If you were recently diagnosed with post-traumatic stress disorder (PTSD), you aren’t alone.
According to low estimates, at least 30% of veterans are currently living with this condition.
You probably know that if you can get a VA rating for PTSD — you may have a rating already. What you may not know is that a hiatal hernia can cause gastroesophageal reflux disease (GERD), and a hiatal hernia is secondary to PTSD.
Getting a GERD VA rating can earn you even more VA benefits. That’s why we’re bringing you this guide.
Keep reading for everything you need to know about how PTSD can cause GERD and other gastrointestinal disorders.
In this article about PTSD and its connection to GERD in veterans:
- Gastroesophageal Reflux Disease (GERD) Explained
- GERD and PTSD
- What Is a Secondary Service Connection?
- Other Gastrointestinal Problems Secondary to PTSD
- How to Get a GERD VA Rating as Hiatal Hernia Secondary to PTSD
- Call a VA Benefits Attorney Today
Gastroesophageal Reflux Disease (GERD) Explained
GERD stands for gastroesophageal reflux disease and is the medical term for acid reflux. This condition is a gastrointestinal (GI) disorder. It occurs when stomach acid flows back into the esophagus and causes irritation.
This disorder is surprisingly common. Estimates suggest that as many as 20% of people develop GERD at some point in their lifetime.
The primary symptom of GERD is heartburn. Heartburn is a burning feeling in the chest or stomach, often directly after eating. Other symptoms of GERD include:
- Trouble swallowing
- Vomiting up food
- Feeling like there’s a lump in your throat
People with GERD may also experience arm and shoulder pain. However, these symptoms are relatively rare and could be a sign of another health issue.
Causes of GERD
GERD is an abnormal flow of acid from the stomach back to the throat.
Normally, food flows from your mouth to your esophagus. It then passes through the lower esophageal sphincter (LES). The LES closes to trap the food and the acids that digest that food in the stomach.
When the LES doesn’t close properly during digestion, stomach acid can flow back into your esophagus, causing GERD.
Risk Factors for GERD
What leads to the LES failing to function properly? Scientists aren’t exactly sure. What they do know is that there are some risk factors correlated with GERD in adults.
Hiatal hernias are the top risk factor for GERD. A hiatal hernia occurs when the stomach gets displaced into the diaphragm.
Not all hiatal hernias lead to GERD, though, and not all people with GERD have hiatal hernias. Risk factors for developing a hiatal hernia include age, obesity, and the use of tobacco products.
Aside from hiatal hernias, the risk factors for GERD include:
- Eating large portions
- Eating later in the evening
- Having food triggers
- Drinking alcoholic beverages
- Drinking caffeinated beverages
Using certain medications may also make you more likely to develop GERD. For example, aspirin can cause acid reflux and GERD.
Here are some tips on your C&P exam from one of our VA disability lawyers.
Complications of GERD
Failing to get GERD treated can lead to complications like chronic inflammation.
Inflammation can, in turn, cause damage to the LES (Lower Esophageal Sphincter). When the LES gets damaged, it may produce scar tissue, which will restrict the esophagus and potentially lead to problems swallowing.
Another side effect of untreated GERD is the formation of ulcers. Stomach acid can irritate the esophagus to the point of creating an open sore.
This can also lead to difficulty swallowing as well as pain and bleeding.
Finally, if you don’t see a doctor for GERD, you could increase your risk of esophageal cancer. This is why it’s so critical to see your doctor as soon as you realize you’re dealing with GERD.
The good thing about GERD is that it’s usually treatable with simple lifestyle changes. Quitting smoking, cutting back on alcoholic and caffeinated beverages, and avoiding food triggers can help reduce your symptoms.
Your physician may also recommend over-the-counter medications like antacids (e.g., TUMS) and H2 blockers (e.g., Pepcid). Over-the-counter or prescription proton-pump inhibitors (PPIs) like Prilosec can offer the most significant relief.
If medication and lifestyle changes don’t alleviate your symptoms, your physician may prescribe surgery.
GERD and PTSD
Research shows that digestive issues are connected to PTSD.
