GERD VA Claim Grants

Findings of Fact (verbatim from decision)

1. The Veteran's sleep apnea not having been satisfactorily disassociated from active duty service, the evidence is in approximate balance for a finding that it is related to such service. 2. The Veteran's GERD not having been satisfactorily disassociated from active duty service, the evidence is in approximate balance for a finding that it is related to such service. 3. The evidence is in approximate balance as to whether the Veteran's Barrett's esophagus was caused by or related to his GERD.

Reasons & Bases (verbatim excerpts from decision)

In an August 2023 VA medical opinion, after confirming a current diagnosis, the examiner opined that the Veteran's GERD was less likely than not caused by the indicated TERAs after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran. As rationale, the examiner stated that the current medical literature did not support GERD caused by toxic exposure, but that GERD was caused by overactive proton pumps found in the stomach lining and/or relaxation of the lower esophageal sphincter which allowed acid into the esophagus. The examiner included a cite to a medical article pertaining to GERD in adults. As above, and for the same reasons, the Board finds this medical opinion inadequate. To start, it is unclear if the examiner actually considered all TERAs of the Veteran, including his MOS-related exposures, as the specific TERAs do not appear to be noted or discussed in the medical opinion. Additionally, although explaining that GERD was caused by overactive proton pumps, the examiner failed to explain the cause or causes of the overactive pumps. And finally, it would have been helpful if the examiner had included medical literature cites which actually discussed toxic exposure and GERD. 38 C.F.R. § 4.2; Bowling, 15 Vet. App. at 12.

Findings of Fact (verbatim from decision)

1. A complete and proper intent to file for VA benefits was received on January 15, 2020, and a formal claim for service connection for the issue on appeal was received within one year. 2. Throughout the period on appeal, the Veteran's GERD is manifested by persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health, or recurrent or refractory esophageal stricture(s) causing dysphagia.

Reasons & Bases (verbatim excerpts from decision)

2. An increased rating higher than 10 percent for GERD. The Veteran seeks a rating higher than 10 percent for her service-connected GERD. […] After reviewing the record, the Board finds that the Veteran's GERD warrants a 30 percent rating assigned under DCs 7399-7346. […] The Board also has considered whether a higher evaluation is warranted. In this regard, the Board finds that a rating in excess of 30 percent is not warranted, as the evidence of record does not demonstrate any material weight loss, hematemesis, melena, or other symptoms productive of severe impairment of health. The Veteran's symptoms are shown to manifest as pyrosis, reflux, regurgitation, substernal pain, anemia, and sleep disturbance. The Board also finds against a rating higher than 10 percent under the revised DC 7206. To warrant a higher rating under DC 7206, at a minimum, the evidence must show a documented history of recurrent or refractory esophageal stricture(s) causing dysphagia. There has been no showing that the Veteran's GERD causes dysphagia during this appeal. Rather, outpatient treatment records show negative findings in this regard.

Findings of Fact (verbatim from decision)

The evidence is at least evenly balanced as to whether the Veteran's GERD with hiatal hernia had its onset during service.

Findings of Fact (verbatim from decision)

The Veteran's microcytic anemia, manifested by fatigue, is caused by his service connected gastroesophageal reflux disease.

Findings of Fact (verbatim from decision)

It is at least as likely as not that his esophageal disability is aggravated by nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat his service-connected orthopedic disabilities and alcohol abuse resulting from service-connected other specified trauma and stressor related disorder.