Barrett's Esophagus

DC 7346Digestive38 CFR 4.114, DC 7346

A precancerous condition where the lining of the esophagus changes due to chronic acid reflux damage. Often develops as a complication of service-connected GERD. Rated under the same criteria as hiatal hernia based on symptom severity.

Rating Levels

You have Barrett's esophagus with symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.

What the VA looks for

Barrett's with high-grade dysplasia or extensive metaplasia
Material weight loss documented
Hematemesis (vomiting blood) or melena (bloody stool)
Moderate anemia on blood work
Severe impairment of health documented by physician

Common Pitfalls

⚠Not getting regular surveillance endoscopies — Barrett's requires periodic biopsies to check for dysplasia (precancer), and these records document the ongoing nature of the condition.
⚠Not filing Barrett's as secondary to service-connected GERD — Barrett's is a well-established complication of chronic acid reflux, and the nexus is straightforward if GERD is already service-connected.
⚠Not documenting the cancer risk — Barrett's esophagus increases esophageal cancer risk 30-60 times, and the need for ongoing surveillance and the anxiety associated with cancer risk support the claim.
⚠Not tracking weight loss and nutritional impact — dietary restrictions and difficulty eating due to Barrett's should be documented at every visit.

Related DBQ Forms

DBQ Esophageal Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Rating Levels

What the VA looks for

Barrett's with high-grade dysplasia or extensive metaplasia
Material weight loss documented
Hematemesis (vomiting blood) or melena (bloody stool)
Moderate anemia on blood work
Severe impairment of health documented by physician

Common Pitfalls

⚠Not getting regular surveillance endoscopies — Barrett's requires periodic biopsies to check for dysplasia (precancer), and these records document the ongoing nature of the condition.

⚠Not filing Barrett's as secondary to service-connected GERD — Barrett's is a well-established complication of chronic acid reflux, and the nexus is straightforward if GERD is already service-connected.

⚠Not documenting the cancer risk — Barrett's esophagus increases esophageal cancer risk 30-60 times, and the need for ongoing surveillance and the anxiety associated with cancer risk support the claim.

⚠Not tracking weight loss and nutritional impact — dietary restrictions and difficulty eating due to Barrett's should be documented at every visit.