Reference: 38 CFR 4.114
Sources & Related GuidesUnderstand why DC 7346 (Hiatal Hernia and paraesophageal hernia) has no rating table of its own -- it is rated entirely as esophageal stricture (DC 7203), a table functionally identical to the GERD hub's DC 7206 criteria.
DC 7346's own current text is a pure redirect, in full: "Hiatal hernia and paraesophageal hernia: Rate as esophagus, stricture of (DC 7203)." There is no independent Hiatal Hernia rating table under the current schedule. DC 7203's own criteria table is functionally identical to DC 7206, which RatingScope already hosts in the GERD hub -- confirmed by RSCH-057 to share the same 80%, 50%, 30%, 10%, and 0% figures with only one immaterial wording variance. Rather than duplicate that table here, this hub cross-links directly to the live GERD hub, which owns those five figures.
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Overview
DC 7346's own current text is a pure redirect, in full: "Hiatal hernia and paraesophageal hernia: Rate as esophagus, stricture of (DC 7203)." There is no independent Hiatal Hernia rating table under the current schedule. DC 7203's own criteria table is functionally identical to DC 7206, which RatingScope already hosts in the GERD hub -- confirmed by RSCH-057 to share the same 80%, 50%, 30%, 10%, and 0% figures with only one immaterial wording variance. Rather than duplicate that table here, this hub cross-links directly to the live GERD hub, which owns those five figures.
Regulatory authority: 38 CFR 4.114, DC 7346
This guide is educational only. It explains DC 7346's redirect and points to the GERD hub's DC 7206 criteria rather than duplicating them. It does not diagnose hiatal hernia, does not infer missing findings, does not determine service connection, and does not predict a VA decision. Section 4.114's predominant-disability-picture rule (diagnostic codes 7301-7329, 7331, 7342, 7345-7350, 7352, and 7355-7357 cannot be combined with each other via section 4.25; a single predominant code is chosen instead, possibly elevated one step) governs both DC 7346 and DC 7303 (the separate post-surgical-complications code discussed below) and is not automated here -- disclosed, not silently applied.
Learn
Use these short guides to connect published terms with the records and observations that may clarify them.
DC 7346's own text reads, in full: "Hiatal hernia and paraesophageal hernia: Rate as esophagus, stricture of (DC 7203)." There is no separate Hiatal Hernia table.
Records to review: Stomach and Duodenum DBQ; Endoscopy, barium swallow, or CT documentation; GERD hub's DC 7206 evidence categories.
A separate diagnostic code, DC 7303 (chronic complications of upper gastrointestinal surgery), may apply after a hiatal hernia repair. DC 7303 is not part of DC 7346's redirect and is already fully hosted in the Peptic Disease hub.
Records to review: Surgical and post-operative records; Peptic Disease hub's DC 7303 evidence categories.
38 CFR 4.114 states that diagnostic codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357 cannot be combined with each other using the standard combined-ratings table. Both DC 7346 (hiatal hernia, via its DC 7203 redirect) and DC 7303 (chronic complications of upper GI surgery) fall within that range. Instead, a single predominant-disability code is chosen, possibly elevated one step. RatingScope does not automate this rule.
Records to review: treatment records documenting each digestive-system diagnosis; clinician assessment of predominant disability.
Evidence
Records confirming a hiatal hernia or paraesophageal hernia diagnosis, and any documented esophageal stricture or dysphagia findings tied to it.
A diagnosis alone does not identify a percentage pathway; the specific stricture, dysphagia, and treatment findings the GERD hub's DC 7206 guide asks about are still needed.
Objective findings can help show whether an esophageal stricture is documented alongside the hernia.
Do not assume a finding exists if the record does not document it.
Relevant if a hiatal hernia repair was performed and post-surgical complications are being separately reviewed under DC 7303.
Surgical history alone does not establish a DC 7303 percentage; see the Peptic Disease hub's specific findings.
May organize the esophageal stricture, dysphagia, and treatment findings relevant to the GERD hub's DC 7206 pathway.
A DBQ helps organize facts, but RatingScope still reviews only the facts provided.
Take the public DBQ to your private physician or review it prior to your C&P examination.
Terminology
DC 7346 covers both hiatal hernia and paraesophageal hernia, and is rated entirely as esophageal stricture under DC 7203.
There is no independent Hiatal Hernia rating table; the current DC 7203 table is functionally identical to the GERD hub's DC 7206 table.
DC 7346's own text says to rate hiatal hernia and paraesophageal hernia as DC 7203, esophageal stricture.
DC 7203's table shares the same 80%, 50%, 30%, 10%, and 0% figures as DC 7206, the current GERD table already hosted in this site's GERD hub.
DC 7303 is not part of DC 7346's redirect. It is already fully hosted in the Peptic Disease hub.
A hiatal hernia repair's post-surgical complications are reviewed under DC 7303's own findings, not duplicated in this hub. DC 7303 and DC 7346 both fall within 38 CFR 4.114's non-combination list, so a single predominant-disability rating applies when both are documented, not two combined ratings.
Even if the schedular rating for Hiatal Hernia does not reach 100 percent, TDIU may still provide a pathway to compensation at the 100 percent rate, based on unemployability from this and/or other service-connected disabilities combined.
