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Considerable Impairment Of Health?



I have a SC for hiatal hernia with gastroesphageal reflux. The SC was established about three years ago. At that time it was rated at 10%--due to "symptoms of reflux, regurgitation and heartburn, dysphagia, epigastric pain, hematemesis, regurgitation of stomach contents, nausea, and vomiting, which occur constantly." In addition, "EGD revealed a small hiatal hernia, nonobstructive Schatzki's ring. Diagnosis is hiatal hernia with GERD."

The rating schedule says that "a higher evaluation of 30 percent is not warranted unless there are symptoms of persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain which is productive of considerable impairment of health."

My question is this: I have recently developed substernal pain that is often associated with the HH and referred to in the 30% rating--but what does the VA consider a "considerable impairment of health?"



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It seems that the more symptoms you have, the higher the rating. Below, I also listed a couple of BVA cases where 30% or 60% was granted. Getting a 30% rating requires you to have a lot of the symptoms. You have to be in really bad shape to get the 60% rating. A strong IMO and supporting evidence to warrant a 30%+ rating is probably your best bet.

§4.114 Schedule of ratings-digestive system

7346 Hernia hiatal:


Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health


Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health


With two or more of the symptoms for the 30 percent evaluation of less severity 10

30% rating granted


The record reflects that although his symptoms are not

constant, the Veteran experiences recurrent gastrointestinal

symptoms including dysphagia, pyrosis, regurgitation, and

substernal pain that has consistently been determined to be

related to his gastrointestinal disorder. He has

additionally been diagnosed with mild anemia. These symptoms

are productive of considerable impairment of health.

Accordingly, giving the Veteran the benefit of the doubt, the

Board finds that he is entitled to an increased rating of 30

percent under DC 7346.

60% rating granted



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Thanks for the info!

Yeah, my deal is that I now have all the symptoms that are listed in the 30% rating so that is what I would look for. I just wasn't sure exactly what the VA definition of considerable impairment of health was--these things sure seem considerable to me!

Thanks again,


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