Inside the exam room
1. You will be asked about reflux, swallowing, and treatment. Explain trouble with food or liquids, how often it happens, and changes to meals.
2. The examiner will review tests, any narrowing of the food pipe, and procedures to widen it. New tests depend on the exam request. Give procedure dates and facility names.
3. You will be asked whether treatment helps and how symptoms affect daily life. Explain longer meals or interrupted work. Identify records of weight loss, feeding tubes, or other complications.
How VA rates GERD
Describe trouble swallowing and use your test and procedure records. The current table looks mainly at narrowing of the food pipe, the treatment it needs, and complications. The current DC 7206 focuses on recorded narrowing of the food pipe (esophageal stricture), trouble swallowing (dysphagia), required treatment, and specified complications. Heartburn or use of an acid-reducing medicine alone does not establish a paid rating under this code. Earlier claim periods may require review of the rules that applied at that time.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 0% | A clinician's records show history without daily symptoms or a requirement for daily medications. |
| 10% | A clinician's records show narrowing of the food pipe (esophageal stricture) requiring daily medication to control trouble swallowing (dysphagia), otherwise without symptoms (asymptomatic). |
| 30% | A clinician's records show narrowing that keeps coming back (recurrent narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia) that needs a procedure to stretch the food pipe open (dilation) no more than twice per year. |
| 50% | A clinician's records show narrowing that keeps coming back or resists treatment (recurrent or refractory narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia), requiring at least one of these: a procedure to stretch the food pipe open (dilation) at least three times per year; OR dilation using steroids at least once per year; OR a tube placed to hold the food pipe open (esophageal stent). |
| 80% | A clinician's records show narrowing that keeps coming back or resists treatment (recurrent or refractory narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia), with food or fluid entering the airway (aspiration), not getting enough nutrition, OR substantial weight loss under section 4.112(a), AND treatment by surgery to correct the narrowing or a feeding tube into the stomach (PEG tube). |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- A clinician's records show history without daily symptoms or a requirement for daily medications.0%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- A clinician's records show narrowing of the food pipe (esophageal stricture) requiring daily medication to control trouble swallowing (dysphagia), otherwise without symptoms (asymptomatic).10%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- A clinician's records show narrowing that keeps coming back (recurrent narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia) that needs a procedure to stretch the food pipe open (dilation) no more than twice per year.30%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- A clinician's records show narrowing that keeps coming back or resists treatment (recurrent or refractory narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia), requiring at least one of these: a procedure to stretch the food pipe open (dilation) at least three times per year; OR dilation using steroids at least once per year; OR a tube placed to hold the food pipe open (esophageal stent).50%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- A clinician's records show narrowing that keeps coming back or resists treatment (recurrent or refractory narrowing) of the food pipe (esophageal stricture) causing trouble swallowing (dysphagia), with food or fluid entering the airway (aspiration), not getting enough nutrition, OR substantial weight loss under section 4.112(a), AND treatment by surgery to correct the narrowing or a feeding tube into the stomach (PEG tube).80%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
What may happen in the exam room
- The examiner reviews tests of your food pipe, such as a barium-swallow X-ray, CT scan, or a camera examination (endoscopy).
- They ask about trouble swallowing, treatment, procedures to stretch the food pipe open (dilation), and other problems it has caused.
What the measurements tell you
- Records of narrowing in the food pipe (stricture) and trouble swallowing (dysphagia).
- How often the food pipe was stretched open during the year, whether steroids were used, and any tube to hold it open (stent) or surgery.
- Records of food or fluid entering the airway (aspiration), not getting enough nutrition, substantial weight loss, or a feeding tube into the stomach (PEG tube).
Questions the examiner may cover
- What testing confirmed the esophageal findings?
- How often have procedures been required?
- What swallowing difficulties and treatment effects do you experience?
Questions to expect
Is swallowing difficult, and has narrowing been confirmed?
Explain: Describe solids or liquids sticking, meal changes and frequency. Identify endoscopy, imaging or swallowing-study findings.
Rating connection: Current DC 7206 evaluates documented esophageal narrowing and swallowing difficulty, not heartburn frequency alone. Earlier claim periods may use earlier rules.
What treatment and complications are recorded?
Explain: List medication, dilation dates, stents, surgery and any recorded feeding-tube need, weight loss or aspiration complications.
Rating connection: The rows distinguish treatment type and recurrence. Procedure counts, timing and complications must meet the complete requirement.
Your answer outline
When I [eat or drink], I experience [what actually happens, or no swallowing difficulty]. It occurs about [frequency]. I respond by [actual adjustment]. My records include [test, procedure, or treatment and date if known], with [actual result of treatment].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Describe actual swallowing difficulty and its frequency.
- Use procedure records rather than estimating how often dilation occurred.
Common mistakes to avoid
- Applying the old rules for hiatal hernia without checking the applicable claim period.
- Treating reflux medication alone as proof of the rule requiring a narrowed food pipe.
Records to get ready before the exam
- Endoscopy, imaging, and procedure reports.
- Stomach and bowel specialist records and medication list.
- Nutrition and weight records when relevant.
Preparation notes
- Describe symptoms and findings recorded by a clinician without assuming a cause.
- Do not change prescribed medication or diet for the examination without clinician guidance.
Important context
Ask your provider which description fits. Under DC 7206, narrowing that comes back (recurrent stricture) means the food pipe cannot stay at the target width beyond four weeks. Narrowing that resists treatment (refractory stricture) means it cannot reach that width despite at least five stretching procedures, two weeks apart. Your procedure records and provider’s assessment establish these findings.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.114, DC 7206. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
Bring camera-exam (endoscopy) and treatment records. They can show narrowing or other changes in the food pipe that matter under DC 7206 and related rules.
If a breathing condition is diagnosed, ask your provider to explain any connection.
Bring dental records and ask your dentist to explain the connection in your case.
Describe how reflux interrupts your sleep. That does not automatically mean a separate disability.
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.