When VA rewrites a rating schedule, veterans tend to fear for the rating they already hold and overlook the opportunity in the new criteria. The May 2024 digestive revision runs the other way: existing ratings are grandfathered, claims pending on the effective date get whichever criteria are more favorable, and IBS gained a 20 percent tier the old schedule never offered.
Veterans often brace for the worst when VA rewrites a rating schedule and miss the opportunity sitting in the new criteria. The May 2024 digestive revision works in your favor: existing ratings are grandfathered, claims pending on the effective date get whichever criteria help you more, and IBS gained a 20 percent tier the old schedule never had.
What changed in 2024
On May 19, 2024, VA's revised rating schedule for the digestive system (38 CFR 4.114) took effect, updating criteria for dozens of conditions. Two of the most common, GERD and IBS, changed in ways that affect a lot of claims. This article covers what changed and how those changes apply to your claim.
GERD now has its own code (7206)
Before the change, VA rated gastroesophageal reflux disease (GERD) by analogy to hiatal hernia (diagnostic code 7346). As of May 19, 2024, GERD has its own diagnostic code, 7206, and the criteria are built around esophageal strictures (narrowing), difficulty swallowing (dysphagia), and complications:
- 0 percent: documented GERD without daily symptoms and without the need for daily medication.
- 10 percent: a documented history of esophageal stricture requiring daily medication to control dysphagia.
- 30 percent: recurrent or refractory stricture causing dysphagia that requires dilation no more than twice a year.
- 50 percent: recurrent or refractory stricture requiring more intensive treatment, such as dilation three or more times a year, dilation with steroid injection, or a stent.
- 80 percent: stricture with serious complications such as aspiration, undernutrition, or substantial weight loss, plus surgical correction or a feeding tube.
Findings are documented with objective testing such as a barium swallow, CT, or endoscopy.
IBS got a clearer scale (7319) with a new 20 percent tier
Irritable bowel syndrome (diagnostic code 7319) was rewritten around the modern clinical definition. To rate, you generally need abdominal pain related to defecation plus at least two of six secondary features: a change in stool frequency, a change in stool form, altered passage such as straining or urgency, mucus in the stool, bloating, or a feeling of distension. The new tiers are based on how often the pain occurs over the past three months:
- 10 percent: pain related to defecation at least once in the past 3 months.
- 20 percent: pain related to defecation at least 3 days per month.
- 30 percent: pain related to defecation at least 1 day per week (the maximum).
The old schedule topped many veterans out at lower numbers. The new 20 percent tier and revised wording help veterans who meet the symptom threshold get a compensable rating.
What it means for existing and pending claims
VA applied this change the way it applies any liberalizing rule (38 CFR 3.400):
- Existing ratings are grandfathered. If you already hold a GERD or IBS rating under the old criteria, the new rule does not automatically cut it.
- Pending claims as of May 19, 2024 are evaluated under both the old and new criteria, and VA assigns whichever is more favorable to you.
- New claims filed after the change are rated under the 2024 criteria.
Common points veterans overlook
- GERD moved from "by analogy" to its own code. If your GERD was rated under the old hiatal hernia analogy, the new 7206 criteria may fit your symptoms better. It is worth a fresh look.
- IBS now has a 20 percent tier. Veterans stuck at 10 percent under the old rule may meet the new 3-days-per-month standard for 20 percent.
- Frequency is everything for IBS. A symptom log covering three months is strong supporting evidence, but any credible documentation of pain frequency, including treatment records, provider notes, and lay statements, can help establish the required threshold.
- Do not pyramid your gut. VA generally rates the predominant digestive disability rather than stacking overlapping GI conditions (38 CFR 4.113 and 4.114).
- A change in the rule can be a reason to file, but a brand new claim starts a new effective date, so weigh timing against your other evidence.