Brian Reese here with VA Claims Insider, and in this expert-level post, I’m going to reveal and explain how to service connect your GERD Secondary to PTSD for VA disability.
We’ll also explore the “3 Magic Pillars” for VA secondary claims to include mission critical medical evidence requirements.
Finally, together we’ll discover tips, strategies, and lessons learned for getting a Nexus Letter for Secondary Conditions (with high probative value) to help you prove secondary service connection under the law and avoid a VA claim denial.
Okay, let’s jump-in.
You Might Also Enjoy the Following Blog Posts:
- Top 5 Secondary Conditions to PTSD
- Top 100+ VA Disability List of Secondary Conditions
- Do I Need a Nexus Letter?
- VA Rating for PTSD: The Ultimate Guide
- How Common is GERD in Veterans?
- GERD and PTSD: Is There a Connection?
- What is the VA Rating for GERD Secondary to PTSD?
- VA GERD Secondary to PTSD: What is a VA Secondary Condition?
- The Caluza Triangle for VA Secondary Claims: What Do I Need to Prove Secondary Service Connection?
- Need a GERD Secondary to PTSD Nexus Letter to Help Prove Secondary Service Connection?
- About the Author
How Common is GERD in Veterans?
GERD is very common in veterans, and is the #23/50 most claimed VA disability.
Gastroesophageal Reflux Disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach, leading to painful acid reflux.
The VA rates GERD as a digestive disability by analogy to hiatal hernia under 38 CFR § 4.114, DC 7346, as that code is normally used to rate GERD due to similarity of symptoms.
VA Ratings for GERD are either: 10%, 30%, or 60%.
What are the VA disability ratings for GERD?
- GERD with symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health rate at 60%.
- GERD with persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health rate at 30%.
- GERD with two or more of the symptoms for the 30% evaluation of less severity rate at 10%.
Pro Tip: Many veterans with GERD or acid reflux, especially those who were diagnosed long after leaving the military are eligible under the law for GERD secondary to PTSD. For example, if veterans are taking SSRIs to help manage their PTSD symptoms, perhaps you’re suffering from side effects of those SSRI medications, which can lead to digestive system issues. Thus, veterans can get a GERD VA rating secondary to PTSD. It’s highly recommended that you get a Nexus Letter for GERD Secondary to PTSD!
GERD and PTSD: Is There a Connection?
Yes, there is a strong connection between GERD and PTSD.
GERD can develop when the symptoms of PTSD, such as anxiety, stress, and depression, lead to an overproduction of stomach acid.
In some veterans, medications taken to treat PTSD can also lead to GERD as a side effect.
In a study where information about GI (Gastrointestinal) symptoms such as diarrhea, constipation, abdominal pain, and gastroesophageal reflux disease (GERD) were extracted from the clinic notes to determine if there is a relationship between PTSD and depression screenings and GI symptoms.
Results state that 28% of the participants had GERD and a positive screening of PTSD was significantly associated with these GI symptoms.
Other medical research studies support a connection between GERD and PTSD.
For example, both veteran and non-veteran studies have reported high rates of comorbidity between PTSD, Depression, and Gastrointestinal (GI) symptoms.
A 2013 study of veterans who deployed to Iraq and Afghanistan found that nearly 45% of patients screened positive for PTSD and 23% screened positive for depression symptoms.
While only 11% of patients reported GI symptoms, 73.4% of these patients had a positive screen for PTSD, indicative of a significant relationship.
Many veterans with GERD or acid reflux, especially those who were diagnosed long after leaving the military are eligible under the law for GERD secondary to PTSD.
For example, if veterans are taking SSRIs to help manage their PTSD symptoms, perhaps you’re suffering from side effects of those SSRI medications, which can lead to digestive system issues.
BVA Case History Example:
What is the VA Rating for GERD Secondary to PTSD?
The VA Ratings for GERD secondary to PTSD are 10 percent, 30 percent, or 60 percent depending upon the severity of your GERD, and how your GERD symptoms affect your work, life, and social functioning.
The highest scheduler rating for GERD secondary to PTSD is 60%.
It also depends upon the frequency, severity, and duration of your symptoms—meaning, the more severe your symptoms, the higher the VA rating for GERD.
For example, a veteran might have a 70% rating for PTSD (lower or higher rating possible for PTSD) but could possibly receive a 10%, 30% or 60% VA disability rating for GERD secondary to PTSD.
|GERD Secondary to PTSD: VA Rating Chart||Rating|
|Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health||60%|
|Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health||30%|
|With two or more of the symptoms for the 30 percent evaluation of less severity||10%|
VA GERD Secondary to PTSD: What is a VA Secondary Condition?
In accordance with 38 CFR § 3.310 disabilities that are proximately due to, or aggravated by, service-connected disease or injury, a current disability condition, which is proximately due to or the result of a service-connected disease or injury shall be service connected.
VA secondary conditions require a “showing of causation.”
A showing of causation requires that the secondary VA claim is “proximately due to” or “aggravated by” another service-connected disability.
There are three evidentiary elements that must be satisfied to prove VA secondary service connection under the law:
- A medical diagnosis of the secondary VA disability you’re attempting to link to the current service connected disability (must be documented in a medical record) AND
- A current service-connected primary disability (e.g., your current list of service connected disabilities from your VA.gov account) AND
- Medical nexus evidence establishing a connection between the service-connected primary condition AND the current disability, which in this example is GERD secondary to PTSD
VA secondary conditions include any of the 900+ disabilities listed in CFR Title 38, Part 4, the Schedule for Rating Disabilities that can be service connected SECONDARY to a current VA disability you’re already rated for at 0% or higher.
The Caluza Triangle for VA Secondary Claims: What Do I Need to Prove Secondary Service Connection?
The FIRST part can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records that shows a diagnosis of GERD.
The SECOND part can be satisfied with a veteran’s existing service-connected disability rated at 0% or higher, which is your PTSD.
The THIRD part, and often the missing link needed to establish secondary service connection, can be satisfied with a credible Nexus Letter (Independent Medical Opinion) from a private healthcare provider that shows the connection between GERD and PTSD.
Did you know there are HUNDREDS of common secondary VA claims that you can get service connected by law?
Here’s a truth bomb fellow veterans…
You could be missing out on thousands of dollars of tax-free disability compensation you deserve by law, and not even realize that your current VA disability might be caused or aggravated by an existing service connected disability.
Pro Tip: A Nexus Letter with “high probative value” is RECOMMENDED to help establish secondary service connection. Why? Because “Medical Nexus Evidence” is needed to satisfy the third evidentiary element that must be satisfied to prove your secondary VA claim on an “at least as likely as not” basis.
Need a GERD Secondary to PTSD Nexus Letter to Help Prove Secondary Service Connection?
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About the Author
Founder & CEO
Brian Reese is VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned, and founder of VA Claims Insider – “The Most Trusted Name in Education-Based Resources for Veterans.”
His frustration with the 8-step VA disability claims process led him to create “VA Claims Insider,” which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.
Brian is also the CEO of Military Disability Made Easy, which is the world’s largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013.
His eBook, the “9 Secrets Strategies for Winning Your VA Disability Claim” has been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).