VA Diagnostic Code 7346Hiatal hernia and paraesophageal hernia
Rated from 0% to 80% under § 4.114. Here is what the VA requires at each level.
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Summary
Rate as esophagus, stricture of (DC 7203).
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 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
General rating formula
Rate as Esophagus, stricture of: (DC 7203)
Hiatal Hernia and Paraesophageal Hernia (VA Diagnostic Code 7346)
Digestive System · 38 CFR § 4.114
Understanding This Condition
A hiatal hernia and paraesophageal hernia are digestive conditions rated by the VA under Diagnostic Code 7346. Under the current rating schedule, these hernias are evaluated using the same criteria the VA applies to stricture of the esophagus (Diagnostic Code 7203).
An esophageal stricture is a narrowing of the esophagus that can lead to dysphagia — difficulty swallowing. The VA assigns a disability rating based on how severe and how frequent the symptoms are, and on the type of treatment the condition requires.
Available Rating Levels
The VA uses the following rating levels for this condition:
| Rating | What the Rating Reflects |
|---|---|
| 80% | A documented history of recurrent or refractory esophageal stricture(s) causing dysphagia, with at least one of these symptoms: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) — and treatment with either surgical correction or a percutaneous esophago-gastrointestinal tube (PEG tube). |
| 50% | A 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 once per year, or (3) esophageal stent placement. |
| 30% | A documented history of recurrent esophageal stricture(s) causing dysphagia that requires dilatation no more than 2 times per year. |
| 10% | A documented history of esophageal stricture(s) that requires daily medications to control dysphagia, but is otherwise asymptomatic. |
| 0% | A documented history without daily symptoms or a requirement for daily medications. |
What the VA Looks For
When rating a hiatal hernia or paraesophageal hernia under DC 7346, the VA reviews the medical record for the factors that appear in the criteria above, including:
- A documented history of esophageal stricture(s), and whether it is recurrent or refractory.
- Dysphagia (difficulty swallowing) and how significantly it affects the individual.
- Serious symptoms such as aspiration, undernutrition, or substantial weight loss as defined by § 4.112(a).
- The type and frequency of treatment, such as:
- Dilatation and how often it is performed each year
- Dilatation using steroids
- Esophageal stent placement
- Surgical correction or a PEG tube
- Daily medications used to control symptoms
The rating assigned depends on which set of criteria the documented evidence matches.
This information is drawn from the VA rating schedule for Diagnostic Code 7346 (§ 4.114), which directs that this condition be rated as stricture of the esophagus (DC 7203). It is provided for general educational purposes and does not guarantee any particular rating outcome.
These criteria are a rendering of § 4.114, diagnostic code 7346. The official version is the one that governs your rating.
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