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What You Should Know About GERD Disability Benefits

Gastroesophageal reflux disease, commonly called GERD, is a chronic digestive disorder that affects many people worldwide. It can range from mild to severe and significantly impact a person’s occupation, activities, and quality of life.

Since GERD is a medical condition, veterans with the disease may be eligible for various benefits through the U.S. Department of Veterans Affairs (VA), and through the Social Security Administration. However, the VA provides disability benefits to veterans with conditions that were caused or made worse by their service in the military. 

Read on to learn more about the GERD VA rating, how to qualify, and the VA benefits available for veterans with GERD.

What Is GERD and How Is It Related to Military Service?

GERD occurs when stomach acid and other contents inside the stomach flow back up into the esophagus and cause a reflex episode, which can create more complications, such as esophagitis or inflammation of the esophagus. Other GERD symptoms include:

  • Epigastric distress

  • Abdominal pain

  • Chest pain

  • Difficulty swallowing

  • Sore throat

  • Heartburn

While many individuals experience acid reflux from time to time, GERD occurs more than twice a week for several weeks. Getting a GERD diagnosis is crucial if GERD symptoms become more frequent.

The Mayo Clinic lists several risk factors that can cause GERD, such as:

  • Pregnancy

  • Obesity

  • Smoking

  • Alcohol

  • Hiatal hernia

  • Certain medications

  • Certain foods and beverages

Traumatic brain injury, heart disease, sleep apnea, and mental health conditions like post-traumatic stress disorder (PTSD) are also linked to GERD.

For veterans and service members, additional risk factors can stem from military service, including high-stress activities, diet changes, chemical exposure, and more. Those with existing chronic GERD may also find that their condition worsens during active duty.

How Does the VA Rate GERD?

The VA rates GERD similarly to hiatal hernia under Diagnostic Code 7346 based on the severity and frequency of symptoms. The VA Disability Rating includes:

  • 10%: This rating is for veterans that have two or more GERD symptoms from the 30% schedule but are not severe enough for the total 30% rating.

  • 30%: Veterans with persistent and recurrent epigastric distress, regurgitation, pyrosis, dysphagia, and arm or shoulder pain may receive this rating.

  • 60%: Veterans with severe impairment of health, such as vomiting, pain, material weight loss, hematemesis, melena, anemia, or symptom combinations, may fall under this rating.

Additionally, the PACT Act extends extra benefits to veterans with toxic exposures.

What Are the Eligibility Requirements for VA Compensation for GERD?

To be eligible for VA disability benefits, veterans must meet specific criteria. These include:

  • Being a veteran or service member of the U.S. Armed Forces

  • Having an official diagnosis from a licensed medical professional

  • Proving the service connection of the disorder

Veterans who can prove that their GERD was caused or made worse by their time in the military may be eligible for a VA disability claim. 

What Evidence Is Needed To Support a Claim for GERD Compensation From the VA?

Veterans must submit evidence to support their claim for GERD compensation from the VA. This could include:

  • Medical records

  • Test results

  • Service documents

  • VA claim exam

If the VA finds that there is a service connection between the veteran’s GERD diagnosis and their military service through a CP exam and written medical nexus letter, they may be eligible for disability benefits depending on their VA rating.

What Is the Process for Filing a Claim for GERD With the VA?

Veterans must file a claim with their local VA regional office, by mail, or online. The VA will review the claim and may contact the veteran for more information or to schedule a VA claim exam. All the veteran needs to do is provide the necessary documents and evidence to support their claim and wait for a decision.

How Long Does It Typically Take To Receive a Rating Decision for GERD From the VA?

It can take an average of 118.3 days to receive a rating decision from the VA. The VA will contact the veteran directly when they have made a decision.

What Are the Possible Ratings for GERD and How Are They Determined?

The VA assigns ratings based on severity, ranging from 0% to 100%. GERD is evaluated using the same criteria as other digestive systems conditions, including irritable bowel syndrome (IBS) and Gulf War syndrome. The level of disability depends on how gravely the symptoms interfere with daily activities.

Veterans can also have combined VA disability ratings if they have multiple medical conditions. They can integrate their GERD VA rating with other ratings, including the following:

  • IBS VA rating

  • PTSD VA rating

  • Radiculopathy VA rating

  • Depression VA rating

How Does the VA Evaluate the Severity of GERD Symptoms?

The VA evaluates GERD severity based on frequency, intensity, and symptom combinations. This includes factors such as the amount of pain and discomfort experienced, the length of time symptoms persist, and how lifestyle changes may affect the condition. The VA also considers how GERD impacts a veteran’s ability to work and perform basic daily activities.

What Is the Difference Between a Temporary and Permanent Rating for GERD?

The VA assigns either a temporary or permanent rating to veterans with GERD. They may give a temporary rating if the veteran’s condition can improve over time and a permanent rating if their condition is likely to remain persistent. The VA may also assign a combined rating, depending on the severity of the veteran’s symptoms.

How Can a Veteran Appeal a Rating Decision for GERD?

Veterans who disagree with a rating decision can file an appeal with their local VA regional office in person, by mail, or by fax no later than one year after the VA issues the rating decision. The veteran can request a direct review, provide additional evidence, or petition a hearing. The VA will review the appeal and make a final determination on the case.

What Are the Common Mistakes Veterans Make When Filing a Claim for GERD With the VA?

Many veterans make the mistake of not providing enough evidence to support their claims. Not providing sufficient evidence can delay the process or even lead to a denied claim. Additionally, veterans should know the deadlines when filing a claim or appeal with the VA, as these can vary depending on individual cases.

What Should a Veteran Do if the VA Denies Them Compensation for GERD?

If a veteran is denied compensation for GERD, they can still appeal the decision. They may resubmit their rejected claim with additional or corrected evidence and information. In some cases, veterans may be eligible to receive a free case evaluation with the appeals process.

Can a Veteran Receive Both Service-connected Disability Compensation and VA Pension for GERD?

The VA Pension provides a monthly tax-free payment to veterans with limited income who are rated totally or permanently disabled due to a service-connected disability. The VA evaluates each claim on an individual basis and can award concurrent benefits if the veteran meets all the requirements. If a veteran meets the requirements, they may be eligible to receive both service-connected disability compensation and VA pension for GERD.

How Can Benefits.com Help Me?

GERD is a medical condition that can significantly impact the lives of veterans and any diagnosed patient. Understanding the rating and filing process can help ensure veterans receive the benefits they deserve. Visit Benefits.com for a free consultation providing information to help you understand the process and get you started as you apply for the program best suitable for you.