Gastroesophageal Reflux Disease (GERD) is a common chronic digestive condition where stomach acid flows backward into the esophagus, causing irritation, persistent heartburn, and regurgitation. This backflow occurs when the lower esophageal sphincter, the muscle between the esophagus and stomach, weakens or relaxes inappropriately. For veterans, GERD can be debilitating, severely impacting daily life and sleep quality. Veterans seeking disability compensation from the Department of Veterans Affairs (VA) must determine if their GERD qualifies for service connection, particularly whether it falls under the category of a “presumptive condition.” This article explores the VA’s classification of GERD and outlines the specific pathways veterans must use to establish service connection.
Understanding Presumptive Service Connection
Presumptive service connection is a designation the VA applies to certain medical conditions for specific groups of veterans, simplifying the process of obtaining disability compensation. When a condition is deemed presumptive, the VA automatically assumes the veteran’s military service caused or aggravated the illness, removing a significant burden of proof from the claimant. This status is typically based on the veteran’s service location, the time period of their service, and documented exposure to environmental hazards.
The primary benefit of presumptive status is the waiver of the “medical nexus” requirement. A medical nexus is a professional opinion linking the current disability to an in-service event or exposure. For a presumptive condition, the veteran only needs to prove they meet the service criteria, such as serving in a specific geographic area during a defined window of time. This streamlined process acknowledges that requiring individual veterans to prove causation for widespread exposures is impractical.
GERD’s Current Status Under VA Regulations
Gastroesophageal Reflux Disease is not currently listed as a primary presumptive condition under general VA regulations or the recently expanded Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 2022. This means the VA does not automatically assume a veteran’s GERD diagnosis is related to their military service based solely on their period or location of duty.
The PACT Act significantly expanded the list of presumptive conditions for veterans exposed to toxic burn pits and environmental hazards, but it does not include GERD itself as a primary presumptive illness. Although the Act covers many respiratory and certain gastrointestinal cancers, GERD is classified as a structural or mechanical issue of the digestive system, rather than a functional disorder like Irritable Bowel Syndrome (IBS), which may be covered for some Gulf War veterans. Therefore, most veterans must pursue service connection for GERD through other pathways, such as a direct or secondary connection.
An exception exists when GERD develops secondary to another condition that is service-connected or presumptive. For instance, respiratory conditions like asthma or chronic bronchitis, which are now presumptive for many toxic-exposed veterans under the PACT Act, can cause chronic coughing that aggravates or leads to GERD. Similarly, the use of medications like Selective Serotonin Reuptake Inhibitors (SSRIs) prescribed to treat service-connected mental health conditions, such as Post-Traumatic Stress Disorder (PTSD), can have GERD as a side effect. In these cases, the GERD is claimed as a secondary disability, which requires proving a medical link to the already service-connected condition.
Establishing Direct Service Connection for GERD
Since GERD is not typically a presumptive condition, veterans must seek service connection through the direct route, which requires proving three distinct elements to the VA.
Current Diagnosis
The first element is a current medical diagnosis of GERD from a qualified healthcare provider. This diagnosis must be documented with medical evidence, such as a physician’s notes or the results of diagnostic tests like an endoscopy.
In-Service Event
The second element requires evidence of an in-service event, injury, or disease that either caused or aggravated the GERD. This could include documented events like specific trauma, severe operational stress, or a digestive issue documented in the Service Treatment Records (STRs).
Medical Nexus
The third element is the medical nexus opinion, which professionally links the current diagnosis to the in-service event. The nexus must establish that the GERD is “at least as likely as not” related to the veteran’s service, meaning there is a 50% or greater chance of causation. This opinion is often provided by a private physician through a formal nexus letter or by a VA physician during a Compensation and Pension (C&P) examination.
Required Documentation and Claim Submission
Successfully filing a GERD claim requires a comprehensive set of documentation to support the required elements of service connection. Veterans must submit VA Form 21-526EZ, which is the standard application for disability compensation. It is important to clearly specify on this form whether the claim is being pursued as a direct connection to service or as a secondary condition to an already service-connected disability.
Essential supporting documentation includes all Service Treatment Records (STRs) from the time of military service, private medical records, and any VA medical records that document the GERD diagnosis and its ongoing treatment. Beyond official records, veterans should gather “lay evidence,” such as personal statements describing the onset and chronic nature of symptoms and how the GERD impacts their daily life. Statements from family members or former service members, often called “buddy letters,” can also provide corroboration of the symptoms and their severity while the veteran was in service.