Gastroesophageal Reflux Disease (GERD) is a digestive disorder characterized by the occurrence of stomach acid flowing back up the esophagus from the stomach, causing discomfort and inflammation. GERD can typically be managed through lifestyle changes and diet, however some may need medication to control their condition.
GERD is caused by frequent episodes of acid reflux. At the bottom of the esophagus, there is a sphincter that allows food to pass down into your stomach, and also prevents it from traveling back up your esophagus. When this sphincter is weak, stomach acid can travel up your esophagus. Common symptoms can include heartburn, difficulty swallowing, regurgitation, and chest pain.
Getting Service Connection for GERD
Most veterans will be service connected for their GERD on a direct basis. Direct service connection requires three elements:
- A current diagnosis
- An in-service event, injury, or symptom
- A medical “nexus” linking the current diagnosis to the in-service occurrence.
There is no presumptive regulation that includes GERD. For example, GERD is not eligible for presumptive service connection as due to Agent Orange exposure or exposure to environmental hazards in the Persian Gulf War. Presumptive service connection is when VA presumes that a veteran’s current disability was caused by their time in service based on specific requirements such as the time period and location of the veteran’s service.
VA’s Persian Gulf War presumption regulation does allow for presumptive service connection for functional gastrointestinal disorders such as irritable bowel syndrome (IBS), functional constipation, functional vomiting, and functional dyspepsia. However, GERD is not considered to be a functional gastrointestinal disorder. According to the International Foundation for Functional Gastrointestinal Disorders, “functional GI disorders are disorders of gut-brain interaction,” of which GERD is not considered to be.
VA Ratings for GERD
VA rates GERD as analogous to other digestive disorders because it does not have its own rating criteria. Analogous ratings are used when a certain condition is not specifically listed in VA’s Schedule of Rating Disabilities. If a condition is not explicitly listed, VA will rate that condition under the diagnostic code for a condition that it is closest to, or that requires the same treatment.
Typically, GERD is rated analogous to a hiatal hernia under 38 C.F.R. 4.114 diagnostic code 7346. Ratings under diagnostic code 7346 range from 10 to 60% disabling, and depend on the presence and severity of a variety of symptoms. The requirements for each are as follows:
- For a 10% rating, a veteran must present with “two or more symptoms of the 30 percent evaluation of less severity.”
- A 30% rating requires “persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm and shoulder pain, productive of considerable impairment of heath.”
- A 60% rating requires “symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.”