VA Disability Rating for GERD (Gastroesophageal Reflux Disease) 

Veterans who suffer from GERD, a condition where stomach acid frequently flows back into the esophagus, may be eligible for VA disability benefits.  

GERD can severely impact a veteran’s health, leading to symptoms like heartburn, regurgitation, and difficulty swallowing. If you developed GERD during or after your military service, you may qualify for a VA rating based on the severity of your condition. This guide breaks down the VA’s rating system for GERD and how to establish a service connection. 

How VA Rates GERD 

GERD and acid reflux are rated under Diagnostic Code 7206. VA evaluates GERD based on symptoms such as dysphagia, weight loss, and esophageal strictures. The severity of symptoms directly affects the percentage rating assigned.  

The rating system for GERD is: 

• 80% – Documented history of 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 as defined by § 4.112(a) and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube) 
• 50% – Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires 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 
• 30% – Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year 
• 10% – Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic 
• 0% – Documented history without daily symptoms or requirement for daily medications 

VA Notes:  

(1) Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.  

(2) Non-gastrointestinal complications of procedures should be rated under the appropriate system.  

(3) This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy. 

(4) Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved. 

(5) Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.  

Is GERD a Presumptive Condition? 

GERD is not considered a presumptive condition under VA regulations, meaning it is not automatically assumed to be service connected. However, under the PACT Act, veterans exposed to certain environmental hazards, such as Agent Orange or burn pits, may still develop GERD as a secondary condition. The PACT Act expands coverage for veterans with exposure to these toxic substances, making it easier for them to establish a link between their GERD and their service. 

In these cases, veterans will need to provide medical evidence that connects their GERD to either their exposure or a service-connected condition resulting from exposure. While GERD itself isn’t presumptively covered under the PACT Act, service connection may still be achievable with proper documentation and proof of exposure. 

What You Need to Service Connect Your GERD 

1. A current diagnosis of GERD 
2. Evidence of an in-service event or exposure that caused or aggravated GERD 
3. A nexus linking your GERD to your military service 

Veterans who did not develop GERD until after their service may still establish a secondary service connection if their GERD is linked to a service-connected condition, such as: 

• PTSD: Veterans with PTSD may develop GERD as a secondary condition due to the medications used to manage their mental health, or from stress-related symptoms that exacerbate acid reflux. Find out more about GERD secondary to PTSD. 
• Anxiety: Anxiety can lead to gastrointestinal issues, including GERD, as it increases acid production and delays stomach emptying. Read about GERD secondary to anxiety. 
• Migraines: Certain migraine medications can aggravate GERD symptoms. See more here. 
• Hiatal Hernia: The upper stomach moves into the chest through the diaphragm, weakening the lower esophageal sphincter and causing GERD. 

GERD Secondary to PTSD 

Gastroesophageal reflux disease (GERD) can be connected to post-traumatic stress disorder (PTSD) as a secondary condition. Veterans with PTSD often experience high levels of stress, which can trigger or exacerbate GERD symptoms like acid reflux and heartburn. Stress can lead to increased stomach acid production and affect the body’s ability to manage it, causing discomfort and ongoing digestive issues. Veterans seeking a VA rating for GERD secondary to PTSD will need to provide medical evidence that links the development or worsening of GERD to their PTSD. 

Winning a Rating 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 (GERD) as secondary to his service-connected posttraumatic stress disorder (PTSD). 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. 

Key Factors That Contributed to Winning the Claim 

• 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. With proper medical evidence, even conditions not directly caused by military service can qualify for VA benefits through secondary connection. 

GERD Secondary to Anxiety 

Veterans suffering from anxiety may develop GERD as a secondary condition due to the physical effects of chronic anxiety on the body. Anxiety often triggers increased acid production, disrupts digestion, and can lead to behaviors like overeating or smoking, which worsen GERD symptoms.  

If you can provide medical evidence that your GERD is aggravated or caused by your anxiety disorder, the VA may grant a secondary service connection for the condition. 

GERD Secondary to Anxiety: Case Example 

In this case, a veteran who served in the U.S. Army from September 1963 to March 1968 filed a claim for gastroesophageal reflux disease (GERD) and sought compensation based on its aggravation by his service-connected generalized anxiety disorder. The veteran reported that his GERD symptoms worsened significantly when he experienced anxiety or nervousness. The claim initially resulted in a noncompensable rating, but the veteran pursued an appeal, arguing that his symptoms were more severe than reflected in the rating. 

