GERD & Hiatal Hernia
Diagnostic Code 7346 • 38 CFR § 4.114
VA often rates symptomatic reflux and hiatal hernia under DC 7346—document symptom clusters, weight change, and endoscopy
Diagnostic Code
7346
Rating Percentages at a Glance (DC 7346)
Severe impairment of health
e.g., pain, vomiting, material weight loss, hematemesis/melena with moderate anemia—or equivalent severity
$1,435.02/mo
vet alone
Major symptom pattern + substantial weight loss
Persistent epigastric distress, dysphagia, pyrosis, regurgitation, pain + substantial weight loss
$552.47/mo
vet alone
Two+ symptoms from 30% level, milder
Document cluster in treatment records
$180.42/mo
vet alone
Not requiring continuous medication
SC only or sub-compensable
$0
vet alone
Paraphrased for readability—match your decision to the exact wording in 38 CFR § 4.114, DC 7346. Analogous ratings may apply when strict DC differs.
Complete regulatory criteria, CFR citations, and official rating notes
Real-World Compensation Scenarios
30% GERD + 70% PTSD + 10% tinnitus
Combined pushes toward 80% tier (~$2,102.15/mo illustrative)—digestive + mental health stack strongly.
60% GERD + secondary anemia / GI bleed workup
Highest schedular for DC 7346—paired with cardiology or hematology if anemia is documented.
10% GERD + 50% migraines + 30% cervical spine
Even 10% GERD adds to other ratings—often mid 70% combined.
Complete Rating Criteria (DC 7346)
| Rating | Criteria (summary) | Pay |
|---|---|---|
| 60% | Pain, vomiting, material weight loss, hematemesis or melena with moderate anemia; or other combinations producing severe health impairment. | $1,435.02 |
| 30% | Persistently recurrent epigastric distress with dysphagia, pyrosis, regurgitation, substernal/radiating pain, and substantial weight loss. | $552.47 |
| 10% | Two or more of the 30% symptoms, less severe. | $180.42 |
| 0% | Symptoms not requiring continuous medication. | $0 |
Detailed Evidence Requirements
EGD (upper endoscopy)
Esophagitis, Barrett’s, stricture, hiatal hernia size—objective severity.
24-hour pH study
When reflux is suspected but endoscopy is mild—documents acid exposure.
Weight & nutrition records
Substantial weight loss unlocks 30%+ when tied to symptoms.
CBC / iron studies
Anemia supports higher ratings when paired with GI blood loss.
PPI / medication history
Continuous medication supports chronicity; still document breakthrough symptoms.
Secondary Conditions Grid
Common primaries for secondary GERD: PTSD, OSA, migraines (medication), obesity.
Claim Timeline
GI referral
Establish diagnosis and get EGD if not done.
Symptom log
Frequency of regurgitation, dysphagia, nausea, night reflux.
Nexus
Link to SC mental health, OSA, or medication side effects.
File claim
Upload endoscopy + pharmacy records together.
C&P
Bring list of food triggers and ER visits.
What Gets You Higher Ratings?
0–10% → 30%
Document substantial weight loss + persistent distress cluster—not “occasional heartburn.”
30% → 60%
Bleeding, melena, hematemesis, moderate anemia, or severe malnutrition documented in records.
Common Mistakes
FAQs
▸ PPIs control symptoms—still rateable?
Yes—rate based on documented severity despite treatment; verify against schedule.
▸ Hiatal hernia on imaging but no symptoms?
May be 0% until symptoms meet compensable criteria.
▸ Secondary to sleep apnea?
Possible with medical nexus—negative intrathoracic pressure promotes reflux; see sleep apnea guide.
Cross-Links
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.
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