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Many veterans develop additional health issues that are linked to their GERD, which may qualify for additional compensation. Veterans should work closely with their healthcare providers to document these secondary conditions and ensure that all relevant medical evidence is submitted with their claim. Here’s what you may be eligible to claim.

Esophagitis and Barrett’s Esophagus 

Esophagitis is the inflammation of the esophageal lining caused by repeated exposure to stomach acid. If GERD remains untreated or resistant to medication, the esophagus can become irritated or ulcerated, leading to pain, bleeding, and difficulty swallowing. Esophagitis is often rated under the same diagnostic code as GERD (DC 7206 or 7346), but it may also qualify for a separate rating if it causes distinct symptoms such as bleeding, ulcers, or infection. Endoscopy reports showing visible inflammation or ulceration can help establish a separate or higher rating. 

Barrett’s esophagus is a serious complication of long-term GERD. It occurs when the lining of the esophagus changes in response to chronic acid exposure, replacing normal tissue with a pre-cancerous type. Veterans with Barrett’s often require ongoing medical surveillance and may need endoscopic procedures to prevent progression to cancer. 

VA Disability for GERD with Barrett’s Esophagus

Barrett’s esophagus can be rated up to 80% disability, depending on the severity of symptoms. To establish a rating for GERD with Barrett’s esophagus, veterans must provide medical documentation of their diagnosis and treatment, including biopsy or endoscopy results 

Case Example: Winning a VA Disability Claim for GERD with Hiatal Hernia and Barrett’s Esophagus

A veteran who served from August 1983 to August 2003 filed a claim for disability benefits for gastroesophageal reflux disease (GERD) with hiatal hernia and Barrett’s esophagus. Initially, the veteran received a 0% rating in October 2003. After further appeals, the rating was increased to 10% and later to 30% as of June 2005, but the veteran believed the symptoms warranted a higher rating throughout the appeal period. 

  • The veteran experienced consistent gastrointestinal symptoms like dysphagia, heartburn, and epigastric pain, documented in multiple medical records, supporting a higher rating.  
  • A June 2005 VA fee-basis examination confirmed that the veteran had suffered from Barrett’s esophagus and GERD for 10 years, with symptoms of reflux and stomach pain, justifying the increased rating.  
  • The Board considered the veteran’s entire medical history and evidence from both VA and private medical examinations, establishing that the symptoms were present and impairing the veteran’s health from the beginning of the appeal period.  
  • The absence of more severe symptoms like material weight loss, vomiting, or anemia prevented a higher rating but did not negate the need for a 30% rating based on the documented symptoms. 

In its decision from February 27, 2007 (Citation Nr: 0705618), the Board concluded that the evidence supported a 30% VA rating from the initial claim date of September 1, 2003, finding that the veteran’s symptoms were present consistently and deserved a higher rating earlier than previously awarded.  

Hernias

Chronic GERD can lead to or worsen certain types of hernias, especially hiatal hernias, where a portion of the stomach pushes up through the diaphragm into the chest cavity. This condition is common in veterans with long-standing GERD, as repeated acid reflux, abdominal strain from coughing or vomiting, and pressure from delayed digestion can weaken the diaphragm over time. A hiatal hernia often makes reflux worse by further weakening the lower esophageal sphincter, creating a cycle of increased acid exposure and worsening symptoms. 

Veterans who develop a hernia after being diagnosed with GERD may be eligible for a higher disability rating, particularly if imaging confirms the hernia and medical records show worsening GERD symptoms. In some cases, hernias may require surgical intervention or long-term medication adjustments, which may increase the overall disability impact. Endoscopy, barium swallow studies, or surgical records can support a claim, along with a provider’s statement linking the hernia to the physical effects of GERD. 

Mental Health Disorders

Patients with anxiety are more likely to experience GERD symptoms and reflux tends to be more severe in anxious patients.  Research indicates that up to 1 in 3 subjects with GERD experience anxiety and depression and that there is likely a bidirectional causal relationship between anxiety/depression and GERD. Veterans with chronic GERD often experience panic or worry over chest pain, choking sensations, or the fear of regurgitation in public. Over time, these symptoms can lead to mental disorders such as: 

  • Depression or Generalized Anxiety Disorder – Constant worry about GERD flare-ups or health complications. 
  • Panic Disorder – GERD-induced chest pain mimicking panic attack symptoms. 
  • Somatic Symptom Disorder – Persistent focus on reflux symptoms that causes distress. 
  • Adjustment Disorder – Emotional strain from lifestyle limits caused by chronic reflux. 

GERD is considered both a physical and psychological stressor. The constant discomfort and lifestyle adjustments it requires can worsen anxiety, depression, and sleep problems, especially when flare-ups are unpredictable or painful.

Evidence Needed for a Secondary Anxiety Claim

  • A current diagnosis of an anxiety disorder from a mental health provider. 
  • Proof of service-connected GERD as the primary condition. 
  • A nexus letter from a psychiatrist or psychologist linking anxiety to GERD. 
  • Lay statements describing the emotional impact of living with the symptoms of GERD. 

