage on both sides, or complete obstruction of nasal passage on one side.

CONCLUSIONS OF LAW

1. The criteria for a disability rating higher than 10 percent for GERD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.114, Diagnostic Code (DC) 7206.

2. The criteria for a compensable disability rating for allergic rhinitis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.97, Diagnostic Code (DC) 6522.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 2011 to October 2014.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a December 2024 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In December 2025 the Veteran filed a timely VA Form 10182, Decision Review: Board Appeal (Notice of Disagreement) and elected the Evidence Review docket. Accordingly, the Board will consider the evidence within the 90 days following the election period, as well as evidence submitted on the date VA received the election form.

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.

Increased Rating

Where entitlement to compensation has been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Where an appeal is based on an initial rating for a disability, however, evidence contemporaneous with the claim and the initial rating decision are most probative of the degree of disability existing when the initial rating was assigned and should be the evidence "used to decide whether an original rating on appeal was erroneous." Fenderson v. West, 12 Vet. App. 119, 126 (1999).

Disability ratings are determined by applying the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity resulting from disability. Separate DCs identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability picture more nearly approximates the criteria for the higher rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3.

1. Entitlement to a disability rating greater than 10 percent for GERD.

The Veteran is seeking a higher rating for his GERD. See August 2024 VA Form 21-526EZ.

Effective May 19, 2024, GERD is rated under 38 C.F.R. § 4.114, Diagnostic Code 7206, a new diagnostic code specific to the condition. Pursuant to Diagnostic Code 7206, a noncompensable disability rating is warranted for a documented history without daily symptoms or requirement for daily medications. A 10 percent evaluation is warranted for a documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic. Thereafter, a documented history of recurrent or refractory stricture(s
percent for GERD.

The Veteran is seeking a higher rating for his GERD. See August 2024 VA Form 21-526EZ.

A 30 percent evaluation is warranted for a documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year. A 50 percent evaluation is warranted for a documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least once per year, or (3) esophageal stent placement. The maximum 80 percent evaluation is warranted for a 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).

A recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved. 38 C.F.R. § 4.114, Diagnostic Code 7206, Note (4).

Turning to the evidence, the Veteran submitted a September 2024 statement that included a description of his GERD symptoms. He described that he experiences indigestion and chest pain that causes burring pain in his chest and throat. Also, he has frequent regurgitation that leads to vomiting. Further, he wrote his condition impacts his sleep and his fatigue is so intense it makes it difficult to think or concentrate.

The Veteran was afforded a VA Esophageal Conditions examination in September 2024. The examiner noted the Veteran's diagnoses of GERD. During the examination the Veteran reported his current symptoms are severe. He described making himself vomit to get rid of the burning sensation, feels acid in his throat, burping, and nausea. Per the examiner, the Veteran had the following signs and symptoms due to his esophageal condition: persistently recurrent epigastric distress, dysphagia, regurgitation, nausea, vomiting, and sleep disturbance. He did not have esophageal stricture.

The frequency of sleep disturbance noted was 4 to 5 times a month, nausea 1 to 2 times a week, and vomiting 2 to 6 times per month. The Veteran reported taking continuous over the counter medication for his diagnosed condition. He did not have symptoms of productive material weight loss, hematemesis, melena with moderate anemia, esophageal stricture, spasms of the esophagus, or an acquired diverticulum of the esophageus. The examiner found his esophageal condition impacts his ability work. The examiner explained that the Veteran has difficulty with sleeping and concentrating when there is pain, resulting in vomiting to release the pain/acid from GERD.

The Veteran was afforded a VA Esophageal Conditions examination in October 2024. The examiner noted the Veteran's diagnoses of GERD. During the examination the Veteran described his symptoms as bad heartburn with acid reflux and food regurgitation, and excessive burping. The examiner found there was worsening of the Veteran's symptoms. The examiner noted that the Veteran currently had anemia which is known to be associated with GERD. The Veteran did not have a documented history of esophageal strictures. Additionally, the examiner found his esophageal condition impacts his ability work. He often calls out of work due to his nausea, vomiting, and pain making it difficult to concentrate.

The Board concludes that throughout the appeal period, the Veteran's GERD symptoms have not more nearly approximated the criteria for a rating in excess of 10 percent, as there is not a documented history of recurrent esophageal stricture causing dysphagia which requires dilatation. Although the Veteran reports having to call out of work due to his GERD symptoms, the evidence of record does not reflect that he is unable to work due to the severity of his GER
GERD. The Veteran did not have a documented history of esophageal strictures. Additionally, the examiner found his esophageal condition impacts his ability work. He often calls out of work due to his nausea, vomiting, and pain making it difficult to concentrate.

The Board concludes that throughout the appeal period, the Veteran's GERD symptoms have not more nearly approximated the criteria for a rating in excess of 10 percent, as there is not a documented history of recurrent esophageal stricture causing dysphagia which requires dilatation. Although the Veteran reports having to call out of work due to his GERD symptoms, the evidence of record does not reflect that he is unable to work due to the severity of his GERD, or that he is unable to secure or follow a substantially gainful occupation. The claim is denied.

2. Entitlement to a compensable disability rating for allergic rhinitis.

The Veteran is seeking a compensable disability rating for her allergic rhinitis. See August 2024 VA Form 526-EZ.

The Veteran's allergic rhinitis is rated pursuant to Diagnostic Code 6522. 38 C.F.R. § 4.97. Diagnostic Code 6522 provides, a 10 percent rating is warranted for allergic or vasomotor rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. See 38 C.F.R. § 4.97, DC 6522. A maximum, 30 percent rating is warranted for allergic or vasomotor rhinitis with polyps. Id.

Turning to the evidence, the Veteran underwent a VA sinusitis/rhinitis examination in September 2024. The examiner noted the Veteran's diagnosis of allergic rhinitis. During the examination the Veteran reported current symptoms include congestion, feeling of sneezing but unable to sneeze, watery eyes, and postnasal drop. The examiner noted he takes over-the-counter medication to treat his condition with minimal improvement.

Upon examination, the VA examiner found the Veteran did not have greater than 50 percent obstruction of nasal passage on both sides; he did not have complete obstruction on either side; he did not have permanent hypertrophy of the nasal turbines; he did not have nasal polyps; and he did not have granulomatous conditions. His allergic rhinitis does not impact his ability to work.

After careful review of the medical evidence of record, the Board finds the Veteran's allergic rhinitis has not resulted in greater than 50 percent obstruction of the nasal passage on both sides, nor complete obstruction on one side. Significantly, the Veteran has not met the burden to show that his over-the-counter medication ameliorates, removes, or otherwise prevents polyps or obstruction of nasal passages from 50 percent bilaterally or from complete obstruction on one side, as he has offered no evidence to that effect.

In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply, and a compensable rating is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001).

S. HENEKS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Braxton

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.

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