VA Rating for GERD and Acid Reflux: Complete Compensation Guide

Gastroesophageal reflux disease (GERD) affects an estimated 20-30% of post-service veterans. While often overlooked compared to more visible injuries, GERD creates significant functional impairment, impacts quality of life, and can develop secondary complications. Many veterans don't realize GERD qualifies for VA disability compensation when service-connected. Understanding rating criteria and evidence requirements is essential for claiming benefits.

Understanding GERD and Military Service Connection

GERD is a chronic condition where stomach acid frequently flows back into the esophagus, causing heartburn, regurgitation, and potential complications. Military service creates conditions promoting GERD development:

Occupational Stress: Military stress increases stomach acid production and relaxes esophageal sphincter

Irregular Sleep Patterns: Military schedules disrupt normal digestion and sleep quality

Poor Dietary Conditions: Field conditions, MREs (Meals Ready to Eat), and limited meal timing

Exposure to Chemicals: Some military occupations involve chemical exposure potentially damaging digestive system

Medication Effects: Certain military medications (NSAIDs for pain) increase GERD risk

Combat-Related Stress: PTSD and anxiety significantly worsen reflux symptoms

Heat Injuries: Severe dehydration during training contributes to GERD development

The VA recognizes GERD (Diagnostic Code 7346) as service-connected when evidence supports military causation.

VA Rating System for GERD

The VA rates GERD based on functional limitation from symptoms and treatment requirements rather than diagnosis alone.

Rating Percentages

0% (Not Rated) - No functional impairment; occasional mild reflux symptoms

10% Rating - Minimal functional impairment:

• Symptoms controlled with minimal medication
• Occasional breakthrough symptoms despite treatment
• Minimal occupational or social impact
• Normal diet tolerated with minor adjustments

20% Rating - Mild functional impairment:

• Symptoms require regular medication
• Occasional medication adjustments needed
• Some dietary restrictions
• Mild occupational impact (avoiding certain foods at work)

30% Rating - Moderate functional impairment:

• Symptoms poorly controlled despite medication
• Multiple medication trials or significant dosages
• Significant dietary restrictions
• Moderate occupational impact
• Mild sleep disruption

40% Rating - Moderately severe functional impairment:

• Severe symptoms despite aggressive treatment
• Multiple medications required
• Significant dietary limitations
• Substantial occupational restrictions
• Sleep disruption affecting function
• Work capacity affected

50%-100% Rating - Severe functional impairment:

• Refractory GERD unresponsive to medical management
• Frequent severe symptoms despite multiple treatments
• Severe dietary restrictions
• Major occupational disability
• Potential esophageal damage or complications

Monthly Compensation for GERD

Monthly compensation varies by rating and dependent status. As of 2025:

10% Rating:

• Veteran alone: $175-$185/month

20% Rating:

• Veteran alone: $253-$270/month

30% Rating:

• Veteran alone: $330-$350/month

40% Rating:

• Veteran alone: $470-$490/month

50% Rating:

• Veteran alone: $605-$625/month

These amounts increase annually with COLA. Your effective date determines your rate and back pay eligibility.

Evidence Requirements for GERD Claims

Medical Documentation

Diagnostic Confirmation:

• Physician diagnosis of GERD documented in medical records
• Date of diagnosis relative to military service
• Diagnostic tests performed (endoscopy, pH monitoring, manometry)

Treatment Records:

• Complete medication list with dosages and duration
• Documentation of medication trials and adjustments
• Specialist referrals and gastroenterology records
• Physical therapy or lifestyle modification attempts
• Hospital records if GERD-related complications occurred

Functional Limitation Documentation:

• Physician notes describing impact on daily activities
• Dietary restriction documentation
• Sleep disruption notes
• Work performance impact statements
• Weight changes related to dietary restrictions

Baseline Military Records:

• Military medical records mentioning reflux or GI symptoms
• Any documented gastrointestinal complaints during service
• Medications prescribed during service

Lay Evidence

Personal Statements:

• Description of GERD symptoms onset
• Relationship to military service (stress, MRE diet, environmental factors)
• Current symptom frequency and severity
• Impact on daily activities
• Occupational restrictions (can't do certain duties due to reflux)
• Dietary limitations
• Sleep disruption from nighttime reflux

Supporting Statements:

• Family members describing reflux symptoms and frequency
• Employers noting occupational restrictions needed
• Service members confirming stressful service conditions

Nexus Letter for GERD Claims

A nexus letter from a gastroenterologist or primary care physician establishing service connection is critical for GERD claims.