Meanwhile, the same study showed that individuals with PTSD are 2 times as likely to develop GERD. This is because PTSD can cause an increase in stomach acid production. An overabundance of stomach acid can exacerbate GERD.
But increased stomach acid isn’t the only way PTSD connects to digestive issues like GERD.
Keep reading for three more reasons you may experience acid reflux after developing PTSD.
Do PTSD Medications Increase the Risk for GERD?
Many people who have PTSD also suffer from anxiety and depression.
A doctor will then prescribe medications to help treat those symptoms. Prescriptions for PTSD symptoms include anti-anxiety drugs and antidepressants.
Diazepam (Valium) and Lorazepam (Ativan) are anti-anxiety medications known to cause GERD. Acid reflux is also symptomatic of tricyclic antidepressant use. This includes the use of imipramine (Tofranil) and amitriptyline (Endep).
A 2015 study found that people with anxiety had worsening symptoms of GERD. At the same time, people with PTSD who also suffer from depression have markedly higher rates of stomach acid production.
We can’t exactly say that PTSD symptoms like anxiety and depression cause GERD. But the correlation between these conditions is strong enough that the VA may grant a service connection for GERD secondary to anxiety and, therefore, PTSD.
What Is a Secondary Service Connection?
When determining disability ratings, the VA differentiates between direct and secondary service connections.
Direct service connections are conditions caused by an event during your service. PTSD caused by the trauma you experienced while on active duty is a direct service connection. A tank driving over your foot is a direct service connection.
A secondary service connection is a condition that develops because of the direct service connection. Your knee and lower back pain that happened due to the altered gait of your broken foot (that got run over by a tank) is a secondary condition.
The VA considers PTSD and GERD secondary to sleep apnea. Also, erectile dysfunction (ED) and diverticulitis are secondary to PTSD.
There’s even a growing body of evidence that GERD has a secondary service connection because hiatal hernia is secondary to PTSD.
Why? Many people diagnosed with PTSD also have PTSD secondary conditions. These disabilities are either caused or exacerbated by PTSD or medications taken for PTSD symptoms.
How Secondary Disabilities Develop
Secondary service connections develop in one of two ways.
The first option is as a direct result of your direct service connection. The second option is as a result of medications you’re taking for your service-related disability. If you have to take medicine for a service-connected disability, the side effects of that medication are a secondary service connection.
Is GERD a Secondary Service Connection to PTSD?
Yes, GERD is a secondary service connection to PTSD. Research shows that PTSD symptoms like anxiety and depression can lead to acid reflux. Plus, as we mentioned above, some medications for PTSD symptoms can cause GERD. If you search for GERD under VA Disability on Reddit, you’ll see a lot of examples of vets winning and losing cases involving PTSD and GERD together. If you want to see if they can combine to help you win your VA disability claim, call us.
Other Gastrointestinal Problems Secondary to PTSD
By now, you may be wondering: are there any other digestive issues secondary to PTSD? Keep reading about the top three gastrointestinal disabilities secondary to PTSD.
1. Abdominal Pain Secondary to PTSD
If you experience abdominal pain that prevents you from working or living your life, you can qualify for a VA disability. You may even be eligible for benefits if a doctor can’t find the cause of your abdominal pain.
Abdominal pain due to a GI disorder doesn’t have a specified rating. Instead, abdominal pain will be treated as a symptom of a similarly scheduled GI disorder.
For example, you can receive a rating for abdominal pain due to a hiatal hernia. You can also receive a secondary service connection to PTSD rating for abdominal pain from a hiatal hernia.
2. Irritable Bowel Syndrome (IBS) Secondary to PTSD
The VA has a specific rating for IBS. But you can only get up to a 30% disability rating for the most severe symptoms of IBS.
If you qualify for a direct service disability for IBS, you may also qualify for secondary service connections to IBS, including:
- Colon polyps
- Constant bowel pain
Alternatively, you could apply for IBS as a secondary condition to PTSD. This is because the symptoms of PTSD include stress and anxiety. And research shows that both of these symptoms can cause IBS. How is that possible? Stress and anxiety put your body and brain in a constant state of fight or flight. When this occurs, your brain secretes a hormone called corticotropin-releasing factor (CRF).
