The Department of Veterans Affairs (VA) recognizes Gastroesophageal Reflux Disease (GERD) as a condition potentially eligible for compensation if service-connection is established. For veterans who suffer from GERD due to their military service, it’s vital to understand how the VA rates this condition to ensure they receive the benefits they deserve.
What is GERD?
Gastroesophageal Reflux Disease (GERD) is a chronic digestive disorder where stomach acid or bile flows back into the esophagus. This backwash (acid reflux) can irritate the lining of the esophagus, leading to discomfort and various symptoms. GERD is a chronic issue and is more severe than the occasional episodes of heartburn most people experience.
GERD - VA Rating Scale
The VA usually rates GERD based on the hiatal hernia criteria in Diagnostic Code 7346. The rating percentage is based on the severity and frequency of symptoms. The VA Disability Rating includes:
10% Rating for GERD
This rating is for veterans that have two or more GERD symptoms from the 30% schedule but the severity is not enough for the 30% rating.
30% Rating for GERD
To receive a 30% rating persistent and recurrent epigastric distress, regurgitation, pyrosis, dysphagia, and arm or shoulder pain. Here is what those terms mean:
- Persistently recurrent epigastric discomfort: you have pain or discomfort in the upper middle part of your abdomen, just below your rib cage, that doesn’t go away.
- Dysphagia: a sign of GERD that makes it hard for you to swallow food or liquid.
- Pyrosis: another word for the heartburn that happens when acid from the stomach flows back into the esophagus.
- Regurgitation: when food or stomach acid that hasn’t been fully digested flows back up into the throat or mouth.
60% Rating for GERD
Veterans with severe impairment of health, such as vomiting, pain, material weight loss, hematemesis, melena, anemia, or symptom combinations, may fall under this rating.
To get a proper rating, veterans should provide detailed medical records and evidence, including endoscopic findings, physician notes, and any other relevant documentation that paints a clear picture of the condition’s severity.
The C&P Exam for GERD
The C&P Exam for GERD is a key part of getting benefits as a veteran. A C&P examiner will look at a veteran’s health and look for signs and symptoms of GERD in the past. The C&P exam for GERD may include blood tests to check for anemia. A blood test is needed to make a correct diagnosis of anemia.
It’s important to tell the C&P examiner how your GERD symptoms affect your ability to work and take part in everyday life and social activities. There may be questions about how often you have symptoms, how bad they are, and how long you have had them.
Reviewing the GERD DBQ form, especially section III: Signs and Symptoms, is a good way to get ready for the C&P exam. By thinking ahead about how often, how bad, and how long esophageal symptoms last, you will be better prepared for the C&P exam. This can help you get the benefits you’re entitled to.
What are the symptoms of GERD?
GERD symptoms vary from person to person, but some of the most common include:
Heartburn: The most common symptom, heartburn feels like a burning pain that starts in the stomach and moves up to the chest, sometimes even reaching the throat.
Regurgitation: This occurs when stomach acid backs up into the throat or mouth, leading to a sour or bitter taste.
Difficulty swallowing: Known as dysphagia, some GERD sufferers might feel like food is stuck in their throat or experience choking or gagging when trying to swallow.
Chest pain: This can be sharp or burning, often confused with heart-related pain. Veterans with chest pain should seek medical treatment because the pain could be related to a heart condition.
Chronic cough: GERD can lead to a persistent dry cough.
Sore throat or hoarseness: Over time, stomach acid can irritate the throat, leading to soreness or a raspy voice.
Bad breath and tooth erosion: The acid can damage teeth and lead to halitosis.
Nausea or vomiting: In severe cases, GERD can cause stomach contents to be regurgitated.
How is GERD diagnosed?
A doctor usually suspects GERD based on symptoms. However, to confirm the diagnosis or gauge its severity, the following tests might be used:
Upper endoscopy: A flexible tube with a camera is passed down the throat to inspect the esophagus. It can detect inflammation or other complications.
Esophageal pH and impedance monitoring: This test measures the amount of acid in the esophagus over 24 hours, usually to determine the effectiveness of medications or if symptoms aren’t typical.
Esophageal manometry: This assesses the muscle function of the esophagus, particularly the esophageal sphincter’s function.
X-ray of the upper digestive system: After drinking a chalky liquid containing barium, X-rays are taken to highlight the esophagus, stomach, and part of the small intestine, helping visualize any abnormalities.
Ambulatory acid probe tests: This measures the amount of acid for an extended period, usually over 24 hours.
GERD as a Primary Disability
If your symptoms of GERD started while you were on active duty, then GERD would be considered a primary disability. The best proof for service-connection would be documentation in a veteran’s service treatment records of GERD with documentation of ongoing issues since discharge.
Stress is a significant trigger for GERD, and military personnel often undergo extreme physical and emotional stress during their service, whether in training or combat. The heightened levels of anxiety and stress can lead to an increased production of stomach acid, consequently contributing to GERD.
Additionally, the irregular eating habits common in deployment situations—like consuming Meals Ready to Eat (MREs) which are often high in fat and spicy ingredients—can exacerbate GERD symptoms. Similarly, limited access to fresh and balanced meals might play a role in the prevalence of GERD among service members.
Injuries, particularly those that affect the chest or abdomen, can influence the functioning of the esophagus and stomach, potentially leading to GERD.
GERD as a Secondary Disability
There are often connections between GERD symptoms and other disabling conditions. You might be eligible to apply for a secondary disability rating for your GERD symptoms if you already receive benefits for one of those conditions. Some of the most common conditions associated with GERD include:
- Anxiety disorders or PTSD (read more about GERD secondary to PTSD)
- Medications (see below for more details)
- Respiratory illnesses that cause chronic coughing
GERD from medication
Gastroesophageal Reflux Disease (GERD) is commonly recognized for its association with diet and lifestyle habits. However, a lesser-known factor that can contribute to GERD is the use of certain medications. Medicines play an essential role in managing various health conditions, but like all interventions, they can come with unintended consequences. If you take a medication for a service-connected condition and the medication has resulted in a diagnosis of GERD, then a veteran may be eligible for compensation based on a secondary connection.
Medications That May Cause Heartburn or GERD:
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Commonly used to manage pain and inflammation, NSAIDs like aspirin, ibuprofen, and naproxen can irritate the esophageal lining and increase the risk of acid reflux.
Calcium Channel Blockers and Beta Blockers: Used for high blood pressure and heart conditions, these medications can relax the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus.
Anticholinergic Agents: Found in drugs for urinary incontinence, glaucoma, and some respiratory conditions, anticholinergics can slow the emptying of the stomach, leading to acid reflux.
Bisphosphonates: Used in osteoporosis treatment, these can cause direct irritation of the esophagus.
Certain Antibiotics: Tetracycline and its derivatives can lead to esophagus inflammation, heightening GERD risk.
Iron Tablets: Consumed for anemia, iron pills can irritate the stomach and lead to acid reflux.
Quinidine: This anti-arrhythmic drug used for heart issues can stimulate acid production.
If you suffer from GERD and the VA has denied your claim for service-connected compensation or assigned a VA rating for GERD that is too low, reach out to our VA accredited attorney today.