Gastroesophageal Reflux Disease (GERD) Secondary to Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis)

How does secondary service connection work?

When the service-connected condition caused it

38 CFR § 3.310(a): “Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.”

When it made an existing condition worse

38 CFR § 3.310(b): “Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.” VA will not concede aggravation unless medical evidence establishes the baseline severity; it then deducts that baseline, and any natural progress, from the current level.

How strong the evidence for the link has to be

38 U.S.C. § 5107(b): “When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.” When the positive and negative evidence on the link is in approximate balance, VA gives the benefit of the doubt to the veteran.

What VA means by reasonable doubt

38 CFR § 3.102: “By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim.”

A statute that asks for an “at least as likely as not” medical opinion

38 U.S.C. § 1168(a)(1)(B): “obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.” § 1168 covers exams and opinions in toxic-exposure claims. For any claim for VA benefits, § 5107(b) above gives the veteran the benefit of the doubt when the evidence is in approximate balance.

How is GERD rated as a secondary condition?

If Gastroesophageal Reflux Disease (GERD) was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Gastroesophageal Reflux Disease (GERD) existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)). Read 38 CFR § 3.310.

Common questions about GERD secondary to Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis)

Can Gastroesophageal Reflux Disease (GERD) be service-connected as secondary to Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis)?

Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Weakened stomach lining. You'll need a current Gastroesophageal Reflux Disease (GERD) diagnosis and a medical nexus opinion linking it to your service-connected Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis), the same standard the VA uses for any secondary claim.

What VA rating can I get for Gastroesophageal Reflux Disease (GERD) as a secondary condition?

Gastroesophageal Reflux Disease (GERD) is rated under VASRD diagnostic code 7206. Possible VA ratings for Gastroesophageal Reflux Disease (GERD) are 80%, 50%, 30%, 10%, 0%. If Gastroesophageal Reflux Disease (GERD) was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Gastroesophageal Reflux Disease (GERD) existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)).

How does a secondary Gastroesophageal Reflux Disease (GERD) claim affect my combined VA rating?

The VA doesn't add ratings together. With example figures of 60% for Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis) and 30% for Gastroesophageal Reflux Disease (GERD): 60% and 30% combine to a Table I value of 72%, which VA converts to a 70% combined rating under 38 CFR 4.25, not 90%. Approving Gastroesophageal Reflux Disease (GERD) as secondary still typically raises your overall combined rating and monthly compensation.

What evidence do I need to service-connect Gastroesophageal Reflux Disease (GERD) as secondary to Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis)?

Strong evidence for the underlying Gastroesophageal Reflux Disease (GERD) diagnosis includes: A barium swallow, computerized tomography, or esophagogastroduodenoscopy report confirming the stricture — Note (1) names these three studies specifically; Dated procedure records for every dilatation, including any performed using steroids, plus placement or operative reports for an esophageal stent, surgical correction, or a percutaneous esophago-gastrointestinal tube (PEG tube); Prescription records showing daily medication taken to control dysphagia, which is what the 10 percent row is written around; Weight measurements over time and any documentation of aspiration or undernutrition, since the 80 percent row names those alongside substantial weight loss as defined by § 4.112(a). For the secondary link itself, a nexus letter from a treating provider explaining how Chronic Gastritis (Including H. pylori and Drug-Induced Gastritis) caused or aggravated Gastroesophageal Reflux Disease (GERD) is typically the deciding piece of evidence. If the claim is that a pre-existing Gastroesophageal Reflux Disease (GERD) got worse, include records showing how severe it was before it worsened: VA will not concede aggravation unless the baseline is established by medical evidence created before the worsening began, or by the earliest medical evidence after it (38 CFR 3.310(b)).