VA Disability Rating for Esophageal Diverticulum (DC 7205)
Diagnostic Code 7205 · 38 CFR §4.114
What Is It?
DC 7205 is “Esophagus, diverticulum of, acquired,” and its rating cell in 38 CFR 4.114 is empty. The entry is one line: rate as esophagus, stricture of (DC 7203). Its Note names the three types the code covers — pharyngo-esophageal (Zenker's) diverticulum, mid-esophageal diverticulum, and epiphrenic diverticulum of the distal esophagus. A diverticulum is a pouch in the wall of the esophagus. Food and liquid collect in it, then come back up hours later undigested, and the pouch can spill into the airway during sleep, which is why chronic cough, morning hoarseness and repeated chest infections are part of the picture. Because the entry routes to DC 7203, the percentage is decided on documented stricture, dysphagia and the treatment that stricture requires — counted dilatations, steroid-assisted dilatation, a stent, surgical correction, a feeding tube. A barium swallow showing the pouch is essential evidence, but the size of the pouch is not itself a rating criterion.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 7205 assigns no percentages of its own — its rating cell in 38 CFR 4.114 is empty. The entry directs: rate as esophagus, stricture of (DC 7203). DC 7203 runs 80, 50, 30, 10 and 0 percent. 80 percent requires a documented history of recurrent or refractory stricture causing dysphagia with aspiration, undernutrition and/or substantial weight loss as 38 CFR 4.112(a) defines it, together with surgical correction or a percutaneous esophago-gastrointestinal (PEG) tube. 50 percent requires dilatation three or more times a year, dilatation using steroids at least once a year, or an esophageal stent. 30 percent is recurrent stricture causing dysphagia needing dilatation no more than twice a year. 10 percent is a documented stricture requiring daily medication to control dysphagia, otherwise asymptomatic. 0 percent is a documented history without daily symptoms or daily medication. Note (1) to DC 7203 requires the findings be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy, and Notes (4) and (5) define recurrent and refractory stricture — target diameter not held beyond four weeks, and target diameter not achieved despite no fewer than five dilatation sessions at two-week intervals. |
Evidence Needed
- A barium swallow showing the diverticulum, its type and location — and the study is also one of the three DC 7203 Note (1) accepts
- An esophagogastroduodenoscopy report where one has been performed
- A dated record of every dilatation, since the 30 and 50 percent rows count them per year
- Records of any stent, cricopharyngeal myotomy, diverticulectomy or other surgical correction, and of any PEG tube
- The medication list, for the 10 percent row where a daily prescription controls the dysphagia
- Documentation of aspiration events, chest infections or undernutrition, which are elements of the 80 percent row
- Weight measurements with a baseline, for the 38 CFR 4.112(a) weight-loss element
C&P Exam Tips
- Bring the barium swallow report itself rather than a summary of it, and the endoscopy report if one exists
- Bring the dated procedure history — the rows count dilatations per year, so dates carry the claim
- Describe regurgitation precisely: how long after eating, whether the food is undigested, and whether it happens lying down or at night
- Report every aspiration event, chest infection and course of antibiotics, which is how the 80 percent row's aspiration element is documented
- Say what surgery was performed and what symptoms remained after it, because post-surgical residuals are rated on the same ladder
- Bring weight records so any loss is measured rather than estimated
How to File
File VA Form 21-526EZ naming the diverticulum — Zenker's, mid-esophageal or epiphrenic — and let the rater apply DC 7205. Lead with the barium swallow, then the dated procedure history, because the percentage is taken from DC 7203 and those are the documents its rows are written on. If aspiration has caused a lung condition, claim that separately: the respiratory schedule sits outside 38 CFR 4.114 entirely, so it is combined rather than absorbed. Neither DC 7205 nor DC 7203 is inside 4.114's non-combination range of DC 7301 through 7329.
Common Mistakes
Filing without imaging. A barium swallow shows the pouch and is one of the three studies DC 7203 Note (1) accepts as documentation. Describing the pouch's size, which is not a rating criterion, instead of the dysphagia and the treatment it required, which are. Leaving the aspiration history out, when aspiration is one of the three named routes into the 80 percent row. Assuming DC 7205 has a table of its own — its rating cell is empty and the entry routes to DC 7203.
Frequently Asked Questions
Why is there no rating table under DC 7205?
Because the code assigns no percentages. Its rating cell in 38 CFR 4.114 is empty and the entry reads “Rate as esophagus, stricture of (DC 7203).” DC 7203's rows — 80, 50, 30, 10 and 0 percent — decide the evaluation.
Does an esophageal diverticulum require surgery?
Not always. Small, minimally symptomatic pouches are managed with dietary changes and posture. Larger or symptomatic ones may need a myotomy or diverticulectomy. Either way the rating follows DC 7203, and residual symptoms after surgery are evaluated on the same rows.
My pouch is large but my rating is low. Why?
Because DC 7203's rows count documented stricture, dysphagia and treatment — dilatations per year, steroid-assisted dilatation, stent, surgery, feeding tube — not the size of the diverticulum. The dated treatment history is what moves the percentage.