Citation Nr: A26026041 Decision Date: 03/24/26 Archive Date: 03/24/26 DOCKET NO. 250827-579708 DATE: March 24, 2026 ORDER Effective January 9, 2023, an increased initial rating of 10 percent for gastroesophageal reflux disease (GERD) is granted. FINDING OF FACT Affording the Veteran the benefit of the doubt, the probative and persuasive evidence indicates that the Veteran's service-connected GERD has been manifested by pyrosis, dysphagia, sleep disturbances from regurgitation and chest pain from January 9, 2023. CONCLUSION OF LAW Effective January 9, 2023, to May 18, 2024, the criteria have been met for a 10 percent disability rating, but not higher, for service-connected GERD. 38 U.S.C. §§1155, 5107; 38 C.F.R. §§3.102, 4.3, 4.7, 4.130. Diagnostic Code (DC) 7346. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1997 to July 2003. See DD Form 214. This case comes before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office. See March 2025 Rating Decision. The Veteran submitted a timely August 2025 Decision Review Request : Board Appeal (Notice of Disagreement), reflecting his wishes to appeal the March 2025 rating decision to the Board of Veterans' Appeals (Board) via the Direct Review docket. A letter accompanying this filing clarified that the Veteran wished to appeal the effective date of the assignment of a 10 percent rating for his service-connected GERD. By law, for claims appealed in this docket, the Board may only consider the evidence of record at the time of the March 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. If any evidence was submitted after the AOJ decision on appeal, then, by law, the Board was not permitted to consider that evidence in this decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. §?3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. The Board notes that, although the Veteran indicated that the appeal is for an earlier effective date, the claim is correctly described as one for an increased rating for an earlier stage in the appeal period. Accordingly, the Board has re-characterized the claim for an "earlier effective date" as a claim for an increased rating from January 9, 2023, as noted above. The adjudication of this increased rating claim will encompass all effective date concerns General Legal Criteria for Increased Ratings Disability ratings are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity caused by the given disability. Separate diagnostic codes identify various disabilities. 38 U.S.C. §1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings applies under a particular Code, the higher rating is assigned if the disability more clearly approximates the criteria for the higher rating. 38 C.F.R. §4.7. After careful consideration of the evidence, any reasonable doubt remaining, including degree of disability, is to be resolved in favor of the Veteran. 38 U.S.C. §5107; 38 C.F.R. §§3.102, 4.3. If the evidence is not in approximate balance or nearly equal, the claim is to be denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Ortiz v. Principi, 271 F.3d 1361, 1364 (Fed. Cir. 2001). Because the level of disability may have varied over the course of the claim, the rating may be "staged" higher or lower for segments of time during the period under review in accordance with such variations, to the extent the evidence shows distinct time periods where the service-connected disability has exhibited signs or symptoms that would warrant different ratings under different criteria. Hart v. Mansfield, 21?Vet. App.?505, 509-510 (2007); Fenderson v. West, 12?Vet. App.?119, 126 (1999). In initial rating cases, where the appeal stems from a granted claim of service connection with respect to the initial evaluation assigned, VA assesses the level of disability from the effective date of service connection. See Fenderson, 12 Vet. App. at 126. In increased-rating claims, where a claimant seeks a higher evaluation for a previously service-connected disability, it is the present level of disability that is of primary concern. Francisco v. Brown, 7?Vet. App.?55, 58 (1994). In such claims, VA considers the level of disability for the period beginning one year prior to the claim for a higher rating. 38 U.S.C. §5110(b)(2); 38 C.F.R. §3.400(o)(2); Hart, 21 Vet. App. at 509. In all claims for increased ratings, the Veteran is presumed to be seeking the maximum possible evaluation; 100 percent compensation for their disability. See A.B. v. Brown, 6?Vet. App.?35 (1993). An increased initial rating for GERD from January 9, 2023 Legal Criteria Effective May 19, 2024, VA amended the schedule of ratings for the digestive system and created Diagnostic Code (DC) 7206 for GERD. Prior to May 19, 2024, GERD did not have its own DC and VA often rated it by analogy to hiatal hernia under DC 7346. DC 7346 pertains to hiatal hernia. A 60 percent disability rating is assigned for symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia, or other symptom combinations that cause severe impairment of health. A 30 percent disability rating is assigned for symptoms of persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, causing considerable impairment of health. A 10 percent disability rating is assigned when two or more of the symptoms listed under the 30 percent disability rating are present but are not as severe. See 38 C.F.R. §4.114, DC 7346. DC 7206 specifically pertains to GERD. An 80 percent