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Gastroesophageal reflux disease (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, you may be eligible for various benefits through the U.S. Department of Veterans Affairs (VA) and the Social Security Administration (SSA).
However, the VA provides disability benefits to veterans with conditions that were caused or made worse by their service in the military. That’s why we help you understand the process and get you started as you apply for the program that is most suitable for you.
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 occasionally, 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.
Additional risk factors for service members can stem from military service, including high-stress activities, diet changes, chemical exposure, etc. Those with chronic GERD may also find 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 with two or more GERD symptoms from the 30% schedule but 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 health impairment, 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 a service connection between your diagnosis and military service through a C&P exam and written medical nexus letter, you may be eligible for disability benefits depending on your VA rating.
Getting a C&P Exam for GERD
1. Understand the Purpose
A C&P exam assesses the severity of your GERD and its impact on your daily life. The VA uses this info to determine your disability rating—basically, it’s how they figure out the benefits you’re owed.
2. Schedule Promptly
Don’t wait! Once the VA requests a C&P exam for your GERD, act fast. Schedule it ASAP; the sooner, the better.
3. Preparing for the Exam
Gather up all relevant medical records, prescriptions, and treatment plans. Make a list of symptoms and how they affect your daily tasks. Preparation makes the process smoother—you won’t forget details that matter.
4. Be Honest and Thorough
You’ll meet with a healthcare provider who’ll ask questions, perhaps run tests, and check out your medical records. Be prepared to discuss your health honestly and in detail. Minimizing or exaggerating symptoms doesn’t help; remember, this is about getting a clear picture of your condition. Discuss the frequency, duration, and intensity of symptoms. Be specific (“I have acid reflux three times a week” instead of “I often have acid reflux”). Stick to the facts, prepare, and stay proactive.
5. Ask Questions
Confused about something? Don’t hesitate to ask. It’s your health and your exam—so ensuring you’re in the loop is essential.
6. After the Exam
The VA will review the examiner’s findings alongside other evidence, like your medical records. You’ll get a letter detailing your benefits (or reasons for a denial).
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. The veteran must 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 system 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, how long symptoms persist, and how lifestyle changes may affect the condition. The VA also considers how GERD impacts veterans’ 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 do not provide enough evidence to support their claims. Not providing sufficient evidence can delay the process or even lead to the claim’s denial. 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?
Veterans who are denied compensation 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 rated totally or permanently disabled due to a service-connected disability. The VA evaluates each claim individually and can award concurrent benefits if the veteran meets all the requirements. If you meet the requirements, you may be eligible to receive service-connected disability compensation and VA pension for GERD.
Seeking Advice on Your Claim
Understanding the rating and filing process helps you receive the benefits they deserve. for our free consultation and see if you may qualify for additional benefits.
