Already rated for GERD?

GERD Secondary Conditions: The Hidden Impact

GERD does not just stay in your stomach. Some of what it causes or worsens can be claimed as its own disability, connected to a GERD rating you already have.

What evidence VA needs — VA.gov
Why I built this page. A flyer has been going around that lists twelve things GERD can cause or make worse, and tells you to go file all twelve. I checked every one of them against NIDDK, the federal government's own digestive disease research agency, and against VA's own regulations. Six hold up. Two are not secondary claims at all — filing them that way gets them denied, not because they aren't real, but because they are already counted somewhere else. Four I could not confirm on any federal source, so they are not on this page. I built this for the Soldier who already has a GERD rating and has never heard the word "secondary." Share it with your Family too.
Read this before anything else. None of this works unless your GERD itself is already service-connected — either you already have a GERD rating, or you are getting one granted in this same claim. A secondary claim has nothing to attach to on top of a GERD claim VA has not granted yet. Get the primary on the books first, or file it together with your secondaries.
Confirmed

What I could confirm GERD causes or worsens

Checked against NIDDK, the federal government's own digestive disease agency.

  • Esophagitis — chronic irritation and inflammation of the esophagus from stomach acid. Confirmed by NIDDK. This is usually already part of your GERD symptoms. Talk to an accredited representative before filing it as its own secondary claim, so you don't run into pyramiding — VA paying twice for the same symptom, 38 CFR 4.14.
  • Barrett's esophagus — changes in the esophagus lining that raise the risk of esophageal cancer. Confirmed by NIDDK. Their own words: most people with Barrett's esophagus do not develop cancer.
  • Dental problems — wearing away of tooth enamel from stomach acid. That much is confirmed by NIDDK, in those words. Cavities and gum disease are not listed by NIDDK as a GERD complication. If you want to claim those too, ask your dentist for a written opinion tying them to your GERD.
  • Chronic laryngitis — irritation of the voice box: hoarseness, voice changes, throat discomfort. Confirmed by NIDDK.
  • Chronic cough — a persistent cough that reflux can trigger or worsen. Confirmed by NIDDK.
  • Asthma, worsened — GERD can trigger asthma symptoms or make existing asthma harder to control. Confirmed by NIDDK. Because this is a "worsened" claim and not a "caused" claim, VA needs your asthma's documented severity from BEFORE the GERD made it worse — the baseline. Without a baseline in your medical record, VA has nothing to measure the worsening against (38 CFR 3.310(b)).
★ Six conditions. Real evidence behind each one.
Read this first

Two of the twelve are not secondary claims

File these as stand-alone secondaries and VA denies them as duplicates — not because they aren't real.

Esophageal stricture. Scarring that narrows the esophagus and makes swallowing hard IS how VA rates your GERD now, under Diagnostic Code 7206. Do not file it as a separate secondary claim — it will be denied as pyramiding. Instead, make sure every dilation, stent, steroid treatment and swallowing study is documented in your medical record. That history is what drives your GERD percentage.
Chest pain. GERD commonly causes chest pain, but NIDDK lists it as a SYMPTOM of GERD, not a separate condition. It is already part of your GERD evaluation and cannot be separately rated. And never assume new, severe, or unexplained chest pain is reflux. Get it checked for a cardiac cause first. Always.
★ Document them. Don't file them twice.
Your GERD rating

GERD has its own rating code now — DC 7206

Effective 19 May 2024, GERD moved onto its own diagnostic code inside 38 CFR 4.114.

The rating turns on your esophageal stricture history — how bad it is, and what it takes to treat it. The top rating, 80 percent, is confirmed for recurrent or refractory strictures causing difficulty swallowing plus aspiration, undernutrition, or substantial weight loss, treated surgically or with a feeding tube. I could not verify the exact wording of the lower rating steps well enough to print them on this page. Look them up yourself at 38 CFR 4.114 before you file, so you know exactly what your own record needs to show.

If you already have a GERD rating, this code change alone will not cut it — VA has said so itself. If your claim was pending on 19 May 2024, VA has to rate it under both the old and new rules and give you whichever is better.
★ Get the stricture history into your record.
How to file

The paperwork, and the exam VA owes you

  1. File a secondary claim on VA Form 21-526EZ, the same form used for any disability claim.
  2. If you're not ready to file everything yet, file a VA Form 21-0966, Intent to File, first. It locks in today's date as your effective date — worth up to a year of back pay, per condition, while you gather evidence.
  3. Document your symptoms, your treatment, and how each condition affects your daily life.
You do not have to buy a private medical opinion to get started. VA's own evidence page says the link can be shown by "medical or lay evidence" — your own and other people's statements count. And when your file shows a condition may be tied to your service-connected GERD, VA must schedule you a claim exam (a "C&P exam") and get a medical opinion, at its own expense (38 CFR 3.159(c)(4)). Go to that exam — missing it can get your claim denied.
★ VA pays for the exam. You don't pay first.
If VA says no

Appeal deadlines, and who can charge you

  • Higher-Level Review and Board Appeal: one year from the decision notice, no exceptions.
  • Supplemental Claim: no deadline to file one, ever. But file within one year of the decision if you want to keep your original effective date and the back pay that comes with it (38 CFR 3.2500). File later and you can still get the claim reopened — you just lose that earlier date.
  • An accredited Veterans Service Organization representative is free. An accredited attorney or claims agent can charge a fee, but only after VA issues its first decision on the claim — never before. A fee up to 20 percent of your past-due benefits is presumed reasonable (38 CFR 14.636).
★ One year keeps your back pay. Free help exists — use it first.