Veterans with PTSD often experience high levels of stress, which can lead to increased stomach acid production and affect the body’s ability to manage it, causing discomfort and ongoing digestive issues. Recent research shows that 20% of veterans returning from Iraq and Afghanistan develop gastrointestinal diseases – and those with a mental health diagnosis are twice as likely to be diagnosed with a gastrointestinal illness.
By providing medical evidence that post-traumautic stress disorder triggered or exacerbated acid reflux, veterans may be able to connect GERD to their PTSD as a secondary condition for a higher VA disability rating and additional compensation.
VA Ratings for GERD Secondary to PTSD
VA rates GERD from 0% to 10%, 30%, 50% or 80%, based largely on daily symptoms and need for treatments and medications:
- 0% – No daily symptoms or requirement for daily medications
- 10% – Esophageal stricture(s) requiring daily medications to control dysphagia
- 30% – Recurrent esophageal stricture(s) causing dysphagia and requiring dilatation no more than 2 times per year
- 50% – Recurrent or refractory esophageal stricture(s) causing dysphagia and requiring at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement
- 80% – Recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube
How to Service Connect GERD as a Secondary Condition
Veterans seeking a VA rating for GERD secondary to PTSD must prove that their GERD was caused or worsened by PTSD. This will require:
- Diagnosis for GERD
- Diagnosis and service connection for PTSD
- Nexus letter – a professional opinion from a physician explaining how the GERD symptoms are linked to the service-connected PTSD
- Personal statements from the veteran, family members and/or fellow service members explaining how PTSD impacted the veteran’s digestive system
VA now places significant emphasis on daily symptoms like difficulty swallowing, medication use, and whether or not the veteran’s GERD requires treatments. See what to expect at the C&P exam.
Winning a Claim for GERD Secondary to PTSD: Case Example
In this case, a veteran who served on active duty from December 1971 to October 1973, with additional service in the Reserves, filed a claim for gastroesophageal reflux disease as secondary to his service-connected posttraumatic stress disorder. The veteran argued that his GERD symptoms were worsened due to his PTSD, leading to the appeal for secondary service connection.
The Board of Veterans’ Appeals granted service connection for GERD as secondary to the veteran’s PTSD. The decision was based on the evidence presented, including a letter from the veteran’s physician confirming that GERD was aggravated by PTSD, even though a VA examiner did not fully address the aggravation aspect of the claim.
How This Veteran Won His Appeal
- Private Medical Opinion on Aggravation: The veteran’s private physician provided a letter stating that the veteran’s GERD symptoms were aggravated by his PTSD. This was pivotal in establishing the secondary connection and proved to be a critical piece of evidence in the appeal.
- Inadequate VA Examination: The VA examiner concluded that GERD was not caused by PTSD but failed to consider whether PTSD aggravated the GERD symptoms. This omission allowed the Board to weigh the private medical opinion more heavily.
- Favorable Ruling with Benefit of the Doubt: By resolving reasonable doubt in favor of the veteran, the Board determined that the medical evidence was at least in equipoise, meaning the evidence for and against the claim was evenly balanced. This principle ultimately led to the grant of secondary service connection.
This case illustrates how veterans can receive service connection for conditions like GERD when they are aggravated by service-connected mental health issues such as PTSD or anxiety. With proper medical evidence, even conditions not directly caused by military service can qualify for VA benefits through secondary connection.
Content Reviewed by
Cassandra, an Accredited Agent and claims advocate for Matthew Hill & Shelly Mark’s teams, reviewed the information provided in this post.
