Evidence Checklist: Hiatal Hernia

Upper GI barium series or endoscopy confirming herniaCritical

Barium swallow upper GI series or upper endoscopy (EGD) report confirming hiatal hernia type (sliding vs. paraesophageal), size, and associated reflux.

Nexus opinion linking hiatal hernia to service ("at least as likely as not")Critical

A medical opinion connecting the hiatal hernia to service-related heavy lifting, abdominal trauma, chronic coughing, or stress-related GERD during service.

Treatment records (PPIs, surgical fundoplication)

Records documenting PPI therapy duration and dosage, and any surgical repair (laparoscopic Nissen fundoplication or other hiatal hernia repair procedures).

Weight loss documentation (if applicable)

Medical records showing material weight loss from restricted eating due to hernia symptoms. Required for 30%+ ratings under the esophageal diagnostic code.

Symptom diary (heartburn, regurgitation, dysphagia, bloating)

Personal log documenting symptom frequency, severity, and impact on eating — particularly symptoms not controlled by medication.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Esophageal ConditionsCritical

Standardized form capturing hernia type, reflux severity, dysphagia, weight impact, and treatment requirements.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.