The VA made a handful of important changes to the gastrointestinal system. Recently, rating criteria for VA disability benefits concerning three different conditions have been updated: barrett's esophagus, gastritis, and peptic ulcer disease. With so many details and frequent changes from the VA, it's common to make mistakes when filing your VA disability benefits. By getting familiar with rating criteria (and preparing documents with us!), however, you are much less likely to do so.
NOTE: The effective date for these changes is May 19th, 2024. If a claim is filed prior to this, the Veteran will be considered on both rating scales. But if a claim is filed after May 19th, then only the new rating scale applies.
Keep reading to learn about what each of these conditions are, and how their VA disability benefits rating criteria has recently changed:
Barrett's esophagus
Barrett's esophagus occurs when the lining of the esophagus connecting the mouth to the stomach becomes harmed by acid reflux, leading to a thickened lining with redness and irritation.
The VA has made the following updates for Barrett's esophagus under Diagnostic Code 7207:
If esophageal stricture is present, rate as espophagus, stricture of (DC 7203)
10% rating: Documented by pathologic diagnosis with low-grade dysplasia
30% rating: Without esophageal stricture: Documented by pathologic diagnosis with high-grade dysplasia
They have also included two new conditions for rating Barrett's esophagus:
Note (1): If malignancy develops, rate as malignant neoplasms of the digestive system, exclusive of skin growths (DC 7343).
Note (2): If the condition is resolved via surgery, radiofrequency ablation, or other treatment, rate residuals as esophagus, stricture of (DC 7203).
Gastritis
Gastritis refers to a group of conditions, all of which cause inflammation of the stomach's lining. Sometimes, gastritis is confused with GERD – although the two are rated differently (see our last blog on recent updates to GERD). Some people might see this as a loophole to receive rating for prior GERD diagnosis/symptoms, but ultimately the doctors need to decide and provide the final documentation.
So, what has changed? The VA has updated that gastritis will now be rated under peptic ulcer disease (DC 7304), which we cover below. This new diagnostic code also includes Helicobacter pylori infection, drug-induced gastritis, Zollinger-Ellison syndrome, and portal-hypertensive gastropathy with varix-related complications.
Peptic Ulcer Disease
Peptic ulcer disease occurs when open sores develop inside the stomach and small intestine's upper portion, leading to stomach pain. Common causes include Helicobacter pylori infection, and also long-term use of NSAIDs, which can also cause GERD to develop or worsen.
The VA has made the following updates for peptic ulcer disease under DC 7304:
100% rating: Post-operative for perforation or hemorrhage, for three months
60% rating: Continuous abdominal pain with intermittent vomiting, recurrent hematemesis (vomiting blood) or melena (tarry stools); and manifestations of anemia which require hospitalization at least once in the past 12 months
40% rating: Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur four or more times in the past 12 months; and are managed by daily prescribed medication
20% rating: Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur three times or less in the past 12 months; and are managed by daily prescribed medication
0% rating: History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies
A strong VA disability benefits claim starts with proper documentation
If you're preparing to file a VA disability benefits claim, get ready with the support of our team of experts. Review our services here. Between Nexus Letters, DBQs, chart reviews, and other consultation, we help Veterans prove their conditions to the VA with expert-crafted documentation.
