The exam form
The examiner fills out VA's "Esophageal Conditions (Including Gastroesophageal Reflux Disease (GERD), Hiatal Hernia, and Other Esophageal Disorders)" form (a Disability Benefits Questionnaire, or DBQ). See the form on VA.gov
Form version checked: Updated on 2026-07-28 (v26_2).
What the exam is for
The exam records your esophagus problem and how it affects you. That includes trouble swallowing, daily medicine, any narrowing and how often it's stretched, and any surgery or feeding tube.
What the examiner will ask and measure
- Your diagnosis. It might be GERD, a hiatal hernia, Barrett's esophagus, or a narrowed or swollen esophagus (stricture or esophagitis).
- How the problem started and changed over time.
- Whether your treatment plan includes medicine you take every day for it, and which medicines.
- Symptoms: whether you have them every day, and whether you need daily medicine. Also whether you have trouble swallowing.
- Narrowing (stricture): whether a barium swallow, CT scan or EGD shows one. Also whether it keeps coming back (recurrent) or won't open up enough even with treatment (refractory).
- Stretching (dilatation): how often. The choices are 3 or more times a year, or no more than 2. Also whether steroids were used at least once a year, and the dates of the most recent ones.
- Whether you need a stent (a small tube placed to hold the esophagus open).
- Food going into your airway, poor nutrition and weight loss. The form defines "substantial weight loss" by how much of your usual weight you lost without trying, over three months.
- Surgery or a feeding tube through the belly into the stomach (PEG tube), with types and dates.
- Barrett's esophagus (changes in the lining found on a biopsy): how severe, whether it caused a narrowing, and whether treatment cleared it.
- Problems after surgery, such as vomiting, nausea, or watery or hard-to-control bowel movements. Also feeling light-headed and sweaty after meals, or pain within an hour of eating. And tube or IV feeding for more than 30 days in a row in the last six months.
- Tests: EGD, upper GI X-rays, barium swallow, MRI, CT, biopsy and blood counts. If your past tests show how you are now, new ones aren't required.
- How your condition affects work tasks.
Be ready to describe
- When your symptoms started in service, and how they've changed.
- Trouble swallowing: which foods or drinks get stuck, how often, and what you do when it happens.
- Each stretching, stent or surgery, with the date and where it was done.
- Every medicine you take each day for it, how often you take it, and any you take only some days.
- Food or drink going into your airway, if it happens.
- Weight loss you didn't try for: your weight before the problem started and now. Older weight records, such as your discharge physical, can help.
Common mistakes
- Talking only about heartburn. If you have trouble swallowing, describe it. That's what VA's levels look at.
- Going to the exam without your EGD, barium swallow or CT report on file.
- Not knowing how many times a year your esophagus has been stretched, or when.
- Leaving out a medicine you take every day for it.
How VA rates it
VA rates GERD mostly on whether a test shows a narrowed esophagus that causes trouble swallowing. It also looks at the treatment the narrowing needs: daily medicine, stretching, a stent, surgery or a feeding tube. A hiatal hernia is rated with the levels for a narrowed esophagus, which match the GERD levels. VA changed its rules for digestive conditions in May 2024.
In plain English
- 0%: A documented history of the condition, with no daily symptoms and no need for daily medicine.
- 10%: A documented history of a stricture that needs daily medicine to control trouble swallowing, with no other symptoms.
- 30%: A documented history of a recurrent stricture causing trouble swallowing that needs stretching (dilatation) no more than 2 times a year.
- 50%: A documented history of a recurrent or refractory stricture causing trouble swallowing that needs at least one of these: stretching 3 or more times a year, stretching using steroids at least once a year, or a stent.
- 80%: A documented history of a recurrent or refractory stricture causing trouble swallowing, with at least one of these: aspiration, undernutrition (your body isn't getting or absorbing enough nutrients), or substantial weight loss. It also needs treatment with either surgery to correct the stricture or a PEG tube.
- Tests: the stricture findings must be documented by a barium swallow, CT scan or EGD.
- What the words mean: "recurrent" means the esophagus can't stay at the target width for more than 4 weeks after it was reached. "Refractory" means it can't reach the target width even after at least 5 stretching sessions 2 weeks apart.
