VA Rating for GERD Secondary to PTSD: How to Prove Service Connection

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Gastroesophageal reflux disease (GERD) is one of the most common digestive-related conditions veterans experience after service. 

The stress, anxiety, and physiological changes that come with post-traumatic stress disorder (PTSD) can directly impact your digestive system, causing or worsening acid reflux and chronic GERD symptoms over time.  

This guide breaks down how the VA rates GERD secondary to PTSD, how to prove service connection and file your claim, and why a strong nexus letter may be the key to approval.

Summary of Key Points

• The VA rates GERD secondary to PTSD under diagnostic code 7206, with possible ratings of 0%, 10%, 30%, 50%, or 80%. 

• To prove secondary service connection, you need a current GERD diagnosis from a qualified licensed provider and medical evidence (a nexus) showing it was caused or worsened by your service-connected PTSD. 

• A strong nexus letter from a qualified healthcare provider can be key to proving GERD secondary to your PTSD. 

GERD in Veterans

Gastroesophageal reflux disease occurs when stomach acid frequently flows back into the esophagus, leading to symptoms like heartburn, regurgitation, chest pain, and difficulty swallowing. 

According to a 2024 study, veterans may be at increased risk for GERD due to: 

• Exposure to toxic substances – Gulf War veterans may have been exposed to chemical warfare agents, pesticides, and prophylactic drugs, which can contribute to chronic gastrointestinal (GI) problems. 

• Increased intestinal permeability – Studies show veterans with chronic abdominal pain and diarrhea may have “leaky gut,” leading to more severe GI symptoms. 

• Changes in the gut microbiome – Deployment-related infections or stress can alter gut bacteria, increasing the risk of GI disease. 

• Acute enteric infections – Food or water-borne pathogens encountered during deployment may trigger long-term GI issues, including diarrhea and irritable bowel syndrome (IBS). 

• Chronic stress – Service-related psychological stress, including PTSD, can worsen digestive function and increase acid reflux. 

• Medication side effects – Common medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or PTSD treatments, can irritate the digestive system and contribute to GERD. 

The Link Between GERD and PTSD

When you live with PTSD, constant stress, anxiety, and tension can cause your body to produce excess stomach acid, leading to acid reflux or GERD over time. 

Some of the medications used to treat PTSD, like SSRIs and other antidepressants, can also trigger or worsen GERD as a side effect. 

A 2013 study of over 1,100 Iraq and Afghanistan veterans found that those who screened positive for PTSD or depression were significantly more likely to report GI symptoms, including GERD. 

In fact, 73% of veterans with GI issues also screened positive for PTSD, showing a strong connection between mental health conditions and digestive problems. 

If your GERD began after developing PTSD or starting related medications, you may qualify for VA disability benefits for GERD secondary to PTSD. 

VA Rating for GERD Secondary to PTSD

The VA rates GERD under diagnostic code (DC) 7206, with potential ratings of 0%, 10%, 30%, 50%, or 80%. 

Your rating for GERD secondary to PTSD depends on how severe your symptoms are and what kind of treatment you need (such as medication, dilatation, or surgery), and documented medical findings. 

The VA looks at whether you have trouble swallowing, need regular esophageal dilations, take daily medication to control symptoms, or have issues like weight loss or aspiration from severe reflux. 

See More: How Are VA Secondary Conditions Calculated? 

GERD VA Rating Chart

Diagnostic Code 7206, Gastroesophageal reflux disease	VA Rating
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)	80%
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	50%
Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year	30%
Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic	10%
Documented history without daily symptoms or requirement for daily medications	0%

Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy. 

Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.  

Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy. 

Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.  

Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals. 

Proving Service Connection for Secondary Conditions

To establish secondary service connection, you’ll need two key elements: 

1. A current diagnosis – Medical documentation of your GERD from a qualified provider. 

2. A medical nexus – Evidence showing that your GERD was caused or aggravated by your service-connected PTSD. 

How to File a VA Claim for GERD Secondary to PTSD

You must file a VA claim to be eligible for a VA rating. 

You can file a VA claim: 

• Online 

• By mail    

• Via fax  

• In person at a VA regional office 

Note: If you don’t file online, you must download and complete VA Form 21-526EZ to submit your claim. 

Learn More: How to File a VA Claim Online 

GERD Secondary to PTSD Nexus Letter

A strong nexus letter with high probative value can make or break your secondary claim.  

This letter is a formal opinion from a qualified healthcare provider linking your GERD directly to your service-connected PTSD. 

The nexus letter provides the “medical nexus evidence” the VA requires to show that your GERD is at least as likely as not caused or worsened by your PTSD.  

It should explain the medical reasoning behind the connection, reference your symptoms and medical history, and detail how your PTSD or its treatments (like SSRIs) contribute to your GERD. 

Learn More: Sample Nexus Letter for VA Disability Claims 

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Conclusion

GERD secondary to PTSD is a common issue for many veterans. The combination of chronic stress, medications, and service-related exposures can all contribute to acid reflux and digestive problems. By obtaining a current diagnosis and gathering strong medical evidence, especially a nexus letter, you can build a solid VA claim and get the compensation you rightfully deserve.

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