You definitely need to appeal. If you have any other medical records or such from doctors saying that you had no problems with this before you started the salsalate, then you should win on appeal. I think it is standard procedure for them to deny first time around. Seemed that way to me. You might see if you can get your VA doctor to write down that you need the omepraz because he has given you the salsalate and it bothers your stomach. Maybe that would get through to them.