Driven primarily by an immune system response that causes inflammation and structural changes in the esophagus, Eosinophilic Esophagitis (EoE) doesn’t strictly fit in either category of digestive issues: functional gastrointestinal disorders, which don’t involve visible structural abnormalities, and structural digestive conditions such as Crohn’s disease or ulcerative colitis. The abnormal immune response results in a build-up of eosinophils, a type of white blood cell, leading to structural damage that can overlap with functional impairments.
Because eosinophilic esophagitis involves clear structural damage such as narrowing (strictures) or scarring and significant inflammation, the VA officially classifies it as a digestive system condition rather than an immune system disorder. This distinction helps the VA determine how to rate your disability accurately.
How to Get VA Disability for Esophagitis
Qualifying for VA disability benefits requires proof of eosinophilic esophagitis and details showing how the symptoms connect to military service. The VA is very particular about this evidence, so understanding exactly what they’re looking for will strengthen your claim and help you get the appropriate disability rating.
Diagnosis Requirements
To get a VA disability rating for eosinophilic esophagitis, you must have strong medical documentation that proves the condition exists and affects your daily life. The VA has specific criteria you need to meet:
- Endoscopy results must show visible inflammation in the esophagus. This is usually one of the first signs doctors look for.
- The presence of esophageal strictures (narrowing of the esophagus) must be confirmed. The VA accepts several methods for this, including a barium swallow test, CT scans and EGD (esophagogastroduodenoscopy), which uses a camera to look inside your digestive tract
- A biopsy must show at least 15 eosinophils per high-power field, which confirms an abnormal buildup of white blood cells in the tissue.
- Medical records should show that your symptoms have continued even after treatment, such as medications or dietary changes.
- Doctors must also rule out other possible causes, like GERD (acid reflux) or a hiatal hernia, to confirm the diagnosis is truly eosinophilic esophagitis.
- If you’ve been tested for food allergies or sensitivities, that documentation should also be included, since allergic reactions often play a role in EoE.
This medical evidence lays the foundation for your claim. Without it, the VA will likely deny or underrate your condition.
Establishing Service Connection
Getting a diagnosis is just the first step. To receive VA disability benefits, you also need to prove that your eosinophilic esophagitis is connected to your military service. This is called establishing service connection. The VA recognizes different types of service connection, each one requiring specific kinds of evidence.
Direct Service Connection
Direct service connection means your eosinophilic esophagitis started during your time in the military. To prove this, you’ll need:
- Evidence that your symptoms began while you were still in service
- Service medical records showing those symptoms, like reports of trouble swallowing or chest discomfort
- A nexus letter from a medical provider. This is a written opinion linking your current diagnosis to what you experienced during service
The VA may also consider your environmental exposures during deployment. For example, if you were exposed to burn pits, the chemicals in that smoke could have irritated both your airways and digestive system. That irritation could trigger an immune response, leading to conditions like esophagitis.
Secondary Service Connection
If the esophagitis didn’t start in service but developed because of another service-connected condition, you may still qualify. This is known as a secondary service connection.
The VA already acknowledges that burn pit exposure can cause conditions like asthma and allergies. These immune-related conditions sometimes share the same triggers as eosinophilic esophagitis. If your immune system overreacts to certain exposures or allergens, it can cause inflammation in your esophagus, too.
So, if you’re already service-connected for a related issue like asthma, allergic rhinitis, or sinusitis and you later develop eosinophilic esophagitis, you may be able to file a secondary claim.
Known Conditions Related to Esophagitis
- GERD (Gastroesophageal Reflux Disease): GERD, also known as acid reflux, may trigger or worsen eosinophilic inflammation in the esophagus. In fact, a large VA study found that veterans dealing with symptoms like heartburn or difficulty swallowing were more likely to be diagnosed with EoE than those without these problems. That makes GERD one of the most important conditions to flag in your claim.
- Allergic Conditions (Rhinitis, Sinusitis, Asthma): Many veterans who have eosinophilic esophagitis also live with multiple allergic conditions. According to the same study, asthma and allergic rhinitis were especially common among veterans with EoE. These issues often share immune system triggers, which means having one makes it more likely you’ll develop another.
- Eczema: This skin condition has a strong association with other atopic conditions. Veterans with eczema often have immune system problems that can include or lead to eosinophilic esophagitis. If you’ve ever had eczema documented in your records, this might help support your claim.
- Medication Side Effects: Some medications used to treat service-connected conditions, especially NSAIDs (like ibuprofen) and antibiotics, can irritate the lining of the esophagus or trigger immune responses. These drugs are commonly prescribed for pain, arthritis, and infections, which many veterans face due to service-related injuries.
- Mental Health Conditions: Anxiety and PTSD can increase stress levels, which may worsen immune system flare-ups and inflammation. For veterans living with these conditions, stress can also make esophagitis symptoms feel more intense or cause them to occur more frequently.
If you’ve been diagnosed with any of these conditions or take medications known to affect the esophagus, they could be playing a role in your EoE and may be used to establish secondary service connection.
What Is the VA Rating for Esophagitis?
Since May 2024, the VA rates eosinophilic esophagitis from 0% to 80% under Diagnostic Code 7203 which evaluates Esophageal Stricture, making it easier for veterans to receive a rating that better reflects how the condition affects their ability to eat, swallow, and function day-to-day.
