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Hiatal Hernia VA Disability Rating

DC 7346 | 38 C.F.R. § 4.114 | M21-1, Part IV.ii.9
OVERVIEW
Hiatal hernia is rated under the same diagnostic code as GERD (DC 7346). It occurs when the upper stomach pushes through the diaphragm, causing reflux symptoms. In veterans, hiatal hernia often develops from heavy lifting, body armor wear, high-stress environments, and NSAID use. The rating criteria mirror GERD and are based on symptom severity and impact on nutrition and health.
RATING CRITERIA (3 LEVELS)
60% -- Symptoms of pain, vomiting, material weight loss, hematemesis/melena with moderate anemia, or other symptom combinations productive of severe impairment of health
Severe esophageal disease with nutritional impact.
30% -- Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal/arm/shoulder pain, productive of considerable impairment of health
Significant daily symptoms affecting health.
10% -- Two or more symptoms of less severity
Documented symptoms requiring ongoing treatment.
KEY EVIDENCE TO GATHER
-Upper GI endoscopy (EGD) showing hiatal hernia and esophagitis
-Barium swallow study documenting hernia size
-Medication records for PPIs, H2 blockers
-Service records showing heavy lifting, body armor use, or NSAID use for other service-connected conditions
-Weight loss documentation and nutritional impact
SECONDARY CONDITIONS (3 MAPPED)
Asthma / Respiratory (aggravation)MODERATE
DC 6602
GERD/hiatal hernia aggravates asthma through acid aspiration and vagal nerve stimulation.
Barrett's EsophagusMODERATE
DC 7346
Chronic acid exposure from hiatal hernia can cause precancerous esophageal changes.
Sleep DisturbanceMODERATE
DC N/A
Nighttime reflux disrupts sleep quality.
C&P EXAM TIPS (4)
1.Hiatal hernia and GERD share the same diagnostic code (7346). You cannot receive separate ratings for both.
2.The key to a 30% rating is documenting that you have MULTIPLE persistent symptoms: heartburn, regurgitation, difficulty swallowing, and pain.
3.If your hiatal hernia/GERD is secondary to NSAID use for a service-connected condition, document the medication nexus.
4.Weight loss from the condition is important for the 60% rating. Track your weight over time.
DOLLAR IMPACT
Hiatal hernia/GERD at 30% pays $552.47/mo. Combined with secondary respiratory aggravation and sleep disruption contributions to mental health ratings.
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EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026