Diagnostic Code 7346 · 38 CFR §4.114
Gastroesophageal reflux disease (GERD) is a chronic digestive condition where stomach acid frequently flows back into the esophagus, causing irritation. The VA rates GERD under Diagnostic Code 7346 (hiatal hernia), as GERD does not have its own separate diagnostic code. This is the analogous code used when the symptoms and functional impairment most closely match. GERD is extremely common among veterans and is frequently claimed as secondary to PTSD (due to stress and medications), NSAIDs used for musculoskeletal conditions, or as a direct condition from service-related dietary and stress factors.
| Rating | Criteria |
|---|---|
| 10% | Two or more of the symptoms required for the 30% rating, but of lesser severity than described for 30%. |
| 30% | Persistently recurrent epigastric distress (upper abdominal discomfort) with dysphagia (difficulty swallowing), pyrosis (heartburn), and regurgitation, accompanied by substernal (behind the breastbone) or arm or shoulder pain, productive of considerable impairment of health. |
| 60% | Symptoms of pain, vomiting, material weight loss and hematemesis (vomiting blood) or melena (dark/bloody stools) with moderate anemia; or other symptom combinations productive of severe impairment of health. This is the maximum schedular rating under DC 7346. |
You need: (1) a current diagnosis of GERD, ideally confirmed by an upper endoscopy (EGD) or barium swallow study showing reflux or esophageal changes, (2) a nexus to military service (direct or secondary), and (3) documentation of symptom frequency and severity. Keep a symptom journal noting how often you experience heartburn, regurgitation, difficulty swallowing, and how it affects your eating and daily life. Medical records showing prescriptions for proton pump inhibitors (PPIs) or H2 blockers demonstrate ongoing treatment. If claiming secondary to PTSD or medication side effects, a nexus letter explaining the connection is recommended.
GERD does not have its own diagnostic code in the VA rating schedule. The VA uses DC 7346 (hiatal hernia) as the analogous code because the symptoms and functional impairment are similar. This is a standard practice under 38 CFR 4.20 for conditions not specifically listed in the schedule.
Yes. GERD is one of the most common secondary conditions claimed with PTSD. The connection can be established through two paths: (1) chronic stress from PTSD directly affects digestive function, and (2) medications prescribed for PTSD (particularly SSRIs) are known to cause or worsen acid reflux.
The maximum schedular rating under DC 7346 is 60%, which requires symptoms including pain, vomiting, material weight loss, and evidence of bleeding (hematemesis or melena) with moderate anemia, or other combinations productive of severe health impairment.