A lower schedular percentage does not by itself foreclose TDIU eligibility -- this hub computes only the schedular percentage for this specific condition and does not determine TDIU eligibility.
Employment history; vocational impact documentation; occupational impairment
Common Questions
DC 7346's own current text is a pure redirect: "Hiatal hernia and paraesophageal hernia: Rate as esophagus, stricture of (DC 7203)." There is no independent Hiatal Hernia table under the current schedule.
DC 7203's table is functionally identical to DC 7206, the current GERD table already hosted on this site: the same 80%, 50%, 30%, 10%, and 0% figures, confirmed by RSCH-057 with only one immaterial wording variance. See the GERD hub for those figures.
Yes. Effective May 19, 2024, the same rule that revised the Liver Conditions range also added "and paraesophageal hernia" to DC 7346's title alongside a rewrite of its rating text into the current redirect. Whether this reflects a scope expansion or only a title clarification could not be determined from the current text alone, so RatingScope discloses this as an editorial-history fact only.
That is a separate diagnostic code, DC 7303 (chronic complications of upper gastrointestinal surgery), not part of DC 7346's redirect. DC 7303 is already fully hosted in the Peptic Disease hub, which owns its findings and percentages. If both DC 7346 and DC 7303 are documented at the same time, section 4.114's non-combination rule applies -- see the next question.
Section 4.114 states that ratings under diagnostic codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357 cannot be combined with each other. DC 7346 (via its DC 7203 redirect) and DC 7303 both fall within that range. A single predominant-disability code is chosen instead, possibly elevated one step. RatingScope discloses this rule but does not automate it.
Possibly, through TDIU (Total Disability rating based on Individual Unemployability, 38 CFR 4.16) -- a separate pathway to 100 percent compensation based on unemployability, from this and/or other service-connected disabilities combined, independent of whether the schedular rating itself reaches 100 percent. This hub computes only the schedular percentage and does not determine TDIU eligibility.
Preparation
Confirmed hiatal hernia or paraesophageal hernia diagnosis
The record should confirm the diagnosis before comparing it against the GERD hub's DC 7206 criteria.
Esophageal stricture and dysphagia documentation
DC 7203, the code DC 7346 redirects to, depends on the same stricture and dysphagia findings as the GERD hub's DC 7206 table.
Surgical repair and post-operative records, if applicable
Relevant only if reviewing a separate DC 7303 complications pathway, hosted in the Peptic Disease hub.
Ready when you are
RatingScope does not provide a separate Hiatal Hernia assessment. DC 7346 is rated entirely as DC 7203, functionally identical to the GERD hub's DC 7206 table, so use the GERD assessment instead. Do not enter hiatal hernia findings into another condition's assessment without confirming the DC 7203/7206 comparison applies.
Informational guidance only. RatingScope does not predict, decide, or guarantee VA outcomes.
Resources
External source/reference
Primary source for DC 7346's current redirect text and DC 7203's rating criteria.
Open 38 CFR 4.114, DC 7346 and DC 7203External source/reference
Primary source for the 89 FR 19743 final rule that updated DC 7346's title and text effective May 19, 2024.
Open Federal Register final rule for digestive system updatesRatingScope resource
Owns DC 7206's 80%, 50%, 30%, 10%, and 0% figures, which DC 7346's DC 7203 redirect functionally mirrors. This hub cross-links rather than recreating those rows.
Open GERD guideRatingScope resource
Owns DC 7303's chronic complications of upper GI surgery criteria, a separate pathway that may apply after a hiatal hernia repair.
Open Peptic Disease guideExternal source/reference
Official source for TDIU, a separate pathway to 100 percent compensation based on unemployability, independent of the schedular percentage. This hub does not determine TDIU eligibility.
Open 38 CFR 4.16 - Total disability ratings for compensation based on unemployability (TDIU)Secondary conditions
No commonly documented secondary connections are tracked for Hiatal Hernia yet.
In-depth analysis of DBQ forms, medical evidence thresholds, and rating schedules for Hiatal Hernia.
Understand how the VA evaluates inguinal, ventral, and hiatal hernias under 38 CFR 4.114 based on reducibility, truss support, and reflux symptoms.
Understand how the VA evaluates GERD under 38 CFR 4.114, Diagnostic Code 7206, based on esophageal stricture, dysphagia, dilatation frequency, and health impact.
Learn the medical evidence required under the VA's revised 2024 GERD rating criteria (DC 7206), including endoscopy proof, esophageal stricture, and DBQs.
Detailed analysis of post-May-19-2024 VA rating criteria for GERD under 38 CFR 4.114 (DC 7206), stricture definitions, dysphagia, and dilatation frequency.
Navigate the VA Esophageal Disorders Disability Benefits Questionnaire (DBQ), clinical evaluation domains, barium swallow, endoscopy, and objective documentation.
Understand the critical distinction between a clinical diagnosis of GERD and the schedular compensable rating criteria under DC 7206 and DC 7203.
Master the specific non-combination rule in 38 CFR 4.114 governing digestive diagnostic codes, predominant disability picture, single step elevation, and anti-pyramiding.
Keep going
Compare a percentage level and combined-rating math, or review evidence context.
Understand the whole-person method, final rounding, and bilateral limits, then calculate how percentages combine.
Open VA Math guideUnderstand common evidence categories and what they can clarify without treating them as a checklist.
Open Evidence Center