Body system: Digestive SystemRegulation: 38 CFR § 4.114
Barrett's esophagus is a precancerous condition where the normal squamous lining of the lower esophagus is replaced by intestinal-type columnar epithelium (metaplasia), typically caused by chronic gastroesophageal reflux. The VA splits DC 7207 into two pathways. WITH esophageal stricture: rate under DC 7203 (Esophagus, stricture of) for the dysphagia-based ladder (0%-80%). WITHOUT esophageal stricture: 30% if biopsy shows HIGH-GRADE dysplasia, or 10% for LOW-GRADE dysplasia. Note (1): If malignancy develops (esophageal adenocarcinoma is the typical risk), rate under DC 7343 (Malignant neoplasms of the digestive system). Note (2): If Barrett's is resolved by surgery, radiofrequency ablation, or other treatment, rate any residuals under DC 7203.
Rating levels
- 30% — You qualify for 30% if you have Barrett's esophagus WITHOUT esophageal stricture, and biopsy/pathology shows HIGH-GRADE dysplasia (severe abnormal cell changes that carry a meaningful risk of progression to esophageal adenocarcinoma). Diagnosis must be confirmed by pathologic examination of tissue samples obtained on endoscopy.
- 10% — You qualify for 10% if you have Barrett's esophagus WITHOUT esophageal stricture, and biopsy/pathology shows LOW-GRADE dysplasia (mild abnormal cell changes, lower risk of progression to cancer but still requires monitoring). Diagnosis must be confirmed by pathologic examination of tissue samples obtained on endoscopy.
- -1% — If your Barrett's esophagus is accompanied by an esophageal stricture (narrowing), the rating shifts to DC 7203 (Esophagus, stricture of), which ranges from 0% to 80% based on the severity of swallowing impairment. The stricture-based rating typically yields a higher percentage than the dysplasia tiers when significant dysphagia, weight loss, or aspiration is present.
- -1% — If your Barrett's esophagus progresses to malignancy (esophageal adenocarcinoma is the typical concern), the rating shifts to DC 7343 (Malignant neoplasms of the digestive system, exclusive of skin growths) which assigns 100% during active disease and treatment, with a mandatory VA examination at the appropriate post-treatment interval followed by residuals rating.
- -1% — If your Barrett's esophagus has been treated and resolved (typical treatments include endoscopic mucosal resection, radiofrequency ablation, cryotherapy, or surgical esophagectomy), the rating shifts away from the dysplasia tiers and onto DC 7203 (Esophagus, stricture of) for any residual swallowing impairment. Even treated Barrett's commonly leaves stricture as a residual, especially after RFA or surgery.