Hiatal Hernia VA Disability Ratings
As of 2023, hiatal hernia is the most commonly service-connected digestive disability among all veterans who receive VA disability benefits. Nearly half a million veterans receive VA disability compensation for hiatal hernias.
A hiatal hernia occurs when the upper part of the stomach bulges through the large muscle which separates the abdomen and the chest. Large hiatal hernias are associated with GERD and GERD symptoms. This can include symptoms like heartburn, nausea, and vomiting.
In 2024, VA updated the ratings for all digestive-system-related conditions. This article will describe the ratings available for hiatal hernia, tips for proving service connection, and other special considerations.
Symptoms of Hiatal Hernia
Small hiatal hernias usually do not cause any symptoms and therefore do not need treatment. Larger hiatal hernias, on the other hand, are associated with GERD. GERD, or gastroesophageal reflux disease, can damage the lining of the esophagus, leading to esophagitis or Barrett’s esophagus, so treatment is usually essential.
Symptoms of hiatal hernias can include:
- Heartburn
- Nausea
- Vomiting
- Wearing down of teeth
- Respiratory problems
- Difficulty swallowing
- Fatigue
- Shortness of breath
- A dry cough
More serious cases of hiatal hernias, such as giant hiatal hernia, may also cause anemia, aspiration, and more.
Diagnosing a Hiatal Hernia
Causes of this type of hernia are often unknown, although the condition can be developed due to an injury or a birth defect. Other risk factors include weakness in the muscles surrounding the hernia, obesity, and smoking.
Doctors usually diagnose hiatal hernia with either an upper GI series, also known as a barium contrast X-ray, or through an esophagoscopy of the esophagus. They are commonly diagnosed in people over age 50.
Treatments for Hiatal Hernia
Most hiatal hernias can be treated with medications and regular monitoring. If GERD worsens or other serious symptoms occur, surgical treatment may be necessary.
Minimally invasive hernia repair can reduce the size of a hernia and the opening in the diaphragm, preventing serious issues such as strangulation. Surgeons may also decide to perform a fundoplication, which creates a bulge of tissue to hold the stomach in place below the hiatus.
How to Get Service Connection for Hiatal Hernia
To qualify for U.S. Department of Veterans Affairs (VA) disability benefits, veterans typically need to provide proof of these three things:
- An in-service event, injury, or illness;
- A current diagnosis by a medical professional; and
- A medical nexus, or link, between the in-service event, injury, or illness and current diagnosis.
Veterans can submit a claim for VA disability compensation for hiatal hernia by filling out VA Form 21-52EZ. This form can be submitted via mail to VA’s Evidence Intake Center or electronically through VA’s website.
Compensation and Pension (C&P) Exams for Hiatal Hernias
VA may also schedule a veteran for a compensation and pension (C&P) exam to evaluate their condition. C&P exams are performed by a VA physician or a VA-contracted physician, and usually have a dual purpose:
- To confirm or deny service connection for the veteran’s claim; and
- To assess the severity of the claimed condition so that a hiatal hernia VA rating may be issued if service connection is confirmed.
It is essential that veterans attend their C&P exams when VA schedules them. If a veteran does not attend a C&P exam, VA may deny their claim. If a veteran cannot attend an exam after it has been scheduled, the veteran should contact VA as soon as possible to reschedule.
In hiatal hernia cases, the veteran may want to consider using a Disability Benefits Questionnaire (DBQ). These forms are intended to quicken the claims process and give veterans the opportunity to answer questions about the symptoms, severity, and causes of their disability, as well as its relationship to other disabilities (e.g., secondary conditions). DBQs may also be filled out by a veteran’s primary care doctor prior to the exam.
It is important for veterans to be honest and thorough during their C&P exam and in their DBQ. Oftentimes, veterans will downplay the severity of their condition, which can be detrimental to their claim.
VA Ratings and Benefits for Hiatal Hernia
Disability benefits are assigned in accordance with VA’s rating system. Ratings are assigned based on severity of symptoms, with the most severe conditions receiving the highest rating.
Hiatal hernias are rated under 38 CFR § 4.114, Schedule of Ratings – Digestive System, Diagnostic Code 7346.
Veterans can be rated at 0, 10, 30, 50, or 80 percent, depending on the severity of their disability. The criteria for each VA rating are as follows:
• 80 percent – “Documented history of recurrent or refractory esophageal esophageal stricture(s) causing dysphagia with at least one of the symptoms present:
- aspiration
- undernutrition, and/or
- substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophagogastrointestinal tube (PEG tube)”
• 50 percent – “Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following:
- dilatation 3 or more times per year, or
- dilatation using steroids at least one time per year, or
- esophageal stent placement”’
• 30 percent – “Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year”
• 10 percent – “Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic”
• 0 percent – “Documented history without daily symptoms or requirement for daily medications”
Did VA Deny Your Hiatal Hernia Claim?
If VA denied your claim for hiatal hernia disability compensation, Chisholm Chisholm & Kilpatrick LTD may be able to help you appeal the decision. The experienced and skilled attorneys at CCK have helped many veterans win the VA compensation they deserve. Contact CCK today to schedule a free consultation.
