Acid reflux, also known as gastroesophageal reflux disease (GERD), is one of the most commonly claimed gastrointestinal conditions among U.S. veterans. For years, the VA has rated acid reflux under criteria designed for hiatal hernia, allowing many veterans to receive meaningful compensation.
That system may soon change. The Department of Veterans Affairs has proposed a new diagnostic framework that could dramatically alter how GERD and acid reflux are evaluated. If finalized, these changes may lower ratings for many veterans especially those whose symptoms do not involve difficulty swallowing.
Understanding what is proposed, what is not yet official, and how to respond now is critical.
Overview of Proposed VA Acid Reflux Changes
The VA has proposed creating a new Diagnostic Code (DC) 7206 specifically for GERD and acid reflux. However, instead of introducing new symptom-based criteria, the proposal would rate acid reflux by analogy under DC 7203, which covers esophageal stricture.
Old vs Proposed VA Rating System
| Category | Current System | Proposed System |
|---|---|---|
| Diagnostic Code | DC 7346 (Hiatal Hernia) | DC 7206 (rated under DC 7203) |
| Primary focus | Reflux symptoms | Esophageal narrowing |
| Ratings available | 10%, 30%, 60% | 0%, 10%, 30%, 50%, 80% |
| Emphasis | Heartburn, regurgitation | Dysphagia and strictures |
A veterans law expert commented:
“This proposal shifts the focus away from reflux symptoms and toward structural damage, which many GERD patients don’t have.”
How Acid Reflux Is Currently Rated by the VA?
Under the existing framework, GERD and acid reflux are rated analogous to hiatal hernia. Veterans may qualify for compensation based on how often symptoms occur and how severely they affect daily life.
Current VA Ratings for Acid Reflux (DC 7346)
| Rating | Typical Criteria |
|---|---|
| 10% | Mild but persistent symptoms |
| 30% | Frequent symptoms with health impact |
| 60% | Severe symptoms with material impairment |
This system recognizes common GERD symptoms such as heartburn, regurgitation, chest pain, nausea, and sleep disruption.
What the New VA Acid Reflux Criteria Would Require?
Under the proposal, GERD would be rated based on esophageal stricture, a condition involving narrowing of the esophagus that interferes with swallowing.
Proposed VA Ratings for Acid Reflux (DC 7206 → DC 7203)
| Medical Finding | VA Rating |
|---|---|
| Severe stricture with weight loss or aspiration | 80% |
| Refractory stricture requiring stents or frequent dilation | 50% |
| Stricture requiring limited dilation | 30% |
| Stricture controlled with daily medication | 10% |
| No daily symptoms | 0% |
A gastroenterologist familiar with VA criteria explained:
“Many GERD patients have significant reflux without any measurable stricture. Under this system, they could receive little or nothing.”
Why Veterans Are Concerned?
The proposed criteria emphasize difficulty swallowing (dysphagia) and documented structural damage, rather than reflux-related symptoms.
However, many veterans experience GERD in ways that may not qualify under the new model.
Common GERD Symptoms Not Clearly Covered
- Chronic heartburn
- Regurgitation or sour taste
- Chest pain
- Nighttime reflux
- Chronic cough
- Sleep disruption
A VA-accredited claims agent warned:
“If your GERD doesn’t cause strictures, your rating could drop sharply even if symptoms are severe.”
Documentation Requirements Under the Proposal
Another major change involves stricter documentation standards. Under the proposed rules, findings must be confirmed through diagnostic testing.
Required Medical Evidence
| Test Type | Purpose |
|---|---|
| Barium swallow | Confirms narrowing |
| CT scan | Visualizes structure |
| Endoscopy | Documents stricture |
Without these findings, veterans may struggle to qualify for compensation.
Implementation Timeline: When Could This Take Effect?
As of now, no final effective date has been announced. The VA has indicated that summer or fall is a possible window, but this remains speculative.
Once finalized, VA rules typically include a 60-day waiting period before enforcement begins.
A regulatory analyst explained:
“Until the final rule is published, everything remains subject to change.”
What This Means for Veterans Filing Claims?
Veterans who file before any new rule takes effect will generally be evaluated under the current criteria.
Key Strategic Points
- Existing ratings are grandfathered
- New criteria usually apply only to future claims
- Filing sooner may preserve higher ratings
A veterans benefits advisor emphasized:
“If you qualify under the current system, delaying could cost you.”
What If You Already Have a GERD Rating?
Veterans with existing acid reflux or GERD ratings are typically protected.
Important Protections
- Current ratings are not automatically reduced
- VA must show sustained improvement for reductions
- New rules do not retroactively apply
However, filing for an increase can trigger a re-evaluation, so strategy matters.
Why the VA Says the Change Is Necessary?
The VA argues that the new criteria better reflect esophageal pathology and align with modern diagnostic practices.
According to VA explanations, symptoms of obstruction and irritation are viewed as more measurable than subjective reflux complaints.
Critics remain unconvinced.
Why Many Experts Disagree?
Medical and legal professionals point out that GERD is primarily a reflux disorder, not a structural one.
A digestive health specialist noted:
“Reflux severity does not correlate neatly with strictures. Many patients suffer greatly without narrowing.”
What Veterans Should Do Right Now?
Until anything becomes official, veterans should focus on current law, not speculation.
Recommended Actions
- File GERD claims promptly if eligible
- Document symptoms thoroughly
- Secure medical opinions early
- Consider filing an Intent to File
Protecting your effective date is often more important than waiting for clarity.
Final Thought
VA disability changes for acid reflux could significantly reshape how GERD is compensated. The proposed shift toward esophageal stricture criteria may reduce ratings for many veterans whose symptoms are severe but not structural.
Nothing is final yet. Until the VA publishes a final rule, veterans remain protected under the current system. Acting early, understanding the risks, and building strong medical evidence remain the best ways to safeguard benefits.
FAQs
Are the VA acid reflux changes official?
No, they are still proposed and not finalized.
Will current GERD ratings be reduced automatically?
No, existing ratings are generally grandfathered.
Should I file my claim now or wait?
Filing sooner is often safer under current criteria.
Will heartburn alone qualify under the new system?
Likely not unless strictures are documented.
Can the VA cancel these changes entirely?
Yes, proposed rules can be delayed or withdrawn.
