VA Rating for Hiatal Hernia 

A hiatal hernia occurs when the upper part of the stomach pushes through the diaphragm into the chest cavity. This condition can cause a range of symptoms, often tied to other digestive issues such as GERD (gastroesophageal reflux disease). Veterans suffering from hiatal hernias may be eligible for VA disability compensation depending on the severity of their condition. Understanding how VA rates hiatal hernias and what veterans need to establish service connection is crucial for obtaining benefits. 

How the VA Rates Hiatal Hernia 

The VA rates hernias, including hiatal, under 38 CFR § 4.114, Diagnostic Code 7338, based on the severity of symptoms. Ratings are assigned at 100%, 60%, 30%, or 20%, 10% or 0%. 

Here are the criteria for each: 

100% – Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:  

• Size equal to 15 cm or greater in one dimension; and  
• Pain when performing at least three of the following activities:  bending over, activities of daily living (ADLs), walking and climbing stairs

60% – Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:  

• Size equal to 15 cm or greater in one dimension; and  
• Pain when performing two of the following activities:  bending over, ADLs, walking and climbing stairs

30% – Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:  

• Size equal to 3 cm or greater but less than 15 cm in one dimension; and  
• Pain when performing at least two of the following activities:  bending over, ADLs, walking and climbing stairs

20% – Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:  

• Size equal to 3 cm or greater but less than 15 cm in one dimension; and  
• Pain when performing one of the following activities:  bending over, ADLs, walking and climbing stairs

10% – Irreparable hernia (new or recurrent) present for 12 months or more; with hernia size smaller than 3 cm. 

0% (noncompensable) – Asymptomatic hernia; present and repairable, or repaired. 

VA Notes: (1): With two compensable inguinal hernias, evaluate the more severely disabling hernia first, and then add 10% to that rating to account for the second compensable hernia. Do not add 10% to that rating if the more severely disabling hernia is rated at 100%. (2): Any one of the following activities of daily living (ADLs) are sufficient for evaluation: bathing, dressing, hygiene, and/or transfers. 

Presumptive Conditions for Hiatal Hernia 

While hiatal hernias are not typically listed as presumptive conditions, they may be linked to other presumptive conditions like GERD or secondary to PTSD. If you can prove that your hiatal hernia is connected to service or is a result of a service-connected condition, you may be eligible for benefits. 

GERD and Hiatal Hernia Connection 

GERD is a common secondary condition associated with hiatal hernia. The stomach’s position through the diaphragm weakens the lower esophageal sphincter, causing acid reflux. Veterans with a service connection for GERD may also qualify for a secondary connection for a hiatal hernia. 

Hiatal Hernia Secondary to PTSD 

Veterans diagnosed with PTSD may develop GERD because of stress-related digestive issues, which can lead to or exacerbate a hiatal hernia. Establishing a connection between PTSD and a secondary hiatal hernia can be critical for a successful claim. 

Winning VA Disability Claims: Hiatal Hernia Secondary to PTSD – Case Example 

In this case, a veteran who served in the U.S. Army from March 1959 to March 1979, including two combat tours in Vietnam, filed a claim for service connection for multiple conditions, including hiatal hernia, claimed as secondary to service-connected post-traumatic stress disorder (PTSD). The veteran initially received a denial for service connection for hiatal hernia but appealed the decision. After a detailed review of the medical records and testimony, the Board of Veterans’ Appeals (Board) reexamined the evidence. 

The Board ultimately granted service connection for hiatal hernia, recognizing that the condition was proximately caused by or aggravated due to the veteran’s service-connected PTSD. The Board applied the benefit of the doubt rule, finding that the evidence was in relative equipoise, meaning the positive and negative evidence regarding the connection between PTSD and the hiatal hernia was balanced. 

Key Factors That Contributed to Winning the Claim: 

• Medical evidence of the hiatal hernia was established through gastrointestinal testing (barium swallow and upper gastrointestinal examination), which diagnosed the veteran with a sliding hiatal hernia. 
• Expert medical opinions linked the hiatal hernia to the veteran’s service-connected PTSD. Several VA and private medical professionals submitted statements suggesting that PTSD and its associated stress are risk factors for gastrointestinal disorders like hiatal hernia. 
• The veteran’s testimony and medical history demonstrated the onset of gastrointestinal symptoms, including vomiting and abdominal distress, which started after service but were associated with ongoing PTSD. 
• The Board applied the benefit of the doubt rule (38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102), granting the claim in favor of the veteran due to the balance of positive and negative evidence. 

The veteran successfully established that his hiatal hernia was secondary to his service-connected PTSD, a significant win that highlights the importance of medical opinions and thorough documentation in service connection claims. This case underscores how gastrointestinal conditions, including hiatal hernias, can be linked to mental health conditions like PTSD, resulting in the veteran obtaining the deserved disability benefits. 

Getting VA Disability for Hiatal Hernia 

To obtain VA disability benefits for a hiatal hernia, you need to: 

• Prove an in-service event, injury, or illness: Show that the hiatal hernia was caused or aggravated during military service. 
• Provide a current diagnosis: A medical professional must confirm that you have a hiatal hernia. 
• Establish a medical nexus: You must show a connection between your military service and the development of the hiatal hernia. 

How to Increase Your VA Rating for Hiatal Hernia 

Veterans who believe their VA rating for hiatal hernia is too low or their condition has worsened may be eligible for an increased rating. To secure a higher rating, veterans should submit new medical evidence that demonstrates the increased severity of their symptoms. 

