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🫃 DigestiveGastrointestinalDC 7346

Gastroesophageal Reflux Disease (GERD)

A chronic digestive condition in which stomach acid frequently flows back into the esophagus, causing heartburn, regurgitation, and other symptoms. Commonly secondary to PTSD, anxiety, stress, or NSAIDs used to treat service-connected conditions.

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VA Rating Tiers

60%
Symptoms causing severe impairment of health — weight loss, pain, vomiting, significant nutritional deficiency
30%
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation
10%
With two or more symptoms of lesser severity
0%
Mild symptoms — service connected but non-compensable

Rating Notes

  • ›60%: Symptoms causing severe impairment of health — significant weight loss, pain, vomiting, or nutritional deficiency. DC 7346.
  • ›30%: Persistently recurrent epigastric distress with dysphagia, pyrosis (heartburn), and regurgitation. DC 7346.
  • ›10%: Two or more symptoms of lesser severity — regular discomfort requiring prescription medication. DC 7346.
  • ›0%: Mild symptoms present — service connected but non-compensable.
  • ›DC 7346 covers hiatal hernia, which VA uses to rate GERD.
  • ›Valid VA percentages: 0, 10, 30, 60.
  • ›Rating is based on severity and frequency of symptoms, not merely the presence of GERD.
  • ›Controlled symptoms on medication still warrant a rating — the underlying condition persists.
  • ›Secondary claims to PTSD are frequently granted when a nexus letter is provided.
  • ›NSAID-caused or NSAID-aggravated GERD from treating another service-connected condition is a valid secondary theory.

Eligibility Basics

✅
Current symptoms
✅
In-service event
✅
Diagnosis or lay evidence
  • •GERD is most commonly claimed as secondary to PTSD, anxiety, or long-term NSAID use from other service-connected conditions.
  • •VA rates GERD under DC 7346 (hiatal hernia) using a symptom-based schedule.
  • •A nexus letter linking GERD to a service-connected condition (e.g., PTSD causing gut dysregulation) strengthens secondary claims.
  • •Direct service connection is also possible — document onset of symptoms during service if applicable.
  • •GERD caused or worsened by NSAID use for service-connected pain is a recognized secondary pathway.

Evidence to Gather

Service Records

  • •sick call records for heartburn, acid reflux, or stomach complaints during service
  • •records of NSAID or antacid prescriptions during service
  • •deployment records noting dietary or environmental stressors

Medical Evidence

  • •primary care or GI records documenting GERD diagnosis
  • •endoscopy results (EGD) showing esophagitis or hiatal hernia
  • •prescription history for acid-suppressing medications
  • •upper GI barium swallow results

Lay Evidence (Buddy Statements)

  • •statement describing onset of heartburn or reflux symptoms during or after service
  • •statement connecting PTSD, stress, or medication use to GERD symptoms
  • •buddy statement noting visible symptoms during deployment

Diagnostic Tests

  • •upper endoscopy (EGD)
  • •esophageal pH monitoring
  • •barium swallow
  • •esophageal manometry
  • •H. pylori testing

C&P Exam Preparation

Exam type: Gastroenterology / Internal Medicine

Be ready to describe

  • •how often and how severely you experience reflux symptoms
  • •whether symptoms occur despite medication
  • •how GERD affects eating, sleeping, and daily function
  • •connection to PTSD, stress, or NSAID use
  • •any complications (esophagitis, Barrett's esophagus)

Prep notes

  • •Bring endoscopy reports, GI records, and prescription history.
  • •Do not take extra antacids right before the exam — describe your typical symptom burden.
  • •If secondary to PTSD, bring your PTSD rating decision or nexus documentation.
  • •Describe nighttime symptoms specifically — waking up with reflux is highly relevant.
  • •A nexus letter from a GI doctor or primary care provider significantly strengthens secondary claims.

Quick Facts

Diagnostic Code
DC 7346
Category
Digestive
Subcategory
Gastrointestinal
Typical Claim Type
secondary
Rating Range
0% – 60%

Also Known As

GERDacid refluxrefluxgastroesophageal refluxheartburnhiatal herniaesophageal refluxchronic heartburnacid regurgitation

Related Conditions

Secondary to

ptsddepression anxietylower back painmigraineshypertension

Commonly leads to

sleep disturbanceibs
📋

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