- 80% rating – Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube)
- 50% rating – Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following: (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement
- 30% rating – Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year
- 10% rating – Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic
- 0% rating – Documented history without daily symptoms or requirement for daily medications
VA Notes: Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved. Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
This updated system provides a clearer path for veterans with eosinophilic esophagitis to receive fair and accurate disability ratings based on real, measurable symptoms.
Getting the Correct VA Rating for Esophagitis
If you were rated for eosinophilic esophagitis before May 2024, there’s a chance your evaluation no longer reflects the current standards. The new Diagnostic Code 7203 focuses on how often you experience esophageal narrowing (strictures), how it affects your ability to swallow (dysphagia), and whether more intensive treatments like surgery or a feeding tube are required.
Now that the VA recognizes eosinophilic esophagitis through more specific language tied to functional symptoms and medical procedures, you may be eligible for a higher rating based on the severity of your condition.
For example, in a recent Board of Veterans’ Appeals decision, a veteran’s symptoms that were previously considered mild were reevaluated using the updated rating criteria, which acknowledged recurrent strictures and swallowing issues that required repeated medical procedures. That veteran received a higher rating based on the new standards.
If you haven’t had your rating reviewed since this policy update, it may be worth requesting a new evaluation to make sure your symptoms match the most accurate level of disability compensation.
How to Appeal a Low Rating
If you’ve already filed a claim for eosinophilic esophagitis and received a rating that doesn’t reflect how badly the condition affects you, you have 1 year to appeal the decision (if more than 1 year has passed, a claim for an increased rating would have to be filed).
The VA often underrates conditions like esophagitis, especially when the symptoms are not clearly documented or the connection to service is not well explained. There are several ways to appeal a decision:
- Request a Higher-Level Review – This asks a more experienced VA claims adjudicator to look over your case again using the same evidence.
- File a Supplemental Claim – You can submit new evidence, such as updated medical records or a nexus letter from your doctor.
- Appeal to the Board of Veterans’ Appeals – If you disagree with the decision even after a review or supplemental claim, you can take your case directly to the Board.
Hill & Ponton specializes in appeals and may be able to assist you. Our team understands what the VA looks for in esophagitis claims and can help you gather the right documentation, explain your condition clearly, and build a stronger case for the rating you deserve. Contact us today to review your case.
If your symptoms have worsened, or if you’ve developed secondary conditions as a result of your eosinophilic esophagitis, you may also qualify for a higher combined rating, which will boost your overall compensation.
Claiming Secondary Conditions to Esophagitis
Eosinophilic esophagitis doesn’t just affect your esophagus; it can lead to other health problems that may also qualify for VA compensation. If EoE causes or worsens another condition, you may be able to file for secondary service connection. Here are some common secondary conditions linked to EoE:
- GERD (Gastroesophageal Reflux Disease): The constant inflammation and narrowing of the esophagus can weaken the lower esophageal sphincter, making it easier for stomach acid to back up into your throat. This can cause or worsen GERD over time.
- Nutritional Deficiencies: If swallowing becomes difficult, you may not be able to eat enough to stay healthy. This can lead to unintentional weight loss, malnutrition, or vitamin deficiencies, all of which can qualify as separate ratable conditions.
- Psychological Impacts: Living with eosinophilic esophagitis can affect your mental health. Many veterans with this condition report a fear of choking, anxiety around eating in public, and even depression. If esophagitis is affecting your social life, mood, or daily functioning, those symptoms may be part of a secondary claim.
If any of these apply to you, it’s worth talking to your doctor and gathering medical evidence. Connecting these conditions to your primary eosinophilic esophagitis diagnosis could increase your total disability compensation.
TDIU: a Path to 100% Rating for Eosinophilic Esophagitis
Even if your esophagitis doesn’t meet the criteria for a 100% schedular rating, you may still qualify for Total Disability based on Individual Unemployability (TDIU). This benefit allows veterans whose service-connected conditions make it impossible to hold steady, gainful employment to receive compensation at the 100% level.
Eosinophilic esophagitis can seriously interfere with your ability to work, especially if you struggle with:
- Severe dysphagia (trouble swallowing)
- Frequent procedures like esophageal dilations
- Strict dietary limits that affect your daily routine
- Physical weakness from undernutrition or weight loss
- Mental health issues like anxiety or depression triggered by food-related stress
If your condition prevents you from maintaining a regular work schedule, even in jobs that are considered “light duty,” you may qualify for TDIU. To apply, you’ll need:
- Medical evidence showing how EoE affects your ability to work
- Employment history that reflects the challenges you’ve faced
- Supportive statements from doctors or vocational experts
Hill & Ponton can help guide you through the TDIU process. We understand what kind of evidence the VA looks for and how to present your case in a way that connects your symptoms to real-world work limitations. If your eosinophilic esophagitis has made it hard or impossible to keep a job, TDIU might be the path that gets you the full compensation you’ve earned. Call us today to get a free case evaluation.
Content Reviewed by
Attorney Anne Linscott
Anne Linscott is an attorney at Hill & Ponton, P.A., dedicated to helping veterans secure the disability benefits they deserve. With a strong background in finance and law, Anne brings compassionate advocacy and a deep commitment to supporting those who have served.
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