Winning VA Disability Claims: Increased Rating for Gastritis with Hiatal Hernia and GERD – Case Example 

In this case, a veteran who served in the U.S. Army from January 1970 to April 1972, filed for an increased rating for gastritis with hiatal hernia and gastroesophageal reflux disease (GERD). The veteran initially received a 30% disability rating but believed his symptoms were more severe than reflected by the rating. After appealing the decision, the Board of Veterans’ Appeals (Board) reviewed the evidence, including medical examinations and testimony. 

The Board ultimately granted the veteran a 60% disability rating for gastritis with hiatal hernia and GERD, recognizing that the condition caused severe impairment to the veteran’s health, meeting the criteria for a higher rating. 

Key Factors That Contributed to Winning the Claim: 

• The veteran presented consistent medical documentation of daily abdominal pain, vomiting, nausea, anemia, weight loss, and regurgitation, which demonstrated that his condition had worsened over time. Multiple medical examinations confirmed these symptoms. 
• During the January 2008 VA examinations, the physician diagnosed the veteran with “moderate to severe” GERD and esophagitis. These findings, along with evidence of a marked GERD diagnosis from an April 2007 barium swallow test, provided compelling evidence for a higher rating. 
• The veteran’s testimony at the Travel Board hearing provided firsthand accounts of his significant weight loss (61 pounds in three years) and severe symptoms, supporting the claim for an increased rating. 
• The Board applied the benefit of the doubt rule due to the difficulty in separating the effects of the veteran’s service-connected gastritis with hiatal hernia and GERD from his nonservice-connected bone marrow cancer, as per the Mittleider v. West precedent, thereby attributing all symptoms to the service-connected condition. 

The Board granted the veteran a 60% disability rating for his gastritis with hiatal hernia and GERD, based on the severity of his symptoms and their impact on his health. This case highlights the importance of detailed medical documentation and testimony in successfully obtaining a higher disability rating for conditions that worsen over time. 

100% VA Rating for Hiatal Hernia  

A 100% VA rating for hiatal hernia is rare but could be achieved through Total Disability Individual Unemployability (TDIU) if the condition severely impairs your ability to work or is secondary to another service-connected condition. Veterans unable to work due to their hiatal hernia or related conditions may qualify for TDIU. 

Winning TDIU Based on Major Depressive Disorder and Hiatal Hernia: A Case Analysis 

In this case, the veteran, who served from March 1981 to March 1985, sought Total Disability Individual Unemployability (TDIU) due to major depressive disorder and a hiatal hernia. Initially rated at 50% for major depressive disorder and 10% for a hiatal hernia, the veteran’s conditions worsened over time. He appealed for an increased rating for both conditions, along with claims for service connection for several other disabilities, including hypertension and gastric ulcers. 

The Board of Veterans’ Appeals ultimately granted TDIU, finding that the combination of the veteran’s major depressive disorder and hiatal hernia rendered him unable to maintain substantially gainful employment. 

Key Points in Securing TDIU: 

• The veteran’s major depressive disorder progressed significantly. By March 13, 2012, his symptoms included total occupational and social impairment, memory issues, social withdrawal, neglect of personal hygiene, and severe concentration problems. These symptoms resulted in the 100% disability rating for major depressive disorder, contributing heavily to the veteran’s unemployability. 
• Initially rated at 10%, the hiatal hernia was later rated 30% as of March 9, 2012, and 60% as of August 11, 2016. The veteran experienced recurrent epigastric distress, dysphagia, and severe abdominal pain. He required a restrictive diet and experienced frequent regurgitation, vomiting, and pain. These symptoms led to the conclusion that his hiatal hernia also severely impacted his daily functioning. 
• The veteran had been unemployed since 2007 and testified that his conditions prevented him from working. Medical evidence supported his claims that major depressive disorder and hiatal hernia were responsible for his inability to sustain gainful employment. The veteran’s condition significantly worsened by 2012, resulting in an eventual TDIU award based on these two service-connected disabilities. 

Evidence Leading to TDIU Award: 

• March 2012 VA Examination Findings: The veteran’s depressive disorder caused severe memory problems, concentration issues, and total occupational and social impairment. His hiatal hernia caused severe digestive issues that further limited his ability to work. 
• August 2016 Board Hearing: The veteran testified credibly regarding the severity of his abdominal symptoms, which included regurgitating food, vomiting blood, and a highly restrictive diet. His symptoms were consistent with the highest rating available under the diagnostic code for hiatal hernia. 
• Combination of Disabilities: The Board recognized that both the major depressive disorder and hiatal hernia combined to preclude the veteran from maintaining employment. His persistent mental health symptoms and digestive issues made it impossible for him to work in any capacity. 

The Board granted TDIU to the veteran based on the debilitating effects of his major depressive disorder and hiatal hernia, recognizing that these conditions caused total occupational impairment and severely impacted his daily life. The decision demonstrates the importance of consistent medical documentation and testimony in substantiating a claim for TDIU based on service-connected disabilities. 

Has the VA Denied or Underrated You? 

If your claim for a hiatal hernia has been denied or you feel the VA underrated your condition, you have options. You can file an appeal, and our team can help you navigate the process. Start with a free case evaluation to see if you are eligible for additional benefits.