Achalasia

DC 7203Digestive38 CFR 4.114, DC 7203

A rare disorder of the esophagus where the lower esophageal sphincter fails to relax properly, making it difficult to swallow food and liquids. The VA rates achalasia based on the severity of swallowing difficulty and nutritional impact.

How the VA rates this condition

The VA rates this condition based on how often symptoms occur and how severe each episode is. The examiner will ask about the frequency, duration, and intensity of your episodes, as well as how they affect your ability to work.

Diagnostic code

DC 7203

Rating range

10% – 80%

Rating levels

Rating criteria are defined in 38 CFR 4.114, DC 7203. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe achalasia where you can only take liquids with marked impairment of general health, or your esophagus is nonfunctional and you require a feeding tube or surgical intervention.

What the VA looks for

Near-complete obstruction documented
Gastrostomy tube placement or surgical myotomy
Severe malnutrition
Marked impairment of general health
Inability to maintain adequate oral intake

Common Pitfalls

⚠Not getting esophageal manometry testing — this is the gold standard diagnostic test for achalasia and definitively documents the lower esophageal sphincter dysfunction.
⚠Not documenting weight loss and nutritional impact — the rating criteria focus on how much the swallowing difficulty impairs your general health.
⚠Not recording all esophageal dilation procedures — each procedure documents the ongoing severity and treatment burden of the condition.
⚠Not filing for secondary conditions such as aspiration pneumonia, malnutrition, or GERD that commonly occur with achalasia.

Related DBQ Forms

DBQ Esophageal Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 7203

Rating range

10% – 80%

Rating levels

Rating Levels

You have severe achalasia where you can only take liquids with marked impairment of general health, or your esophagus is nonfunctional and you require a feeding tube or surgical intervention.

What the VA looks for

Near-complete obstruction documented
Gastrostomy tube placement or surgical myotomy
Severe malnutrition
Marked impairment of general health
Inability to maintain adequate oral intake

Common Pitfalls

⚠Not getting esophageal manometry testing — this is the gold standard diagnostic test for achalasia and definitively documents the lower esophageal sphincter dysfunction.

⚠Not documenting weight loss and nutritional impact — the rating criteria focus on how much the swallowing difficulty impairs your general health.

⚠Not recording all esophageal dilation procedures — each procedure documents the ongoing severity and treatment burden of the condition.

⚠Not filing for secondary conditions such as aspiration pneumonia, malnutrition, or GERD that commonly occur with achalasia.