The Board of Veterans’ Appeals ultimately granted a 10% rating for the veteran’s GERD, recognizing that the veteran’s anxiety exacerbated his GERD symptoms. The Board determined that the combination of GERD symptoms, such as epigastric distress, dysphagia, and pyrosis, were sufficient for a compensable rating. 

Key Factors That Contributed to Winning the Claim 

• Medical Evidence Supporting Anxiety as an Aggravating Factor: The veteran’s VA examination and treatment records consistently noted that his GERD symptoms, including abdominal discomfort, were aggravated by his anxiety. A VA examiner specifically linked the veteran’s anxiety to the worsening of GERD, providing a direct secondary connection. 
• Consistent Symptom Reporting: Throughout the appeal, the veteran consistently reported GERD symptoms like regurgitation, right shoulder pain, and episodes of choking, which occurred more frequently when his anxiety was elevated. This consistency in symptom reporting contributed to the Board’s decision. 
• Inadequate Initial Evaluation: The veteran argued that his initial noncompensable rating underestimated the severity of his symptoms. After further review, the Board agreed, granting a compensable rating based on the veteran’s GERD symptoms in conjunction with his anxiety. 
• Legal Precedent for Aggravation by Anxiety: The veteran’s case was supported by legal precedent, allowing for secondary service connection for GERD as it was aggravated by his service-connected anxiety disorder. The Board applied this rule to justify the compensable rating. 

This case highlights how veterans with anxiety or other mental health conditions can seek secondary service connection for physical conditions like GERD. In this instance, the veteran’s consistent medical documentation and the link between his anxiety and GERD led to a favorable outcome. 

GERD Secondary to Migraine Medications 

Many veterans with migraines take medications that, while effective for pain relief, can irritate the digestive tract and lead to the development of GERD. Common migraine medications, including NSAIDs and certain triptans, are known to cause acid reflux and heartburn over time.  

Veterans experiencing GERD because of long-term migraine medication use may qualify for a secondary service connection if they can demonstrate that their GERD was caused or worsened by the treatment for their migraines. 

GERD Secondary to Migraines: Case Example 

In this case, a veteran who served in the U.S. Army from September 1989 to September 1992 filed a claim for disability benefits due to multiple conditions, including gastroesophageal reflux disease (GERD) secondary to service-connected migraines. The veteran believed that his use of non-steroidal anti-inflammatory drugs (NSAIDs) for migraine relief had caused or aggravated his GERD. Initially, the veteran’s GERD was not service-connected, but the veteran pursued an appeal. 

The Board of Veterans’ Appeals ultimately granted service connection and a VA rating for GERD as secondary to the veteran’s service-connected migraine headaches. The Board recognized the veteran’s long-term use of NSAIDs for migraines, which contributed to his GERD symptoms, providing sufficient grounds for secondary service connection. 

Key Factors That Contributed to Winning the Claim 

• Medical Nexus Linking GERD to Migraines: A private medical opinion strongly supported the claim by explaining how the veteran’s long-term use of NSAIDs for migraines, such as Excedrin, aspirin, and Motrin, likely caused or worsened the veteran’s GERD. 
• Diagnosis and Medical Evidence: The veteran’s GERD was confirmed through medical testing, including a fluoroscope in 2013. This diagnosis provided a solid foundation for the claim and showed a persistent condition that developed over time, correlating with his migraine treatments. 
• Secondary Service Connection Criteria: The Board concluded that the veteran met the criteria for secondary service connection under 38 C.F.R. § 3.310, as the GERD was determined to be caused or aggravated by a service-connected condition (migraines), with evidence from both VA and private medical sources supporting this link. 
• Expert Testimony and Documentation: The veteran’s representative submitted compelling medical documentation and testimony at the appeal hearing, showcasing the impact of the migraine medication on his GERD, which contributed to the Board’s decision in favor of the veteran. 

This case demonstrates how veterans can successfully claim GERD as secondary to service-connected conditions like migraines, especially when long-term medications contribute to the development of GERD symptoms. Medical evidence and expert opinions linking the primary condition to the secondary one are crucial for building a strong case. 

My Disability Claim Was Denied, What Can I Do? 