Essential Components

Medical Opinion Statement that GERD is "at least as likely as not" caused by military service or its effects.

Service-Related Cause Explanation of how service caused or significantly aggravated GERD:

• Chronic military stress triggering acid production
• Poor dietary conditions during service
• Sleep disruption from military demands
• Secondary to PTSD or anxiety from combat
• Medication side effects from military treatments

Medical Evidence Review Reference diagnostic records and treatment history.

Functional Impact Assessment Description of resulting functional limitations.

Quality Nexus Providers

• VA Gastroenterologists: Free through VA gastroenterology
• Private Gastroenterologists: Board-certified specialists ($400-$800)
• VA Primary Care Physicians: May provide nexus letters
• Civilian Primary Care Providers: Familiar with military service context
• Telehealth Services: Specialized VA providers ($300-$600)

C&P Exam Preparation

The VA sometimes schedules C&P exams for GERD claims. These are typically conducted by internists or gastroenterologists.

Exam Components

Medical History:

• GERD symptom onset and progression
• Relationship to military service
• Current symptoms and frequency
• Treatment history
• Medication list
• Dietary restrictions
• Sleep impact

Physical Examination:

• Abdominal examination for tenderness, distension
• Weight and height
• General health assessment

Functional Assessment:

• Occupational impact from GERD
• Social impact of dietary restrictions
• Sleep disruption effects
• Treatment burden assessment

Preparation Tips

• Document Medication History: Bring complete list of all GERD medications tried
• Describe Symptoms Specifically: Not just "heartburn" but "severe acid reflux 3-4 times daily despite medication"
• Note Occupational Impact: "I can't eat lunch with coworkers due to symptoms," "I can't attend evening events due to nighttime reflux"
• Mention Dietary Restrictions: List foods you avoid
• Sleep Disruption: "I can't sleep flat; must elevate head 45 degrees"
• Treatment Burden: Describe time spent on medication management, dietary planning
• Progression: Explain how GERD has worsened or remained severe despite treatment

The examiner evaluates both medical documentation and your description of functional impact.

Real Claim Examples

Case 1: PTSD-Related GERD

A former infantryman filed for GERD secondary to PTSD. Evidence included:

• VA psychiatry records documenting PTSD (70% rated)
• Gastroenterology records showing severe GERD
• Documentation: GERD symptoms worsened during anxiety episodes
• Medication list showing multiple GERD medication trials
• Nexus letter from VA gastroenterologist connecting PTSD-induced anxiety to GERD

Outcome: 30% GERD rating. Combined with 70% PTSD = 80% overall. Monthly compensation: $2,500. Back pay: $10,500.

Case 2: Combat Stress with Refractory GERD

A veteran with 10 years combat service filed with:

• Military medical records documenting reflux complaints during service
• Current gastroenterology records showing persistent severe symptoms
• Medication history showing failed trials of multiple medications
• Statement of occupational restriction: "Can't perform job duties requiring meal participation"
• Medical opinion on service connection

Outcome: 40% GERD rating. Monthly compensation: $490.

Case 3: Delayed Onset GERD Claim

A veteran filed 3 years post-discharge for GERD developing shortly after service:

• Medical records documenting GERD diagnosis 6 months post-discharge
• Detailed statement about military stress contributing to GERD
• Family statement: "GERD started immediately after military service"
• Current gastroenterology records showing ongoing symptoms

Outcome: 20% GERD rating. Effective date: Discharge date. Back pay: $8,100.

Common Mistakes to Avoid

Mistake 1: Underestimating Functional Impact

Simply filing a GERD claim without documenting functional limitation weakens the claim.

Solution: Detail occupational restrictions, dietary limitations, and sleep disruption.

Mistake 2: Missing Service Connection Explanation

Not explaining how military service caused or aggravated GERD.

Solution: Clearly connect GERD to military stress, MRE diet, or other service factors in your statement.

