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Rating guide · Digestive

Gut Claims: GERD & IBS Since the 2024 Rewrite

In May 2024 the VA rewrote how it rates the digestive system. Reflux is now judged mostly by documented narrowing of the esophagus, and IBS by how often pain tied to bowel movements shows up. Each needs a different kind of proof.

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IBS frequency tiers
GERD stricture tiers
Gulf War presumption
Secondary routes

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38 CFR 4.114 · DC 7319

IBS: Rated by How Often

The rater looks back over the prior three months and counts how frequently abdominal pain linked to bowel movements occurred. Amounts are 2026 monthly pay for a single veteran.

Criteria as of October 2026. The same scale is used for other functional digestive disorders, such as functional dyspepsia, bloating, constipation and diarrhea.
Rating	VA criteria	2026 pay (alone)
30%	Abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.	$552.47
20%	Abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.	$356.66
10%	Abdominal pain related to defecation at least once during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension.	$180.42

38 CFR 4.114 · DC 7206

GERD: Rated by Stricture

Under the current schedule, reflux that medication keeps in check, with no documented stricture, usually lands at 0%.

Criteria as of October 2026. A stricture must be shown on a barium swallow, CT scan or upper endoscopy. A rating granted under the old rules isn’t cut simply because the schedule changed.
Rating	VA criteria	2026 pay (alone)
80%	Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of: aspiration, undernutrition, and/or substantial weight loss, and treatment with either surgical correction of esophageal stricture(s) or a PEG tube.	$2,102.15
50%	Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of: dilatation 3 or more times per year, dilatation using steroids at least once per year, or esophageal stent placement.	$1,132.90
30%	Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year.	$552.47
10%	Documented history of esophageal stricture(s) that requires daily medications to control dysphagia, otherwise asymptomatic.	$180.42
0%	Documented history without daily symptoms or requirement for daily medications.	$0.00

Service connection

Ways to Tie Them to Service

Gulf War and post-9/11 deployments: functional gastrointestinal disorders such as IBS are presumed service-connected for those who served in the Southwest Asia theater, and in certain other countries on or after September 19, 2001.
Pain medication: long-term NSAID use for a service-connected back or knee can damage the esophagus and stomach and lead to reflux.
Mental health: with a supporting medical opinion, PTSD, anxiety and depression are often linked to both GERD and IBS.

If IBS is part of your claim, begin a daily symptom diary today and keep it going for at least three months, since that window is exactly what the rater reviews. Ask your provider at the Davenport VA clinic or any Illinois doctor to note frequency in your chart too.

FAQ

GERD & IBS VA Rating: Common Questions

Does the Gulf War presumption cover IBS?

Yes. IBS is one of the functional gastrointestinal disorders presumed connected for veterans with qualifying Southwest Asia or other covered service.

My reflux is real, so why 0%?

Since May 2024, GERD ratings depend mainly on a documented esophageal stricture. Reflux controlled by medication without one generally rates 0%.

Will the new digestive rules lower the rating I already have?

Not on their own. A change to the rating criteria by itself is not grounds to reduce an existing rating.

What is the best way to prove how often IBS flares?

A daily log covering three months or more that records days with abdominal pain related to bowel movements, plus your other symptoms.

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