Hiatal hernia and paraesophageal hernia
Hiatal hernia and paraesophageal hernia is rated under 38 CFR 38 CFR § 4.114, Diagnostic Code 7346, from 0% to 60% based on the frequency and functional severity of symptoms. The maximum 60% rating requires: Symptoms of epigastric distress, pyrosis, regurgitation, dysphagia, vomiting, with marked impairment of health as evidenced by weight loss, hematemesis (vomiting blood), or melena (blood in stool); or; with severe impairment of health necessitating surgery.. Most claims establish the 0% or 10% rating before reaching the top tier.
Rating schedule — DC 7346 at a glance
- Minimum rating
- 0%
- Maximum rating
- 60%
- Rating tiers
- 4
- CFR section
- 38 CFR § 4.114
- Body system
- Digestive System
- Secondary conditions
- 4
Lowest schedular rating available
TDIU may raise effective compensation to 100%
0%, 10%, 30%, 60%
Part 4 rating schedule
Mapped in our database
What are the VA rating criteria for Hiatal hernia and paraesophageal hernia?
Rate as esophagus, stricture of (DC 7203).
Note: Cross-reference — see referenced criteria for rating tiers
Symptoms of epigastric distress after eating, nausea, vomiting, regurgitation with occasional episodes of heartburn or pyrosis; or; ratable condition that is controlled by diet or antacid drugs.
Note: DC 7346 covers hiatal hernia. As of May 2024, GERD is rated separately under DC 7206. The rating is based on symptom frequency, severity, and required treatment. Many veterans develop hiatal hernia secondary to NSAID use for service-connected musculoskeletal conditions.
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.
Symptoms of epigastric distress, pyrosis, regurgitation, dysphagia, vomiting, with marked impairment of health as evidenced by weight loss, hematemesis (vomiting blood), or melena (blood in stool); or; with severe impairment of health necessitating surgery.
Note: The 60% rating for hiatal hernia requires severe systemic manifestations such as bleeding, significant weight loss, or surgical necessity. Documentation of objective findings (EGD, barium swallow, weight records) is essential for this rating tier.
“Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.”
Which conditions are commonly secondary to Hiatal hernia and paraesophageal hernia?
View 4 secondary conditions linked to Hiatal hernia and paraesophageal hernia
Medical rationale, evidence strength, and filing tips — rated under 38 CFR § 3.310
Common Questions About Hiatal hernia and paraesophageal hernia VA Ratings
What is the VA rating range for Hiatal hernia and paraesophageal hernia?
The VA rates Hiatal hernia and paraesophageal hernia under Diagnostic Code 7346 at 0%, 10%, 30%, 60%. The minimum 0% rating requires: Rate as esophagus, stricture of (DC 7203).. The maximum 60% rating requires: Symptoms of epigastric distress, pyrosis, regurgitation, dysphagia, vomiting, with marked impairment of health as evidenced by weight loss, hematemesis (vomiting blood), or melena (blood in stool); or; with severe impairment of health necessitating surgery..
Which 38 CFR diagnostic code does the VA use for Hiatal hernia and paraesophageal hernia?
The VA rates Hiatal hernia and paraesophageal hernia under Diagnostic Code (DC) 7346, governed by 38 CFR 38 CFR § 4.114. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 0% and a 60% rating for Hiatal hernia and paraesophageal hernia?
A 0% rating requires: Rate as esophagus, stricture of (DC 7203).. A 60% rating requires: Symptoms of epigastric distress, pyrosis, regurgitation, dysphagia, vomiting, with marked impairment of health as evidenced by weight loss, hematemesis (vomiting blood), or melena (blood in stool); or; with severe impairment of health necessitating surgery.. The difference typically reflects the frequency, severity, or functional impact of the condition as documented in medical records and C&P examination findings.
Can Hiatal hernia and paraesophageal hernia qualify for TDIU (Total Disability Individual Unemployability)?
Veterans rated for Hiatal hernia and paraesophageal hernia may qualify for TDIU if the condition — alone or in combination with other service-connected disabilities — prevents substantially gainful employment. A single disability rated at 60% or higher (or multiple disabilities combining to 70%, with one at 40%) can support a TDIU claim under 38 CFR § 4.16.
What evidence do I need to establish service connection for Hiatal hernia and paraesophageal hernia?
Service connection for Hiatal hernia and paraesophageal hernia requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease, and (3) a medical nexus linking the current diagnosis to that in-service occurrence. A nexus letter from a treating or independent medical examiner is the most reliable nexus evidence.
Which conditions are commonly secondary to Hiatal hernia and paraesophageal hernia?
Hiatal hernia and paraesophageal hernia is associated with 4 documented secondary conditions. Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. See the secondary conditions page for the full list with medical rationale and evidence strength ratings.
What is the C&P exam like for Hiatal hernia and paraesophageal hernia?
A Compensation & Pension (C&P) exam for Hiatal hernia and paraesophageal hernia uses a Disability Benefits Questionnaire (DBQ) specific to the body system involved. The examiner documents the frequency, severity, and functional impact of your symptoms. Bring all relevant treatment records and be prepared to describe your worst-day symptoms — the examiner rates your condition based on the full clinical picture, not a single visit.
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