VA Diagnostic Code 7206Gastroesophageal reflux disease:
Rated from 0% to 80% under § 4.114. Here is what the VA requires at each level.
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What each rating requires
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- 80%
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 of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube)
- 50%
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 one time per year, or (3) esophageal stent placement
- 30%
Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year
- 10%
Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic
- 0%
Documented history without daily symptoms or requirement for daily medications
Notes on this code
These notes are part of the regulation. They change how the levels above are applied.
- Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
- Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.
- Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
- Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
- Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
Gastroesophageal Reflux Disease (GERD) — VA Disability Rating (Diagnostic Code 7206)
Digestive System · 38 CFR § 4.114
Understanding the Condition
Gastroesophageal reflux disease (GERD) is rated by the VA under Diagnostic Code 7206. This code covers a range of esophageal conditions and their complications, including:
- Esophagitis (mechanical or chemical)
- Mallory-Weiss syndrome (bleeding at the junction of the esophagus and stomach caused by tears) due to caustic ingestion of alkali or acid
- Drug-induced or infectious esophagitis (from Candida, a virus, or other organism)
- Idiopathic eosinophilic or lymphocytic esophagitis
- Esophagitis due to radiation therapy
- Esophagitis due to peptic stricture
- Any esophageal condition that requires treatment with sclerotherapy
This diagnostic code applies to these conditions but is not limited to them.
A central concept in this rating is esophageal stricture — a narrowing of the esophagus that can cause dysphagia (difficulty swallowing). The VA recognizes two specific types:
- Recurrent esophageal stricture: the inability to maintain the target esophageal diameter beyond 4 weeks after that diameter has been achieved.
- Refractory esophageal stricture: the inability to achieve the target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
Available Rating Levels
The VA assigns one of the following disability ratings based on documented history, symptoms, and required treatment:
| Rating | What It Reflects |
|---|---|
| 80% | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of these symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) — and treatment with either surgical correction of the stricture(s) or a percutaneous esophago-gastrointestinal tube (PEG tube). |
| 50% | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia that requires at least one of the following: (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement. |
| 30% | Documented history of recurrent esophageal stricture(s) causing dysphagia that requires dilatation no more than 2 times per year. |
| 10% | Documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic. |
| 0% | Documented history without daily symptoms or requirement for daily medications. |
What the VA Looks For
- Objective documentation of findings. Under Note (1), findings must be documented by barium swallow, computerized tomography (CT), or esophagogastroduodenoscopy (EGD).
- The type and frequency of treatment, such as dilatation sessions, use of steroids during dilatation, stent placement, surgical correction, or a PEG tube.
- Whether dysphagia is present and how it is managed — including whether daily medications are required.
- Associated symptoms at the higher rating levels, specifically aspiration, undernutrition, and/or substantial weight loss as defined by § 4.112(a).
- Whether a stricture is recurrent or refractory, as defined in Notes (4) and (5).
Please note: Under Note (2), non-gastrointestinal complications of procedures are rated under the appropriate body system rather than under this code.
This information summarizes the VA rating schedule for Diagnostic Code 7206 under 38 CFR § 4.114. It is provided for general educational purposes and does not guarantee any particular rating or outcome.
These criteria are a rendering of § 4.114, diagnostic code 7206. The official version is the one that governs your rating.
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