CRF regulates various processes, including contractions within the colon. In IBS, colon contractions are dysregulated, providing evidence of a link between this GI condition and PTSD.
The Ultimate Guide to Irritable Bowel Syndrome VA Disability
IBS can be hard to diagnose, but the VA recognizes that it can be a service-connected disability.
3. Gastric Ulcers
A gastric ulcer is an open sore inside your stomach. You can get a 10% to 60% rating for gastric ulcers directly related to your service. The actual rating you get will depend on the severity of your symptoms.
Mild gastric ulcers can earn you a 10% rating. The VA would consider your ulcer mild if it causes symptoms only a few times per year. The gastric ulcer should be severe to get a 60% rating. Symptoms of a severe gastric ulcer include loss of appetite, weight loss, and vomiting food or even blood.
While stress alone doesn’t cause gastric ulcers, the symptoms of PTSD can increase the risk of developing one. This is why so many veterans apply for secondary service connections for PTSD-related stomach ulcers.
How to Get a GERD VA Rating as Hiatal Hernia Secondary to PTSD
The VA Rating tables for 2021 do not have a specific GERD VASRD code (Veterans Affairs Schedule for Rating Disabilities). Instead, the VA will rate you for a hiatal hernia, which, if you recall, is the leading cause of acid reflux.
You can get a 10%–60% rating for hiatal hernia, depending on the severity of your symptoms. However, you must prove that you developed your hiatal hernia as a result of injury during your service.
Other direct service connections that include GERD as a secondary disability include:
- Certain respiratory diseases causing violent coughing
- Peritoneal adhesions leading to scar tissue on the LES
- Hormone imbalances due to exposure to toxic chemicals
- Non-PTSD medications with heartburn as a side effect
Otherwise, you must prove that your acid reflux is secondary to hiatal hernia, PTSD, the use of PTSD medications, or another acid reflux-related disability.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.
Prove PTSD as a Service Connection
To receive a secondary service connection, you must be receiving benefits for your disorder already. This means you need to have a pre-existing PTSD or hiatal hernia diagnosis and benefits before you can apply for secondary service connection benefits.
If you need help applying for PTSD benefits, the lawyers at Woods and Woods LLC can help.
Gather Evidence, a Diagnosis, and a Nexus Letter
Do you think your acid reflux symptoms stem from PTSD, PTSD medication, or another direct service connection disability? You can then apply for an increased VA rating.
First, you need to gather evidence of your secondary service connection. You’ll first want to get a formal diagnosis for GERD from your physician.
Your doctor should also provide a medical opinion that your acid reflux is due to PTSD symptoms, medication, or another direct service disability.
Sometimes, the VA might ask for additional evidence. This includes statements from family or friends about your GERD symptoms and when they began. A personal statement may also help determine your rating.
File Form 21-526b Via Ebenefits
The final step in the process of filing GERD as a secondary service disability is submitting your claim. As with a direct service connection, you’ll have to file a VA form 21-526. You can file your claim online or in person at your local VA office.
Unfortunately, getting a secondary service connection benefit can be difficult. This is especially true if you’re filing your secondary service disability claim on your own.
Hiring an experienced VA benefits attorney can help you get approved the first time you apply. A lawyer may also help you improve your rating if you’re unhappy with the results of your application.
Call a VA Benefits Attorney Today
At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to better serve disabled veterans in difficult times.
Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.
Talk to Us About Your Claim: (866) 232-5777
No, since you have already proven a service-connected disability, half of the work is all done! That doesn’t mean adding more will go fast. Talk to your doctor and make sure you are getting a VA rating for all of the conditions that you deserve. The more you can add-on at once, the less time you’ll have to wait to get the full compensation for your injuries.
Yes, but you might have to call it something else. Since the VA doesn’t have a VASRD code for GERD, you’d get it for diagnostic code 7346: Hiatial Hernia. The VA gives a lot of ratings like that. If you have a service-connected disability that isn’t on their list, the VA is required to give you a rating based on the closest kind of condition that would end up with the highest rating. You can talk to our team for free and we’ll help you apply for the most accurate VA disability to your condition.