VA Ratings for Hernia & GERD

Hernias and gastroesophageal reflux disease (GERD) are among the most common service-connected gastrointestinal conditions for veterans. They are also among the most underrated, because veterans frequently file without understanding the specific rating criteria. The VA rates hernias under four distinct diagnostic codes (DC 7338 inguinal, DC 7339 ventral, DC 7340 femoral, and DC 7346 hiatal), and GERD is rated by analogy under DC 7346.

This guide explains each diagnostic code, the differences between hernia types, how GERD ratings work, and how the PACT Act has expanded service connection for veterans exposed to burn pits and airborne hazards.

01
Hernia & GERD Overview

A hernia occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. The major types relevant to VA disability:

• Inguinal hernia: Bulge in the groin area; most common type, especially in men
• Femoral hernia: Bulge below the inguinal ligament; less common but often more dangerous
• Ventral hernia: Protrusion through the abdominal wall, often at sites of prior surgery (incisional hernia)
• Umbilical hernia: Bulge at the belly button
• Hiatal hernia: Stomach protrudes upward through the diaphragm into the chest cavity, often causing GERD

GERD is a chronic condition in which stomach acid flows back into the esophagus, causing inflammation, heartburn, regurgitation, and potentially Barrett's esophagus or esophageal damage. GERD frequently occurs with hiatal hernia but can exist independently.

02
DC 7338, Inguinal Hernia

Inguinal hernias are rated under DC 7338:

• 0%: Small, reducible, or without true hernia protrusion
• 10%: Postoperative recurrent, readily reducible, well-supported by truss or belt
• 30%: Small postoperative recurrent, or unoperated irremediable, not well-supported by truss, or not readily reducible
• 60%: Large, postoperative recurrent, not well-supported under ordinary conditions and not readily reducible, when considered inoperable

The 60% rating requires the hernia to be inoperable. Most veterans with surgical repair receive 0% to 30% ratings unless the repair fails repeatedly. Bilateral inguinal hernias add 10% to the rating of the more severely affected side.

03
DC 7339, Ventral Hernia

Ventral hernias (including incisional hernias after abdominal surgery) are rated under DC 7339 with a higher rating ceiling:

• 0%: Healed, without disability, no protrusion
• 20%: Small, not well-supported by belt under ordinary conditions, or healed ventral hernia or postoperative wounds with weakening of abdominal wall
• 40%: Large, not well-supported by belt under ordinary conditions
• 100%: Massive, persistent, severe diastasis of recti muscles or extensive diffuse destruction or weakening of muscular and fascial support of abdominal wall

The 100% rating is reserved for catastrophic abdominal wall failure. The 40% rating is more typical for veterans with significant ventral hernia that cannot be controlled with an abdominal binder.

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DC 7340, Femoral Hernia

Femoral hernias are rated using the same criteria as inguinal hernias under DC 7340. The ratings (0%, 10%, 30%, 60%) follow identical descriptions. Femoral hernias are less common but require similar evaluation of reducibility, surgical history, and support requirements.

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DC 7346, Hiatal Hernia & GERD

Hiatal hernia is rated under DC 7346, and GERD is most commonly rated by analogy to this code:

• 10%: Two or more of: epigastric distress, dysphagia, pyrosis (heartburn), regurgitation, accompanied by substernal/arm/shoulder pain, productive of considerable impairment of health
• 30%: Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal/arm/shoulder pain, productive of considerable impairment of health
• 60%: Symptoms of pain, vomiting, material weight loss and hematemesis (vomiting blood) or melena (black stool) with moderate anemia; OR other symptom combinations productive of severe impairment of health

The 30% rating is the most commonly achieved tier for veterans with documented GERD. The 60% rating requires either GI bleeding with anemia OR severe combination symptoms causing major functional impairment.

