The Playbook › Condition guides
VA rewrote the digestive section of its rating schedule effective May 19, 2024. Two of the most commonly claimed conditions, gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS), were both affected. If you are reading advice written before then, it is out of date.
In short: IBS criteria became clearer and are based on how often you have abdominal pain. GERD became harder to rate above 0% unless it has caused narrowing of the esophagus.
The short version
- GERD now has its own code, 7206, rated at 0%, 10%, 30%, 50%, or 80%, based on esophageal stricture and difficulty swallowing.
- IBS, code 7319, is rated at 10%, 20%, or 30%, based on how often you have abdominal pain plus other symptoms.
- If you were rated before May 19, 2024, your rating is not reduced because of the change.
- Both are often claimed as secondary conditions. IBS is also presumptive for many Gulf War veterans.
On this page
IBS, Diagnostic Code 7319
| Rating | Abdominal pain related to defecation | Plus |
|---|---|---|
| 10% | At least once during the previous three months | Two or more of the symptoms below |
| 20% | At least three days per month during the previous three months | Two or more of the symptoms below |
| 30% | At least one day per week during the previous three months | Two or more of the symptoms below |
The additional symptoms are:
- Change in stool frequency
- Change in stool form
- Altered stool passage, such as straining or urgency
- Mucus in the stool
- Abdominal bloating
- A feeling of distension
Thirty percent is the maximum for IBS.
Documenting IBS
Because the rating depends on frequency over three months, keep a simple log: date, abdominal pain, and which of the listed symptoms you had. Tell your doctor the frequency so it appears in your records, and describe it the same way at the exam.
GERD, Diagnostic Code 7206
GERD is now rated using the criteria for stricture of the esophagus.
| Rating | Criteria |
|---|---|
| 0% | Documented history without daily symptoms or need for daily medication |
| 10% | Documented esophageal stricture causing difficulty swallowing that requires daily medication to control |
| 30% | Recurrent stricture causing difficulty swallowing that requires dilation no more than twice a year |
| 50% | Recurrent or refractory stricture causing difficulty swallowing that requires at least one of: dilation three or more times a year, dilation using steroids at least once a year, or placement of an esophageal stent |
| 80% | Recurrent or refractory stricture causing difficulty swallowing, with at least one of aspiration, undernutrition, or substantial weight loss, and treatment by surgical correction or a feeding tube |
What this means in practice
Before the change, GERD was usually rated by analogy to hiatal hernia, based on symptoms such as heartburn, regurgitation, and chest or arm pain, at 10%, 30%, or 60%. Many veterans received 10% or 30% for reflux controlled by medication.
Under the current criteria, the ratings above 0% are tied to a documented stricture, usually confirmed by endoscopy or a barium swallow, and to difficulty swallowing. Ordinary heartburn managed with a daily tablet, with no stricture, is likely to be rated 0%.
A 0% rating is still service connection. It gives you VA care for the condition and a base to build on if complications such as Barrett’s esophagus or a stricture develop later.
If you were rated before May 19, 2024
- Your existing rating continues. VA does not reduce a rating just because the schedule changed.
- If you had a claim pending on that date, VA should apply whichever version of the criteria is more favorable to you, with the new criteria applying only from the date they took effect.
- If you ask for an increase now, VA applies the current criteria. Depending on your symptoms, that may not help you. Look at the tables carefully before filing. See rating increases.
Getting service connected
Direct
Symptoms and treatment in service: sick call visits for stomach pain, reflux, or diarrhea, and prescriptions for antacids or similar medication.
Secondary
Both conditions are commonly linked to other service-connected problems:
| Primary condition | How it connects |
|---|---|
| Any condition treated with anti-inflammatory painkillers | These medications are well known to cause stomach irritation and reflux |
| PTSD, anxiety, depression | The gut and stress response are closely linked; some psychiatric medications also cause digestive side effects |
| Sleep apnea | Associated with reflux |
A nexus opinion is needed. Your pharmacy records showing years of prescribed anti-inflammatories are useful supporting evidence. See secondary conditions.
Presumptive for Gulf War veterans
IBS and other functional gastrointestinal disorders are presumptive for veterans who served in the Southwest Asia theater and nearby locations from August 2, 1990, if the condition has lasted six months or more. You do not need to prove the cause. GERD is a structural condition and is not covered by that presumption. See Gulf War illness.
You cannot be paid twice for the same symptoms
Certain digestive conditions cannot be rated separately from each other because their symptoms overlap. Where that applies, VA assigns one rating under the code that reflects the main disability, and may raise it one level if the overall picture warrants. If you have both GERD and IBS, ask your representative how this affects you.
Other digestive conditions changed in 2024
The same update revised criteria for hemorrhoids, celiac disease, liver conditions, and others. If you have any service-connected digestive condition, read the current text of the regulation linked below.
Free printable checklist. Everything to gather before you file, what to bring to your C&P exam, and what to check in your decision, on two pages.
Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.