Sleep Disorders

GERD frequently disrupts sleep, particularly when acid reflux occurs at night. Many veterans wake up coughing, choking, or with a burning sensation in the throat. These events fragment sleep and can lead to chronic insomnia or worsen existing mental health conditions like PTSD or anxiety. Research found that GERD was associated with a 3% decrease in sleep efficiency, an 8.8-minute increase in wake time after sleep onset, and a 13.4-minute reduction in total sleep time. 

Sleep Apnea and GERD

GERD can also contribute to the development or worsening of obstructive sleep apnea, particularly when obesity is also present. When acid travels up the esophagus during sleep, it can irritate the airway, cause swelling, and trigger reflexes that momentarily close the throat. These episodes can make breathing more difficult at night and increase the frequency of apnea events. Likewise, the repeated pressure changes that occur during sleep apnea can force stomach acid upward, creating a cycle in which each condition aggravates the other.

Veterans with GERD who experience snoring, gasping at night, or daytime fatigue should discuss the possibility of sleep apnea with their provider and consider a sleep study, as this may support a secondary service‑connection claim.

Migraines and Headaches

GERD can cause repeated physical stress on the body due to poor sleep, persistent nausea, and pain from acid reflux – all of which are known headache triggers. The constant strain from regurgitation, coughing, and disrupted digestion may increase tension in the neck and shoulders, contributing to tension-type headaches.

Additionally, veterans who experience nighttime reflux often suffer poor-quality sleep, which can further raise the risk of morning headaches or migraine attacks. Certain GERD-related medications or dietary restrictions may also impact hydration or trigger rebound headaches. A 2024 study from the University of Maryland found that people who take prescription medications for reducing stomach acid are more likely to have migraines and other severe headaches.

In cases where migraines or chronic headaches began after GERD or became more severe as GERD progressed, veterans may qualify for secondary service connection. Supporting documentation should include a clear headache or migraine diagnosis, records of all symptoms, and a nexus letter from a provider explaining how acid reflux contributes to or aggravates the headache condition. Lay statements describing timing, patterns, or triggers can also strengthen the claim. See how to claim a VA rating for migraines. 

Respiratory Conditions

Research indicates that GERD symptoms such as heartburn, acid reflux and coughing can significantly aggravate respiratory symptoms. People with COPD who also have GERD tend to experience flare‑ups more often, and those flare‑ups are usually more severe. As a result, their overall health outcomes are worse than those of COPD patients without GERD. Research on other long‑term lung conditions, like idiopathic bronchiectasis, also shows that swallowing problems and silent aspiration can lead to more frequent exacerbations and poorer health. Learn how to get a respiratory rating.

GERD and Asthma

Acid reflux can trigger airway irritation and bronchospasms, causing asthma-like symptoms or worsening preexisting lung disease. The relationship is bidirectional: reflux may worsen lung inflammation, while chronic coughing or inhaler use may aggravate reflux. Veterans with both asthma and GERD should ensure that treatment for one condition is not intensifying the other. Documentation from both pulmonology and gastroenterology specialists is key in establishing this link. Find out more claiming a VA rating for asthma.

Conditions of the Throat and Mouth

When acid reflux travels beyond the esophagus and reaches the throat or larynx, it causes laryngopharyngeal reflux (LPR). This condition can lead to chronic throat irritation, hoarseness, or coughing, even when stomach symptoms are mild. Veterans with service-connected GERD may pursue a secondary claim for LPR or related throat disorders if symptoms persist despite medication.  

ENT evaluations, laryngoscopy reports, or records of speech therapy can all help substantiate these claims. Common secondary conditions include:

  • Chronic Laryngitis – Rated under Diagnostic Code 6516 at 10% for hoarseness with inflammation and 30% for thickening or nodules on the vocal cords.
  • Pharyngitis (Chronic Throat Inflammation) – Rated under DC 6520–6522 depending on airway involvement.  

Dental Erosion or Oral Conditions

Chronic acid exposure can also damage the mouth and teeth, especially during nighttime reflux. Veterans with severe GERD may experience tooth enamel erosion, gum irritation, or mouth ulcers due to constant acid contact. In some cases, these effects can qualify for secondary dental claims or VA dental treatment eligibility, especially if dental erosion interferes with nutrition or overall health. Dentists can document visible enamel loss or acid wear patterns consistent with reflux exposure.

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Written by

Jessica Pierce, Senior Claims Advocate

Prior to joining Hill & Ponton in March 2025, Jessica Pierce spent nearly 20 years at the Department of Veterans Affairs in high-level policy development and program administration positions, advocating for improvements in disability compensation benefits for veterans. She is a career public servant, starting at the Social Security Administration after earning her bachelor’s degree in English from the University of Washington in Seattle, and has a master’s degree in public policy from George Mason University.