- Substantial weight loss: losing more than one-fifth of your baseline weight without trying, lasting three months, making it harder to care for yourself or do work tasks. Baseline weight is your documented average weight for the two years before the illness started, or your weight at your most recent discharge physical. If neither is available or relevant, VA uses an ideal body weight, figured by whichever of two standard methods favors you more.
- Hiatal hernia and paraesophageal hernia: VA rates these under the levels for a narrowed esophagus (esophageal stricture, code 7203). Those levels are the same as the GERD levels above, except that at 80% the rule says "surgical correction" without adding "of the stricture."
- Other esophagus problems: the GERD levels also apply to esophagitis from many causes and to some other esophagus problems.
- No double counting: VA's rules say the same symptoms can't be rated twice under different codes. If GERD and a hiatal hernia cause the same swallowing problems, VA counts those problems once.
- Hiatal hernia with some other digestive conditions: VA doesn't combine a hiatal hernia rating with ratings for certain other digestive conditions, such as peptic ulcer disease, chronic gastritis or IBS. It gives one rating under the condition that best fits your overall problem, and can raise it one level if your overall disability is severe enough. The list includes the hiatal hernia code but not the GERD code.
The regulation, word for word
Quoted from 38 CFR Part 4 (current as of October 16, 2026). This is what VA applies. The plain-English version above is our summary of it.
| Criteria | Rating |
|---|
| 7206 Gastroesophageal reflux disease: | |
| 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 of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube) | 80 |
| 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 | 50 |
| Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year | 30 |
| Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic | 10 |
| Documented history without daily symptoms or requirement for daily medications | 0 |
| Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy. | |
| Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system. | |
| Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy. | |
| Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved. | |
| Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals. | |
38 CFR 4.114, diagnostic code 7346: Hiatal hernia and paraesophageal hernia Open in the Rating Criteria Lookup
| Criteria | Rating |
|---|
| 7346 Hiatal hernia and paraesophageal hernia: | |
| Rate as esophagus, stricture of (DC 7203). | |
Related
About every C&P exam
What is it?
After you file a claim, VA may ask you to have a claim exam, also called a compensation and pension (C&P) exam. It helps VA decide whether your condition is connected to your service, and how severe it is. It isn't treatment: the examiner won't treat you, prescribe medicine or refer you to anyone.
Who does it?
A VA provider or a provider from one of VA's exam contractors (Loyal Source, OptumServe, QTC or VES). VA picks; you can't choose. Hearing, mental health, eye and dental exams are done by specialists. For a reproductive, breast, rectal or mental health exam, or a claim related to military sexual trauma, you can ask for a male or female examiner.
How long does it take?
VA says anywhere from 15 minutes to an hour or more, depending on what you claimed. Some exams are by phone or video. If you claimed more than one condition, VA tries to schedule them on the same day.
Does the examiner decide my claim?
No. The examiner writes a report on a standard form (a Disability Benefits Questionnaire, or DBQ) and sends it to VA. VA decides your claim using all the evidence: the report, your medical and service records, and statements from you and others. The examiner can't tell you the results or answer questions about your claim.
Does everyone get one?
No. If your records already have what VA needs, VA can decide from the records alone (VA calls this Acceptable Clinical Evidence, or ACE).
What if I can't make it?
Call the number on your appointment letter at least 48 hours ahead to reschedule. Missing an exam delays your claim. VA may decide your claim on the evidence it already has, and some claims, such as a claim for an increase, are denied (38 CFR 3.655). If you had a good reason, such as being in the hospital or a death in your family, tell VA and ask for a new exam.
What should I bring?
VA says you don't need to bring anything. Send any new medical records to VA before the exam, because the examiner can't send them in for you. Arrive 15 minutes early and wear clothes you can move in. Many veterans find it helps to bring a short list of their symptoms, medicines and side effects, and key dates, so nothing is forgotten.
Can someone come with me?
You can ask the examiner. They may ask family members or caregivers to wait outside. For a sensitive physical exam, you can ask for a chaperone in the room.
Can I get a copy of the report?
Yes. Ask VA with a Freedom of Information Act or Privacy Act request (VA Form 20-10206). VetEZ Claim can help you fill it out and send it.
Can my own doctor fill out the form instead?
For many conditions, yes. VA publishes the exam forms (DBQs) your own doctor can fill out and you can send in. VA doesn't pay for this. A few exam forms are for VA's own examiners.
Checked against VA's forms and rules on October 20, 2026. General information only, not medical or legal advice about your claim. VA decides every claim.
