Hiatal Hernia

DC 7203Digestive38 CFR 4.114, DC 7346 (rated as DC 7203)

A condition where part of the stomach pushes up through the diaphragm, closely related to GERD. As of May 19, 2024, hiatal hernia (listed under DC 7346) is rated as esophageal stricture under DC 7203 — the rating turns on a documented esophageal stricture, difficulty swallowing (dysphagia), and how it is treated (daily medication, dilations per year, a stent, or surgery/feeding tube), not on heartburn frequency. For claims pending before May 19, 2024, the VA must apply whichever is more favorable to you: the new DC 7203 criteria or the old symptom-based DC 7346.

How the VA rates this condition

The VA rates this condition based on the type and intensity of treatment you require. Higher ratings correspond to more aggressive treatment regimens, such as daily medication, insulin dependence, or the need for ongoing medical management.

Diagnostic code

DC 7203

Rating range

0% – 80%

Rating levels

Rating criteria are defined in 38 CFR 4.114, DC 7346 (rated as 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 a documented recurrent or refractory esophageal stricture causing difficulty swallowing with aspiration, undernutrition, and/or substantial weight loss, treated with surgical correction of the stricture or a feeding tube (PEG tube).

What the VA looks for

Recurrent or refractory stricture causing dysphagia
Aspiration, undernutrition, and/or substantial weight loss
Treated with surgical correction of the stricture or a PEG feeding tube

Common Pitfalls

⚠Since May 19, 2024, hiatal hernia is rated as esophageal stricture (DC 7203), which turns on a documented stricture and how it is treated (daily medication, dilations per year, stent, or surgery/feeding tube) — not on how often you have heartburn. Bring objective evidence: an endoscopy (EGD) or barium swallow documenting a stricture, and records of any dilations, stents, or surgery.
⚠Hiatal hernia and GERD affect the same underlying reflux disability — you generally cannot receive separate ratings for both (pyramiding rule).
⚠If your claim was pending before May 19, 2024, the VA must apply whichever is more favorable — the new DC 7203 criteria or the old symptom-based DC 7346 — so make sure both are considered.
⚠Not documenting dysphagia (difficulty swallowing) and the exact number of esophageal dilations per year — these drive the 30% and 50% levels.
⚠Not documenting aspiration, weight loss, or a feeding tube — the findings needed for the 80% level. Also connect hiatal hernia to secondary conditions like asthma or chronic cough from acid aspiration.

Related DBQ Forms

DBQ Esophageal Conditions (including GERD)
DBQ Stomach and Duodenal Conditions

View evidence checklist →C&P exam prep guide →See secondary conditions →

Related Conditions

Conditions commonly associated with Hiatal Hernia or rated under the same body system.

GERD (Gastroesophageal Reflux Disease)

DC 7206·Digestive

Irritable Bowel Syndrome (IBS)

Hepatitis C

Crohn's Disease

Hemorrhoids

Ulcerative Colitis

Liver Cirrhosis

Pancreatitis

Condition Rating Guides

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

Hiatal Hernia

How the VA rates this condition

Diagnostic code

DC 7203

Rating range

0% – 80%

Rating levels

Rating Levels

What the VA looks for

Recurrent or refractory stricture causing dysphagia
Aspiration, undernutrition, and/or substantial weight loss
Treated with surgical correction of the stricture or a PEG feeding tube

Common Pitfalls

⚠Since May 19, 2024, hiatal hernia is rated as esophageal stricture (DC 7203), which turns on a documented stricture and how it is treated (daily medication, dilations per year, stent, or surgery/feeding tube) — not on how often you have heartburn. Bring objective evidence: an endoscopy (EGD) or barium swallow documenting a stricture, and records of any dilations, stents, or surgery.

⚠Hiatal hernia and GERD affect the same underlying reflux disability — you generally cannot receive separate ratings for both (pyramiding rule).

⚠If your claim was pending before May 19, 2024, the VA must apply whichever is more favorable — the new DC 7203 criteria or the old symptom-based DC 7346 — so make sure both are considered.

⚠Not documenting dysphagia (difficulty swallowing) and the exact number of esophageal dilations per year — these drive the 30% and 50% levels.

⚠Not documenting aspiration, weight loss, or a feeding tube — the findings needed for the 80% level. Also connect hiatal hernia to secondary conditions like asthma or chronic cough from acid aspiration.