Secondary To

[bakerkd]

I have Hiatal Hernia, GERD, and IBS. I have seen that GERD is rated secondary to Hiatal Hernia. Here is the question; Will irritable bowel and GERD both be rated secondary to the Hernia or will the irritable bowel be rated on its own? I only ask because I havent seen IBS rated secondary to the hiatal hernia, only to the GERD. Is it possible to rate something secondary that is secondary to something else?

[Scott D]

I too have been rated for GERD, IBS and Hiatal Hernia. None of these conditions have been declared as secondary to one of the others. My DR. says that the IBS is more likely due to anxiety and food allergies. Here is some more information related to pyramiding but specific to diseases of the digestive system:

§4.114 Schedule of ratings—digestive system.

Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.

IBS most likely rated alone as ICS code 7319

Hiatal Hernia rating code 7346

These two would fall under the above criteria.

GERD seems to be rated under 7346 as well.

So a combination of all three conditions would be rated as one condition, but getting the VA to accept all three separate issues as service connected in advised.

[bakerkd]

I too have been rated for GERD, IBS and Hiatal Hernia. None of these conditions have been declared as secondary to one of the others. My DR. says that the IBS is more likely due to anxiety and food allergies. Here is some more information related to pyramiding but specific to diseases of the digestive system:

§4.114 Schedule of ratings—digestive system.

Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.

IBS most likely rated alone as ICS code 7319

Hiatal Hernia rating code 7346

These two would fall under the above criteria.

GERD seems to be rated under 7346 as well.

So a combination of all three conditions would be rated as one condition, but getting the VA to accept all three separate issues as service connected in advised.

My Gastroenterologist told me that my IBS was likely a combination of diet (altered because of GERD) and inflammation caused by GERD. Guess I will have to see when I file. I've seen a number of BVA case linking IBS and GERD