Key terms:

• Epigastric distress: Discomfort in the upper abdomen
• Pyrosis: Heartburn
• Dysphagia: Difficulty swallowing
• Regurgitation: Return of stomach contents to the mouth or throat
• Hematemesis: Vomiting blood
• Melena: Black, tarry stools indicating GI bleeding

06
Post-Surgical Hernia Ratings

After hernia repair surgery, the rating depends on the outcome:

• Successful repair, no recurrence: 0% (still service-connected for monitoring)
• Recurrent hernia, readily reducible with truss/belt: 10%
• Recurrent hernia, not well-supported: 30%
• Large recurrent hernia, inoperable: 60%
• Post-surgical complications (chronic pain, nerve damage): May be separately rateable

Chronic post-surgical pain (ilioinguinal or genitofemoral neuropathy) is a common but often unrated complication of inguinal hernia repair. Veterans with chronic groin pain after repair should pursue a separate nerve damage rating.

07
GERD & PACT Act Presumptives

The PACT Act of 2022 significantly expanded VA presumptive service connections for veterans exposed to burn pits and airborne hazards during deployments to Iraq, Afghanistan, the Gulf War theater, and other locations. Several GI conditions have gained recognition as PACT Act presumptives or as conditions linked to qualifying exposures.

For GERD specifically:

• Reflux conditions are recognized as common among PACT Act-eligible veterans
• Chronic gastritis and esophagitis often qualify
• Documented burn pit exposure can support nexus opinions
• Medical literature links environmental exposures to GERD and esophageal disease
• Toxic Exposure Risk Activity (TERA) documentation strengthens claims

08
Hernia & GERD Secondary Conditions

• Barrett's esophagus: Precancerous change in the esophagus caused by chronic GERD
• Esophageal stricture: Scarring and narrowing from chronic acid exposure
• Chronic sinusitis: Acid reflux can affect upper airway
• Sleep apnea: GERD and sleep apnea are bidirectionally linked
• Asthma exacerbation: Reflux can worsen asthma
• Dental erosion: Acid damage to teeth
• Chronic nerve pain from inguinal hernia repair (ilioinguinal nerve)
• Anxiety or depression from chronic GI symptoms
• Iron deficiency anemia from chronic GI bleeding

09
Establishing Service Connection

Service connection paths for hernias and GERD:

• Direct: Hernia diagnosed during service from documented in-service injury or activity (heavy lifting, combat injury)
• Presumptive (PACT Act): GERD or esophagitis in veterans with qualifying burn pit/airborne exposure
• Secondary: Hernia caused by repeated strain from service-connected conditions; GERD secondary to service-connected sleep apnea, medications, or stress
• Aggravation: Pre-existing condition made worse by service activities

For repetitive stress hernias, document the specific physical demands of your service: load-bearing equipment, heavy lifting requirements, combat operations, parachute landings.

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Evidence Needed

• For hernias: Physical examination documenting the hernia, ultrasound or CT imaging
• For GERD: Esophagogastroduodenoscopy (EGD) findings, pH monitoring if available, response to PPI therapy
• Surgical records if hernia repair was performed
• Medication history: PPIs, H2 blockers, antacids
• Records of GI complications: Bleeding episodes, anemia, weight loss
• Service treatment records with GI complaints, abdominal exams
• Deployment records documenting exposures
• GERD or hernia DBQ from treating provider
• Nexus letter linking condition to service
• Lay statements documenting functional impact

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Preparing for the C&P Exam

• For hernias, describe size, reducibility, and use of support: Truss, belt, or no support
• For GERD, describe symptom frequency: Daily heartburn, regurgitation, dysphagia, vomiting
• Mention all qualifying symptoms: Use specific terms from the rating criteria (epigastric distress, pyrosis, dysphagia, regurgitation, substernal pain)
• Document GI bleeding if applicable (hematemesis, melena)
• Bring weight records: Document any weight loss
• List medications currently being taken for the condition
• Describe functional impact on work, sleep, and daily activities
• Bring imaging and EGD reports
• For PACT Act claims, mention deployment exposures explicitly

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Frequently Asked Questions

VA Claims US Editorial Team

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