If your claim for GERD was denied, you still have several options to pursue benefits: 

• Request a Higher-Level Review: If you believe the decision was made in error but don’t have new evidence, you can request a higher-level review. A senior reviewer will take a fresh look at your claim and may overturn the denial if mistakes are found. 
• File a Supplemental Claim: If you have new and relevant evidence that wasn’t included in the original claim, you can file a supplemental claim. This new information can strengthen your case and lead to a different outcome. 
• File an Appeal at the Board of Veterans’ Appeals: You can appeal the decision within one year of receiving the denial. 

Choosing the best option depends on the specifics of your case and why the VA denied your claim. For guidance on your next steps, contact us for a free review of your case. We’ll help you understand your options and how to move forward. 

How to Increase Your GERD VA Rating with Secondary Conditions 

If you believe your GERD rating is too low or if your symptoms have worsened, you can file for an increased disability rating. To do this, gather new medical evidence, such as updated treatment records or documentation of increased symptom severity, and submit it to VA. 

However, if you are already receiving the maximum VA rating for GERD under Diagnostic Code 7206, you may still be eligible to increase your overall rating by connecting GERD to secondary conditions.  

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. 

What Conditions Are Secondary to GERD? 

• Esophagitis: Inflammation of the esophagus caused by chronic acid reflux. 
• Barrett’s Esophagus: A condition where the esophageal lining changes due to long-term acid exposure, potentially leading to cancer. Read more below. 
• Asthma: GERD can exacerbate respiratory issues by irritating the airways. 
• Dental Erosion: Stomach acid can damage tooth enamel, causing decay and sensitivity. 
• Laryngitis: Repeated acid exposure may cause inflammation of the voice box. 
• Sleep Disorders: Nighttime acid reflux can disrupt sleep, leading to insomnia or other sleep-related issues. 

VA Disability Rating for GERD with Barrett’s Esophagus 

Barrett’s esophagus, a potential complication of GERD, occurs when the lining of the esophagus changes due to chronic acid exposure. Veterans with Barrett’s esophagus may qualify for higher VA ratings due to the risk of cancer and the severe impact on health. 

To establish a rating for GERD with Barrett’s esophagus, veterans must provide medical documentation of their diagnosis and treatment. Barrett’s esophagus may qualify veterans for up to 80% disability, depending on the severity of symptoms. 

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

In this case, 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 2003. After further appeals, the rating was increased to 10% and later to 30% as of June 2005, but the veteran believed their symptoms warranted a higher rating throughout the appeal period. 

The Board ultimately decided to assign a 30% rating retroactively from September 1, 2003, finding that the veteran’s symptoms, including stomach pain, heartburn, difficulty swallowing, and regurgitation, were present consistently and deserved a higher rating earlier than previously awarded. 

Key Factors That Contributed to Winning the Claim  

• 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. 

The Board concluded that the evidence supported a 30% VA rating from the initial claim date of September 1, 2003, leading to a successful outcome for the veteran. 

Get 100% Disability for GERD with Total Disability Individual Unemployability (TDIU) 

TDIU allows veterans to receive compensation at the 100% disability rate, even if their rating is less than 100%. Veterans should note that it is typically the combination of multiple service-connected conditions, in addition to GERD, that would qualify them for this benefit, and that GERD itself would not be severe enough on its own. 

Below is a great example of a veteran who was secondary connected for GERD, but it was not the primary factor in the Board’s decision to grant TDIU. However, it was evident in the veteran’s medical history and was important in demonstrating the need for this benefit.

Winning TDIU with Secondary Connected GERD 

In this case, a veteran who served in the United States Army from January 1966 to December 1967 filed a claim for disability benefits due to a combination of service-connected conditions, including mild atheromatous changes of the bilateral lower extremities, bilateral shoulder sternum costochondritis, glaucoma, and gastroesophageal reflux disease (GERD). The veteran initially sought an increased disability rating and Total Disability Individual Unemployability (TDIU) due to the inability to maintain gainful employment. 

The Board of Veterans’ Appeals reviewed the evidence and ultimately granted TDIU, finding that the veteran’s service-connected conditions collectively prevented him from securing substantially gainful employment. However, it is important to note that TDIU was not awarded solely based on GERD. Instead, the Board recognized that the combined impact of bilateral lower extremity disabilities, shoulder conditions, and glaucoma were the primary contributors to the veteran’s inability to work, with GERD being a secondary, but not decisive, factor.