Secondary Condition Claim · VASRD 7206
Gastroesophageal Reflux Disease (GERD) Secondary to Hiatal Hernia
A condition caused or aggravated by an already service-connected disability can be granted its own service connection as a secondary condition under 38 CFR § 3.310. Here's how that works for Gastroesophageal Reflux Disease (GERD) when it develops after Hiatal Hernia.
Why Gastroesophageal Reflux Disease (GERD) Is Linked to Hiatal Hernia
Often a primary symptom
Primary condition · VASRD 7346
Hiatal Hernia
A hiatal hernia is part of the stomach pushing up through the diaphragm into the chest, which can cause reflux, chest discomfort and difficulty swallowing. DC 7346 carries no criteria of its own: the entry for hiatal hernia and paraesophageal hernia reads "Rate as esophagus, stricture of (DC 7203)." That means the evaluation is built on a documented esophageal stricture causing dysphagia and on the treatment it requires — dilatation, a stent, surgical correction or a feeding tube — rather than on how severe the reflux symptoms are.
Secondary condition · VASRD 7206
Gastroesophageal Reflux Disease (GERD)
GERD is stomach acid and stomach contents flowing back up into the esophagus, causing heartburn, regurgitation and chest discomfort. DC 7206 has its own criteria table, and what that table measures is not how often heartburn occurs — every step is written around a documented esophageal stricture causing dysphagia (difficulty swallowing) and the treatment that stricture requires. Note (1) requires the findings to be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
Gastroesophageal Reflux Disease (GERD) VA Rating Tiers
The VA rates Gastroesophageal Reflux Disease (GERD) the same way whether it's claimed directly or as secondary to Hiatal Hernia — severity of Gastroesophageal Reflux Disease (GERD) itself determines the percentage.
| Rating | Criteria |
|---|---|
| 80% | Aspiration, undernutrition, or big weight loss needing surgery or a feeding tube |
| 50% | Dilation 3+ times a year, steroid dilation yearly, or an esophageal stent |
| 30% | Recurrent narrowing needing dilation no more than twice a year |
| 10% | Daily medicine controls the swallowing trouble; no other symptoms |
| 0% | Documented history, but no daily symptoms and no daily medicine |
Example combined rating
30% Hiatal Hernia + 30% Gastroesophageal Reflux Disease (GERD) = 51%
The VA combines ratings with Table I of 38 CFR 4.25, not simple addition — 30% and 30% combine to 51%, not 60%. These figures are illustrative; your actual rating for each condition depends on your own evaluation.
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Evidence for a Gastroesophageal Reflux Disease (GERD) Secondary Claim
- •A barium swallow, computerized tomography, or esophagogastroduodenoscopy report confirming the stricture — Note (1) names these three studies specifically.
- •Dated procedure records for every dilatation, including any performed using steroids, plus placement or operative reports for an esophageal stent, surgical correction, or a percutaneous esophago-gastrointestinal tube (PEG tube).
- •Prescription records showing daily medication taken to control dysphagia, which is what the 10 percent row is written around.
- •Weight measurements over time and any documentation of aspiration or undernutrition, since the 80 percent row names those alongside substantial weight loss as defined by § 4.112(a).
Common questions about Gastroesophageal Reflux Disease (GERD) secondary to Hiatal Hernia
- Can Gastroesophageal Reflux Disease (GERD) be service-connected as secondary to Hiatal Hernia?
- Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Often a primary symptom You'll need a current Gastroesophageal Reflux Disease (GERD) diagnosis and a medical nexus opinion linking it to your service-connected Hia…
- What VA rating can I get for Gastroesophageal Reflux Disease (GERD) as a secondary condition?
- Gastroesophageal Reflux Disease (GERD) is rated under VASRD diagnostic code 7206 using the same criteria whether it's a direct or secondary claim: possible ratings are 80%, 50%, 30%, 10%, 0%. The rating depends on the severity of Gastroesophageal Reflux Disease (GERD) itself, not on the severity of Hiatal Hernia.
- How does a secondary Gastroesophageal Reflux Disease (GERD) claim affect my combined VA rating?
- The VA doesn't add ratings together. Using the official combined-ratings formula (38 CFR 4.25): a 30% rating for Hiatal Hernia combined with a 30% rating for Gastroesophageal Reflux Disease (GERD) (example figures) produces a combined rating of 51%, not 60%. Approving Gastroesophageal Reflux Disease (GERD) as secondar…
- What evidence do I need to service-connect Gastroesophageal Reflux Disease (GERD) as secondary to Hiatal Hernia?
- Strong evidence for the underlying Gastroesophageal Reflux Disease (GERD) diagnosis includes: A barium swallow, computerized tomography, or esophagogastroduodenoscopy report confirming the stricture — Note (1) names these three studies specifically.; Dated procedure records for every dilatation, including any performe…
Primary condition
Full Hiatal Hernia guide
Secondary condition
Full Gastroesophageal Reflux Disease (GERD) guide
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