Mistake 3: No Nexus Letter

Many GERD denials result from lack of professional medical nexus.

Solution: Obtain nexus letter from gastroenterologist or primary care provider.

Mistake 4: Incomplete Medication Documentation

Failing to list all GERD medications attempted.

Solution: Provide comprehensive medication history showing treatment attempts and current regimen.

Mistake 5: No Secondary Condition Connection

If GERD develops from PTSD or other service-connected condition, failing to file it as secondary.

Solution: Explicitly file GERD as secondary to primary condition in your statement.

Step-by-Step Filing Process

Step 1: Obtain Medical Evidence

• Request all VA GERD-related medical records
• Obtain gastroenterology records and diagnostic test results
• Compile medication records from VA pharmacy

Step 2: Gather Service Connection Information

• Document military service stressors
• If GERD secondary to another condition, gather those records
• Obtain any military medical records mentioning GI symptoms

Step 3: Seek Medical Evaluation

• Schedule VA gastroenterology evaluation if not recently seen
• Or obtain civilian gastroenterologist evaluation
• Request documentation of functional limitation

Step 4: Obtain Nexus Letter

• Request from VA gastroenterologist (free but may wait)
• Or obtain from private gastroenterologist
• Ensure letter addresses service connection

Step 5: Complete VA Form 21-526EZ

• Available at VA.gov or Regional Office
• Describe GERD condition and functional impact
• Explain military service connection
• If secondary, note primary condition

Step 6: Submit Claim

• Online: VA.gov (fastest)
• Mail: VA Regional Office
• In-Person: Local VA office or VSO

Step 7: Attend C&P Exam (if scheduled)

• Bring all medical records and medication list
• Describe symptoms, triggers, and occupational impact
• Explain dietary restrictions

Step 8: Await Rating Decision

• VA responds within 60-120 days
• Rating Decision explains approval and percentage
• First payment arrives 30-45 days after approval

Timeline Expectations

Claim to Decision: 60-120 days Effective Date: Usually diagnosis date or discharge date First Payment: 30-45 days after approval Back Pay: Calculated from effective date

Appeal Strategies if Denied

Denial is not final. Many GERD claims succeed on appeal with better documentation.

Option 1: Supplemental Claim

File Form 21-0995 with:

• Better nexus letter from gastroenterologist
• More detailed functional limitation documentation
• Medication history showing treatment efforts
• Specialist evaluation of severity

Option 2: Higher-Level Review

Request senior reviewer examine decision.

Option 3: Board Appeal

For weak denials, request Board hearing.

Secondary Conditions

Veterans with GERD may develop:

• Esophageal Stricture: GERD-related tissue damage (10-50% rating)
• Barrett's Esophagus: Precancerous condition (10-100% rating)
• Anxiety/Depression: From chronic GERD impact (10-100% rating)
• Sleep Disorders: From nighttime reflux (10-100% rating)
• Medication Side Effects: From high-dose GERD medications

Filing secondary conditions increases total compensation.

Frequently Asked Questions

Q: Can I get disability for GERD if it's controlled with medication? A: Yes. Rating is based on the condition itself, not just uncontrolled symptoms. Medication requirements factor into rating determination.

Q: Is GERD secondary to PTSD automatically approved? A: Not automatically, but having both PTSD and GERD significantly strengthens the claim. Nexus letter should explicitly connect the two.

Q: What if I developed GERD years after military discharge? A: Still potentially service-connected if military service was the cause (stress, MRE diet, etc.). Timing is less important than causation.

Q: Should I try stronger medications before filing? A: Not necessary. File with current treatment status. If you try stronger medications post-filing, that supports claim.

Q: Can I file for both GERD and another digestive condition? A: Yes, if both service-connected, they'd be rated separately and combined.

Conclusion

GERD represents a winnable VA disability category when properly documented with clear functional limitation and service connection. While less visible than physical injuries, GERD significantly impacts daily functioning and occupational capacity.

Start your claim through VA.gov, your VA Regional Office, or with VSO assistance. Proper documentation of symptoms, medication history, and functional limitations combined with a strong nexus letter leads to successful approvals.

With persistence and comprehensive evidence, most veterans successfully secure GERD disability ratings and meaningful compensation for service-connected gastroesophageal reflux disease.