What Is GERD
GERD (gastroesophageal reflux disease) is a chronic condition where stomach acid repeatedly flows back into the esophagus, causing inflammation and symptoms like heartburn, chest pain, and difficulty swallowing. The VA rates GERD under diagnostic code 7346, with ratings ranging from 0% to 60% depending on severity and frequency of symptoms.
In VA disability claims, GERD is frequently pursued as a secondary condition rather than a primary service-connected disability. Veterans often develop GERD after service due to medications prescribed for other service-connected conditions, particularly NSAIDs taken for pain management, or as a result of service-connected injuries affecting the gastrointestinal system.
VA Rating Schedule for GERD
- 0%: Symptoms controlled by dietary management alone, no medications required
- 10%: Occasional symptoms despite treatment, minimal impact on daily function
- 20%: Symptoms present despite continuous medication, occasional flare-ups requiring dietary modification
- 40%: Severe symptoms with frequent exacerbations despite medication, significant dietary restrictions needed
- 60%: Severe ulcerative esophagitis with hemorrhage or stricture requiring ongoing medical management
Most GERD claims fall into the 10-20% range. Higher ratings require documented evidence of structural complications like esophageal stricture or Barrett's esophagus confirmed through endoscopy.
Filing GERD as a Secondary Condition
When submitting a GERD claim as secondary to another service-connected condition, you need to establish a nexus between the primary condition and GERD development. This typically means showing that medications taken for the primary condition caused or aggravated GERD.
Common primary conditions leading to secondary GERD claims include:
- Service-connected back or joint pain requiring chronic NSAID use
- PTSD or anxiety requiring medications that relax the lower esophageal sphincter
- Service-connected abdominal injuries or surgical procedures
- Agent Orange exposure linked to gastrointestinal conditions
Your nexus letter must come from a medical provider and specifically connect the primary condition's treatment to GERD development. A generic statement that GERD "can be caused by" NSAIDs is insufficient. The provider must address your specific medication regimen and explain the causal relationship to your individual case.
C&P Examination for GERD
The VA will schedule a Compensation and Pension (C&P) exam to evaluate your GERD claim. The examiner will review your medical records, symptom frequency, medication usage, and functional limitations. Bring documentation showing:
- Frequency and severity of symptoms (daily, weekly, triggered by specific foods or medications)
- List of all current medications, including antacids and proton pump inhibitors (PPIs)
- Any diagnostic testing results (endoscopy, pH monitoring, upper GI imaging)
- Impact on eating, sleeping, and work activities
- Visits to gastroenterologists or primary care providers for GERD management
Be specific during the exam. Describing "frequent heartburn" is weaker than explaining "daily heartburn occurring 4-5 times weekly, requiring medication before meals and at bedtime, with occasional nighttime symptoms waking me from sleep."
Common Questions
- Can I claim GERD if it developed before service but worsened during service? Only if you can show service aggravation. You'll need medical evidence that military service or a service-connected condition significantly worsened pre-existing GERD. This requires a nexus letter addressing the aggravation specifically.
- What percentage rating should I expect for GERD alone? Most initial ratings are 10% or 20%. The VA rarely grants higher ratings without documented structural damage (stricture, Barrett's esophagus, or hemorrhage confirmed by endoscopy). If rated lower than you believe warranted, you can file a supplemental claim with updated medical evidence.
- Will I need VSO representation for a GERD claim? Not required, but a VA-accredited Veterans Service Officer (VSO) can help ensure your nexus letter adequately connects your primary condition to GERD and can represent you in appeals. Many veterans' organizations provide free VSO services.
Appeals and Rating Increases
If initially denied or rated lower than expected, file a Supplemental Claim with new medical evidence. Many GERD denials are overturned when veterans provide updated gastroenterology records, medication logs, or stronger nexus letters. Appeals typically take 3-6 months for decisions under the current VA process.
Related Concepts
Secondary Condition covers how GERD qualifies when linked to a service-connected primary disability. Diagnostic Code explains how diagnostic code 7346 is used in the rating process.