38 CFR 4.114, Gastroesophageal reflux disease (GERD)
- Diagnostic Code: 7206
- Typical Rating Range: 0%,10%, 30%, 50%, 80%
On May 19, 2024, the VA rating criteria for GERD changed. You may be wondering if the change was good or bad for veterans. The answer is a little bit of both, depending on your condition.
The good: The highest rating for GERD used to be 60%, but now it is 80%. This means there’s room for some veterans to increase their VA disability compensation.
The bad: It is now more difficult for veterans to increase their rating without documentation of two conditions: esophageal stricture and dysphagia.
Esophageal stricture is a narrowing of the esophagus due to inflammation or scar tissue. Dysphagia is difficulty swallowing.
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What Is GERD?
Gastroesophageal reflux disease (GERD) is characterized by food and stomach acids coming back up into the esophagus after eating. The acids cause your esophagus to become raw and inflamed, leading to esophageal stricture and dysphagia.
You might have GERD if you suffer from the following symptoms:
- Frequent heartburn and acid reflux (burning discomfort or pain in the chest or stomach, usually after eating)
- Regurgitation (a feeling of stomach acid or food coming back into the throat or mouth)
- Belching
- Difficulty swallowing (dysphagia)
- Chronic coughing
- A hoarse voice (due to acid reflux)
- Feeling of food getting stuck in the throat
- Asthma-like symptoms (wheezing and shortness of breath)
- Unexplained weight loss
What Causes GERD in Veterans?
Veterans are susceptible to GERD due to various service-connected triggers, including:
- High-stress work situations
- Exposure to toxins in the environment (such as burn pits)
- Limited access to healthy foods (think of deployed soldiers eating MREs)
- Disrupted sleep
- Prolonged use of other medications (NSAIDs, antidepressants)
What Changed in the VA Rating Schedule for GERD?
Before the May 2024 change, GERD used to fall under Diagnostic Code 7346, the code for hiatal hernias. The rating was based on the veteran’s symptoms—how often they occurred, how long they lasted, and how bad they were. It ranged from 10% to 60%.
The new rating has its own diagnostic code—7206—and ranges from 0% to 80% as follows:
- 0% “Documented history without daily symptoms or requirement for daily medications”
- 10% “Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic”
- 30% “Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year”
- 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”
- 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)”
Do I Have to Get Tested to Show I Have GERD?
GERD can be established with diagnostic tests like a barium swallow, CT scan, or EGD (esophagogastroduodenoscopy). However, you do NOT need to get one of these tests to prove your initial service connection. These tests come into play later to establish your rating, though you may be awarded a 10% disability rating for GERD without imaging if you have been prescribed daily medication to manage your symptoms.
What If I Wasn’t Diagnosed with GERD While in the Military?
There is still ample opportunity to show a service connection, even if you didn’t get a diagnosis or treatment while you were serving. One straightforward and simple way to do this is if you were regularly prescribed those 800 mg ibuprofen “horse pills.” Most veterans’ experience was that these painkillers were handed out like candy for back pain, knee pain, headaches, etc., but they can contribute to GERD. So can other medications like NSAIDs, antidepressants, beta-blockers, asthma medications, etc., that you may have been prescribed while in the military.
You can also connect your condition to high-stress work environments, toxin exposure (from burn pits, Agent Orange, water, etc.), poor sleep and disrupted circadian rhythms, and limited access to healthy foods.
Will a 0% Rating Do Me Any Good?
Yes, even though you won’t get compensation with a 0% rating, you will have established a service connection. This will be invaluable down the line if your condition worsens or if you develop a secondary condition as a result of your GERD.
What Secondary Conditions Are Associated with GERD?
GERD can contribute to secondary conditions. It can also develop secondary to other health conditions. Here’s a closer look at some secondary conditions associated with GERD.
● Asthma
Stomach acid flowing back up to the esophagus can irritate the airways, worsening asthma symptoms. In addition, some asthma medications can worsen GERD.
● Mental Health Conditions (Depression, Anxiety, PTSD)
There’s a strong link between our mental health and our physical health. Mental health conditions can affect the body’s autonomic nervous system, which controls involuntary bodily functions like digestion. It can slow down the digestive processes and increase the amount of acid your stomach produces.
Also, some medications prescribed for mental health conditions, like selective serotonin reuptake inhibitors (SSRIs), can relax your esophagus muscles and make acid reflux worse.
In turn, your GERD can trigger mental illness by causing chronic pain, stress, and sleeplessness.
● Obesity
Veterans may be at greater risk for obesity due to limited mobility and chronic pain from injuries or as a side effect from taking medications for other service-connected conditions. When you gain excessive weight, it can put pressure on the stomach and force stomach acid to flow into the esophagus.
If you have service-connected GERD, and it leads to a secondary condition, you can open up a path to show a service connection to that secondary condition as well (even if the condition developed long after you got out of the military).
Conversely, if you develop GERD and are already rated for a secondary condition associated with GERD, you will have an easier time getting rated for GERD.
How Do I Get Rated for or Increase My Rating for GERD?
Get a Current Medical Diagnosis
Make sure you have a current diagnosis from a qualified physician.
Prove a Service Connection
If you were diagnosed with GERD while in the service, this one is easy. If you developed it later, or if you developed it while serving but didn’t get a diagnosis, you can strengthen your claim with the help of a nexus letter. A nexus letter must be written by a qualified physician and show that it is “more likely than not” that your GERD is service-connected.
Your nexus letter can also show that your GERD developed as a result of another service-connected condition.
Show the Severity of Your GERD
You can do this with medical records that give evidence of your GERD (like a prescription for daily medications or medical tests showing esophageal strictures). You can also do this by writing a brief personal statement showing how your GERD developed and how it affects you on a daily basis.
Pro Tip: If you believe you are underrated for GERD and are wondering how to appeal a VA disability claim, you may try to file your appeal with the help of an attorney. But remember, appeals are often the least efficient way to get an increased rating, and if you file with an attorney, they’ll collect a big chunk of your backpay dating back to your intent to file date (usually around 30%).
Rather, try submitting a supplemental claim. If filing an appeal is like starting over again, a supplemental claim simply asks the VA to review an existing claim in light of new evidence. It’s often the easiest way for VA claims to get approved.
Need help getting an increased VA rating for GERD? Contact VA Claims Academy. We DON’T take a portion of your backpay. However, we DO provide education, templates (simply drop in the information and send), resources for getting a rock solid nexus letter, and ongoing support to help you get the GERD rating you are entitled to.