- Hi, today we're gonna be talking about GERD,
and how that relates to VA disability claims,
GERD G-E-R-D which is Gastroesophageal reflux disease,
and everything related to it,
you know, can you get benefits for it?
How is it rated?
How does this relate to Gulf War syndrome and so much more,
so we hope you'll join us.
(bright upbeat music)
Hi, and welcome back to Hill and Pontons,
VA disability blog.
I'm Natalia Jofre the company COO,
- And I'm attorney Allison Reddick.
- And Allison and I,
are gonna be talking about GERD today,
and how those relate to VA benefits.
So Allison, once again,
can you let everyone know what GERD G-E-R-D stands for?
- So GERD is the acronym,
for Gastroesophageal reflux disease.
What this is, it's a condition where gastric acid,
and partially digested food flow up from the stomach,
into the esophagus,
which results into painful sensations,
that are associated with heartburn and other symptoms.
- And sometimes people will say,
well, is it just heartburn?
Because I mean, if it's just heartburn,
that doesn't sound that bad,
but it can be a little bit more than that.
- Yes, so symptoms that can be associated with GERD,
are of course heartburn, but also nausea.
You can have pain in your chest or upper abdomen,
you can have difficulty swallowing, painful swallowing.
You can develop respiratory problems,
and you can even vomit,
because of the severity of the symptoms.
- And I think that sometimes people don't realize,
just how severe that pain can be.
I mean, I know I've talked to people that thought,
they were having a heart attack,
and it turned out to be GERD.
So it can be pretty intense.
- No, absolutely.
It's literally acid from your stomach,
going up into your esophagus,
which isn't built to handle the acidity,
and it can erode it and change the function of it.
- Wow, how does it start?
What are some of the causes for GERD?
That you know.
- So, basically, when you swallow food,
there's muscles in your esophagus,
that move the food down to your stomach.
So at the base of the esophagus,
there's a band of muscles,
called the lower esophageal sphincter,
and it opens and closes,
so it's only supposed to open when you're swallowing food.
The only other time It opens naturally,
is if you were poor belch,
but that's the only time it's supposed to open.
What happens when you suffer from GERD,
is that, that sphincter opens,
once the food has already passed,
and has already started,
to become broken down by the stomach acids,
and regurgitates back up into your esophagus,
and causes those painful symptoms.
Common causes are types of foods you eat,
lifestyle choices,
and non related physical orders.
But the one that we see most often,
is that certain medications,
can cause as a side effect GERD.
There's like calcium channel blockers.
There's ones that are respiratory disorders,
medications for that, that's a big one.
If you take (laughs) non steroid
anti inflammatory medications,
like ibuprofen and naproxen,
those can irritate the lining of the esophagus and such.
- That's great.
So, I mean that's not great,
but it's great information.
So the million dollar question,
of course, that I'm gonna ask you is,
can you get rated, can you get VA benefits for GERD?
- So what's interesting with GERD,
is that it doesn't have its own rating schedule,
in the rule book of regulations.
So what they do is they use an analogous rating.
I think they normally use the hiatal hernia criteria for it.
But absolutely, you can get service-connected for GERD,
whether it's direct service connection.
Let's see, I had a vet who he had stomach issues,
and service and we ended up and he developed GERD from it.
We ended up connecting,
that he suffered from a bacterial infection,
from like food poisoning it was H.pylori bacteria,
and that actually caused his GERD,
so that would be an example of direct service connection.
A lot of it would be secondary service connection,
like the respiratory condition.
So if you have asthma or COPD service-connected,
and you take medications that GERD is a side effect,
you can get service-connected secondary.
- Okay.
- That way.
- Okay, good.
So in a nutshell, yes you can get secondary benefits,
for this condition.
- Absolutely.
- Okay.
What sort of evidence do you find is helpful,
to prove these claims?
- So I would definitely say a Nexus statement from a doctor.
Getting your doctor to one actually diagnose you,
with GERD and to say,
yes this medication is a side effect,
of it and is causing the GERD.
A statement of your symptoms to show the severity,
and the symptoms that you suffer from,
because the way it's rated,
is based of how many symptoms you're having,
and what type of symptoms you're having.
- Okay.
