Need The Rating Code For Gerds

[mountain tyme]

Hello...I need some information regarding the Schedule for rating disabilities for gerds...

I called the 800 number and I was told the number was #7299-7203 and I can not find it on the VA web site.

My husband just received his decision and he was granted service connected due to having been diagnoised with Reflux during his time in service.

His decision was Gastroesophageal Reflux disease 10%...I feel the percent is two low...based on his medical documentation. Also he had one of those procedures done where they send a camera down and it is documented that he has a sliding hiheria..also some of his Symptoms are pain, vomiting, hard time swollowing after reflux takes place..and sometimes his arm will pulsate with pain...but not all the time...he is on maintance medication for the reflux and has 8-9 episodes per week.

esp. at night. so we keep the bed elevated at the head...due to the reflux he can not use his c-pap machine because he does has re-geration with the reflux...so he can not use his machine at all...

I feel a higher percentage is in order...

Also do they rate the sliding herina differnt from the Gerds?

on the decision it states...

1.) Service connection for gastroesophageal reflux disease.

Service medical records show complaint and treatment for this chronic condition.

during the VA exam you reported pyrosis and regurgitation two to three days a week. There is no dysphagia reported. Va exam shows that there are no signs of anemia. You have a normal appearing esophagus. There was no erosive esophagitis or Barrett's esophagus. Diagnosis is gastroesophageal reflux disease.. The Va examiner ipined that it is at least as likely as not that your current gastoesophageal reflux diesease is related to the treatment for gastroesophageal reflux noted during your military service.

Service connection for gastroesophageal reflux disease has been established as directly related to military service.

As evaluation of 10 percent is assigned from FEdxx,xxxx. An evaluation of 10 percent is assigned if there are two or more of the following symptoms: epigastric distress, dysphagia, pyrosis, regurgitation, or substernal or arm or should pain.

A higher evaluation of 30 percent is not warranted unless the record shows persistently recurrent epigastric with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain which is productive of considerable impairment of health.

This disability is not specifically listed in the rating schedule; therefore, it is rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms are closely related.

What I find distrubing is that the C/P doctor...didn't even ask all the questions because she came running up to us as we were leaving the VA hospital saying she missed a few pages of questions...and she said...oooo I will just fill in the blanks...I couldn't believe it...My husband did tell her about the pain that shoots through his arms...we at one time thought he was having a heart attack until our doctor told us that is caused by the reflux...now if his arm feels that why when he isn't refluxing to go to the ER asap...

so I do not understand why he did not receive a higher percentage...

Also in the evidence that they used to grant s/c they did not use the report we had faxed to them from the Univeristy hospital of his gastro exam that shows the sliding herina...

so we would like to ask for a reconsideration but I don't know how to word it...and should I go get a copy of the gastro exam and diagnosis and attach it to the reconsideration...

and would a statement from me or him help as to the pain he experiances...

Thanks in advance..

MT

[Ron II]

You might try: http://www.oqp.med.va.gov/cpg/GERD/gerdguidelinesfinal.pdf

Good luck...

[rentalguy1]

Dx code 7299 means that his diagnosis doesn't fit any of the dx codes in the rating schedule, it's a catch-all. They don't have a rating for GERD, yet. The 7203 dx code is what most closely approximates his condition, so the rater has to use it. I would get a copy of the C&P exam, and try to get a IMO. Be sure the IMO doc knows that he has all of the conditions listed for a 30% evaluation under dx code 7203 and also be sure that he states he has looked at all the SMR's and VA records. Then send that in with the NOD.

[mountain tyme]

I quess he better get a copy of the C/P because if it was rated under 7203 the lowest eval. would have been 30%...so we are going to have to get a copy of that report...how what if they did put it under perhaps an ulcer or something like that...could gerds be under an ulcer?

I will need to update later when we get all the facts...

thanks everyone

MT

[rentalguy1]

I just went back and looked again...this makes about as much sense as a football bat. GERD most closely approximates a hiatal hernia, which he has. You're right, there is no 10% rating under 7203, but there is under 7346. Somebody screwed up on this one. I would NOD it right away.

7346 Hernia hiatal:

Symptoms of pain, vomiting, material weight loss and 60

hematemesis or melena with moderate anemia; or other symptom

combinations productive of severe impairment of health.......

Persistently recurrent epigastric distress with dysphagia, 30

pyrosis, and regurgitation, accompanied by substernal or arm

or shoulder pain, productive of considerable impairment of

health.......................................................

With two or more of the symptoms for the 30 percent evaluation 10

of less severity.............................................

[recruiterrick]

i am 0% for gerd and i just looked at my rating decision. it states "Since the disability at issue does not have its own evaluation criteria assigned in VA regulations, a closely related disease or injury was used for this purpose. A noncompensable evaluation is assigned unless there are two or more of the following symptoms associated with epigastric distress: dysphagia, pyrosis, regurgitation, or substernal or arm or shoulder pain."

i don't know what this means, but i hope it helps you.

[mountain tyme]

rentalguy1...

The more I look over his medical records that were submitted the more I believe they (VA) rater made a mistake...

In the decision it states

"

A higher evaluation of 30 percent is not warranted unless the record shows persistently recurrent epigastric with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain which is productive of considerable impairment of health.

This disability is not specifically listed in the rating schedule; therefore, it is rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms are closely related."

and since the medical records DO SHOW...persistently recurrent epigastric with dysphagin, pyrosis (heartburn), and regurgitation accompanied by substernal pain...he should have received the higher rating of 30%..

with his history...they had to do an upper ig because it became medically necessary since after 14 years he is on the highest regime of medication needed..to help control the frequency of the attacks...which prior to the medication was 2-3 times a day...now he has one-2 per day...he never goes without reflux...and he has been on a bland diet for about 6 years...he is not overweight..so it may be due to enviromental he worked on Aircrafts his whole service career working in corrosion control painting mixing ect...so it is possible it has something to do with the solvents he worked with...

well...will keep you updated...

Mt