Digestive conditions like GERD (acid reflux) and IBS (irritable bowel syndrome) are extremely common among veterans. They're rated under 38 CFR §4.114 and can be claimed as secondary conditions OR as Gulf War presumptives.
GERD Rating Criteria (DC 7346)
| Rating | VA Criteria |
|---|---|
| 10% | Two or more symptoms (heartburn, regurgitation, difficulty swallowing) of less severity |
| 30% | Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, with substernal/arm/shoulder pain, causing considerable health impairment |
| 60% | Pain, vomiting, material weight loss, and vomiting blood or black tarry stools with moderate anemia; OR other severe health impairment |
IBS Rating Criteria (DC 7319)
| Rating | VA Criteria |
|---|---|
| 0% | Mild: occasional episodes of bowel disturbance with abdominal distress |
| 10% | Moderate: frequent episodes of bowel disturbance with abdominal distress |
| 30% | Severe: diarrhea or alternating diarrhea/constipation with more or less CONSTANT abdominal distress |
For 30% IBS: Use the phrase "constant abdominal distress" in your statements. This is the exact language VA looks for to justify the maximum IBS rating.
Gulf War Veterans: IBS is PRESUMPTIVE!
🎖️ Gulf War Presumptive Conditions
If you served in Southwest Asia, these GI conditions are presumptive under 38 CFR §3.317:
- Irritable Bowel Syndrome (IBS)
- Functional dyspepsia
- Functional GI disorders
✓ No nexus letter needed!
✓ Just need diagnosis + qualifying service
Service Connection Paths
GERD Service Connection
- Direct: Started in service (stress, diet, conditions)
- Secondary to PTSD: Stress increases stomach acid production
- Secondary to medications: NSAIDs and pain meds damage stomach lining
IBS Service Connection
- Gulf War Presumptive: No nexus needed
- Secondary to PTSD: Strong medical link between anxiety and IBS
- Direct: Started during service
GERD Secondary to Medications: If you take NSAIDs or other pain medications for a service-connected condition and developed GERD, file it as secondary. This is a commonly approved secondary claim.
Evidence That Wins
Evidence That Wins
- ✓Symptom frequency documentation: how often, how severe, how long
- ✓Medication history: PPIs, antacids, anti-diarrheals (prescription AND OTC)
- ✓Work/life impact: missed work, dietary restrictions, activity limitations
- ✓Treatment records: endoscopy, GI specialist visits, ER visits
- ✓Weight changes (for higher GERD ratings)
- ✓Lay statements describing bathroom frequency, dietary limitations
Evidence That Loses
- ✗Diagnosis only without symptom documentation
- ✗No treatment records
- ✗Symptoms described without frequency/severity
- ✗No functional impact documented
PTSD to GI Connection
Medical research strongly supports that PTSD and anxiety:
- Increase stomach acid production (causing GERD)
- Affect gut motility (causing IBS symptoms)
- Create chronic stress response affecting digestive system
If you have service-connected PTSD and GI issues, claim them as secondary with a nexus letter.
Secondary Conditions
GERD/IBS may support claims for:
- Anxiety/depression — Chronic GI issues affect mental health
- Weight loss/malnutrition
- Anemia — If bleeding is present
- Sleep disturbance
Filing Tips
For GERD:
- Document all symptoms: heartburn, regurgitation, difficulty swallowing
- List ALL medications (prescription AND OTC)
- Note any weight loss
- If taking NSAIDs for SC condition → claim secondary
- If you have PTSD → claim secondary with nexus
For IBS:
- Gulf War veteran? File as PRESUMPTIVE
- Document frequency of episodes
- Use phrase "constant abdominal distress" for 30% rating
- If you have PTSD → claim secondary
- Keep symptom diary tracking episodes