How does the VA rate for GERD for compensation,
'cause I know, sometimes you have these caps,
and no in some crazy different,
so how does it work for GERD?
- So, for GERD like I said,
it's an analogous rating,
they normally use the hiatal hernia,
and basically you're rated based off of your symptoms.
So for there you can get a 10% rating,
a 30% rating, or a 60% rating.
So I'm gonna start at 60,
because you'll see,(laughing)
so 60 would be you have symptoms of pain,
vomiting, material weight loss,
you're vomiting blood, you have moderate anemia,
or other symptom combinations,
of severe impairment of health, which is very subjective.
30% would be persistent recurrent epigastric distress,
with dysphasia which means trouble swallowing,
vomiting, regurgitation, arm and shoulder pain,
and productive considerable impairment of health,
which again is very subjective,
and that's why you should be very specific,
about the symptoms that you suffer.
And then for a 10% rating,
you have to have two or more of the symptoms,
and the 30% rating so,
- Okay,(laughing)
- That's why I started from the top and went down.
- I like it.
So of course, I immediately zoned in on the fact,
that you did not mention 100%.
So you can't get 100% for GERD.
- You can't get 100% for GERD.
But as we always talk about TDIU individual unemployability,
is always an option.
I mean, depending on the severity of your GERD,
if you're having severe impairment of health,
where your GERD is so distressful,
that you're having to take frequent breaks,
too many breaks because you're vomiting,
or you've had so much weight loss,
or you have such severe anemia,
that you're fatigued all the time,
I could definitely see an argument,
for individual unemployability,
based off of 60% rating for GERD.
- Okay, great.
That's why I always like to ask you,
if there's an exception,
because I know that you always have one,
in the back of your pocket.(laughing)
What doesn't fit in the box?
What doesn't apply Gulf War?
So how is Gulf War linked to GERD?
- So Gulf War syndrome?
There are a lot of people,
or a lot of veterans who suffer from it,
have a lot of Gastrointestinal issues,
because of the exposures.
So there are presumptive Gastrointestinal conditions,
like IBS that you can get service-connected for.
However, to get presumptive service connection,
for one of the Gastrointestinal disorders,
you have to have a functional Gastrointestinal disorder,
which means there's abnormal functions of one of the organs.
And so GERD isn't considered,
a Functional Gastrointestinal disorder,
it's considered a structural Gastrointestinal disorder,
so you can't get presumptive service connection for good.
However if your exposures,
where you served during the Gulf War,
and you developed GERD,
you can definitely still do direct service connection,
just getting a medical Nexus,
getting a doctor to state,
because of his service and his exposures,
he developed GERD.
- So as usual, this is so complex,
and so not simple.(laughing)
So I guess my question to you is,
if I'm a veteran and I served in the Gulf war
and let's say I'm already getting,
service-connected benefits for IBS,
but now I'm also having severe GERD,
can I come to you and you figure out,
whether I can get any more for GERD,
and if so, how much or how to prove that, or what to do,
because I don't know how a laypersons,
gonna figure out what I'm getting,
and what more could I get,
or what I need to do in order to get it?
'cause you just said a whole lot.(laughing)
- I mean I can absolutely try,
it is a case by case situation,
depending on the facts of your case,
and your exposures and where you were stationed and such.
But absolutely I mean,
there're different symptoms with IBS,
and there is with GERD,
so there would be no pyramiding,
or where you're trying to double dip.
You can definitely be service-connected for both,
so because of the complicated nature of it,
I would absolutely reach out for help,
and advice on--
- Okay what common issues,
have you encountered with these types of claims?
- So like we just discussed the complexity of it,
getting a diagnosis specifically that you have GERD,
sometimes that can be difficult,
but I would say the most difficulty,
would be trying to figure out,
how your GERD is related to service.
So was it where you served?
Was it something that happened to you in service?
Or is it secondary?
Is it a medication that you're taking,
because of another service-connected issue?
So just going through and trying to figure out,
Okay I have this condition,
I think it's related to service.
Now how can I get it service-connected?
- Okay, all right, great.
All right Allison, thank you so much.
I appreciate it.
- Of course.
- We hope you'll join us again,
but in the meantime,
if you have any questions or concerns,
please feel free to visit our website
or call our office.
- Thank you.
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