disability rating is assigned for a 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). A 50 percent disability rating is assigned for a 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. A 30 percent disability rating is assigned for a Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year. A 10 percent disability rating is assigned for a documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic. A 0 percent rating is assigned for a documented history without daily symptoms or requirement for daily medications. Also, effective May 19, 2024, VA amended 7346 for hiatal hernia and now directs VA adjudicators to rate such disabilities pursuant to DC 7203 for stricture of the esophagus. DC 7203's rating criteria mirror those presented in the new DC 7206. Factual Background In January 2023, the Veteran filed a claim for service connection of GERD. See January 2023 VA 21-526EZ. In a statement in support of his claim, he reported symptoms including heartburn with acid reflux, regurgitation of stomach contents into throat, chest pain during flare-ups, difficulty sleeping for more than 3 straight hours and nighttime choking (which is frightening and makes it hard to catch breath). He reported taking over-the-counter medications like Tums and Zantac two to three times a week. He asserted that the resulting sleep difficulties cause other symptoms including difficulty concentrating, mood changes, weight gain, low libido, irritability, memory trouble, extra time needed for decisions, and having moments when "he doesn't care about anything." See January 2023 Statement in Support of Claim. In February 2023, the Veteran was afforded a VA examination related to esophageal conditions. The examiner diagnosed the Veteran with GERD. The Veteran reported that his GERD is "intertwined" with sleep apnea and that he sometimes feels bad heartburn at night, which he self-manages with over-the-counter medications. The examiner noted symptoms of pyrosis, reflux, 4 or more sleep disturbances caused by reflux a year. The episodes had a duration of 10 days or more. The Veteran also experienced nausea, with two episodes a year lasting 1 to 9 days in duration. The examiner noted no esophageal strictures and that no diagnostic testing had been performed. See February 2023 Esophageal Conditions Disability Benefits Questionnaire. In March 2025, the Veteran was granted service connection for GERD with an evaluation of 0 precent effective January 9, 2023, and 10 percent effective May 19, 2024. See March 2025 Rating Decision. The Board notes that the staging of this initial rating corresponds to the changes to the applicable rating criteria. Analysis The Veteran asserts that he should be assigned a higher rating of at least 10 percent from the effective date of service connection for GERD, which is January 9, 2023. See August 2025 Third Party Correspondence. As such, the appeal period for consideration is the propriety of the disability rating assigned for the Veteran's service-connected GERD from January 9, 2023, to May 18, 2024 - the day before the schedule amendment. In this case, the appeal period begins prior to the change in the Rating Schedule. See 38 C.F.R. §§ 20.300(a), 301. Thus, the Board must apply the regulation in effect between January 9, 2023, and May 18, 2024, which was DC 7399-7346. (DC 7399 indicates GERD was not listed in the Schedule for Rating Disabilities and had been rated by analogy under a closely related disease or injury). 38 C.F.R.§§ 4.20, 4.27. A 10 percent rating has been assigned from May 19, 2024, under current DC 7206. The Veteran presented consistent and competent reports throughout the appeal period endorsing pyrosis (heartburn/acid reflux), nighttime dysphagia (choking), sleep disturbances from regurgitation, and chest pain during flare-ups. HE reported taking over the counter medications 2 to 3 times a week. These reports have been present in both his VA examination and lay statements. The Veteran is competent to report his symptoms as he experienced them. See Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Board finds that the severity of the Veteran's symptoms of dysphagia, pyrosis, regurgitation and chest pain are accounted for in former DC 7346 under a 10 percent rating criteria. The Board finds that the Veteran's symptoms, occurring multiple times a week are "persistently recurrent," but do not cause considerable impairment of health. The evidence of record does not include reports of formal treatment aside from over the counter medication. The Board acknowledges the Veteran's reports of sleep difficulties leading to other symptoms, including difficulty concentrating, mood changes and weight gain; however, these symptoms may also be related to other service-connected conditions such other specified trauma and stressor related disorder, obstructive sleep apnea. Thus, the Board finds that the Veteran's GERD does not cause the "considerable impairment of health" required for a 30 percent evaluation under DC 7346. Accordingly, the Board finds that the criteria for 10 percent disability rating, but no higher, for the Veteran's service-connected GERD is warranted from January 9, 2023 to May 18, 2024, under DC 7346 and from May 19, 2024, under DC 7206. The appeal is granted. Scott W. Dale Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board De Angelis, A. The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.