GERD rating

[marinevet1987]

I have read in several places that it is almost impossible to get more than 10% for GERD.  Is this true?  I am asking because I just had a C&P exam and I have several symptoms, but was told it probably isn't enough.  Any ideas?

My symptoms that were checked are: 

Persistently recurrent epigastric distress
Pyrosis
Reflux
Regurgitation
Sleep disturbance caused by esophageal reflux

Frequency of symptom recurrence per year: 4 or more
Average duration of episodes of symptoms: Less than 1 day 

[Vync]

10 hours ago, marinevet1987 said:

I have read in several places that it is almost impossible to get more than 10% for GERD.  Is this true?  I am asking because I just had a C&P exam and I have several symptoms, but was told it probably isn't enough.  Any ideas?

My symptoms that were checked are: 

Persistently recurrent epigastric distress
Pyrosis
Reflux
Regurgitation
Sleep disturbance caused by esophageal reflux

Frequency of symptom recurrence per year: 4 or more
Average duration of episodes of symptoms: Less than 1 day 

GERD is rated as hiatal hernia.

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#se38.1.4_1114

7346   Hernia hiatal:
Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health	60
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health	30
With two or more of the symptoms for the 30 percent evaluation of less severity	10

 

You meet the requirements for 10%, but the question is severity. What was checked on the C&P exam?

Edited June 22, 2016 by Vync

[marinevet1987]

4 hours ago, Vync said:

You meet the requirements for 10%, but the question is severity. What was checked on the C&P exam?

Nothing physical was checked on the C&P.  She even said herself that she could of done the C&P without me being there. 

I see that several of my symptoms (Persistent recurrent epigastric distress, pyrosis, regurgitation) are in the 30% range, so I don't know what to think.  A copy of my C&P is below.

 Esophageal Conditions (Including gastroesophageal reflux disease (GERD), hiatal hernia and other esophageal disorders)
Disability Benefits Questionnaire 
Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No

ACE and Evidence Review -----------------------
Indicate method used to obtain medical information to complete this document: [X] In-person examination
Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS Diagnosis ---------

Does the Veteran now have or has he/she ever been diagnosed with an esophageal condition? Yes
Gastroesophageal reflux disease (GERD) ICD code: R69 Date of diagnosis: IN SERVICE
Hernia hiatal ICD code: R69 Date of diagnosis: 2011

Medical history ---------------
Description of the history (including onset and course) of the Veteran's esophageal conditions: SEEKING INCREASE IN SC GERD CURRENTLY, WAKES UP WITH BURNING ACID IN THROAT AND HAS REFLUX THROUGHOUT THE DAY ON DAILY BASIS. WAKES UP SEVERAL TIMES A WEEK. GREASY FOODS MAKES SYMPTOMS WORSE. OMEPRAZOLE 20 MG DAILY TUMS THROUGHOUT THE DAY Does the Veteran's treatment plan include taking continuous medication for the diagnosed condition? Yes Medications used for the diagnosed condition: OMEPRAZOLE 20 MG QD Signs and symptoms

- Does the Veteran have any of the following signs or symptoms due to any esophageal conditions (including GERD)? Yes

Sign and Symptoms:
Persistently recurrent epigastric distress
Pyrosis
Reflux
Regurgitation
Sleep disturbance caused by esophageal reflux
Frequency of symptom recurrence per year: 4 or more
Average duration of episodes of symptoms: Less than 1 day

Esophageal stricture, spasm and diverticula -------------------------------------------
Does the Veteran have an esophageal stricture, spasm of esophagus (cardiospasm or achalasia), or an acquired diverticulum of the esophagus? No

Other pertinent physical findings, complications, conditions, signs, symptoms and scars ---------------------------------------------------------------- -------------

Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? No

Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? No

Diagnostic Testing ------------------
Have diagnostic imaging studies or other diagnostic procedures been performed? No
Has laboratory testing been performed? No
Are there any other significant diagnostic test findings and/or results? No

Functional impact -----------------
Do any of the Veteran's esophageal conditions impact on his or her ability to work? No

Remarks, if any: ---------------- 07/28/2011 UPPER GI AIR CONT W/O KUB Thoracic esophageal, gastric, proximal small bowel motility morphology were notable only for small variably reducing hiatal hernia documentation of gastroesophageal reflux into the distal third thoracic esophagus.07/28/2011 08:32

[marinevet1987]

Would "Sleep disturbance caused by esophageal reflux" be considered detrimental to health?  I wake up almost every night choking on acid in my throat.

[Navy04]

It is really hard to get over 10%. I have severe Crohns Disease along with Barrett's Esophagus, and yet I am only rated at 30% for both combined. My GERD is so bad, the VA Docs thought I had Throat Cancer at one time due to all of the eroding of the esophagus. Good luck and keep us posted

[marinevet1987]

This has me nervous.  I talked to my VSO today and he said it is very likely it should be 30%, but of course gave me the speech that nothing is 100% guaranteed.  He said he is rated 30% for GERD and has basically all of the same symptoms.  Now I have other people telling me no, no chance.  Not sure what to think.

[ArNG11]

Bubba quit worrying about this or you will drive yourself nuts. If I had a dollar for every time a VSO said this and that I wouldn't need my benefits.

Go on what you know and when you get a hard decision then you know how to go about attacking the BS.

From what you wrote it seems that you have a good grasp on what is needed for the higher ratings.  I don't disagree, much like my GERD claim I was low balled and I know from reading and interpreting the regs I qualified for higher, I just didn't get what my evidence warranted.

Don't go by what other people state, or how their claims went, each claim is unique according to the specific circumstances and evidence surrounding the claim, not to mention the evidence used and the documented symptoms.  Then you have to factor a rater that can read and an agency that does the right thing according to the regulations and law. The VA Claim process is no such animal.

I'll give my circumstances, I had to have a hernia repaired, restricted the esophagus using my stomach as a knot and still use medication daily for the reflux, still have to sleep in an elevated position, still have that fire in the throat that won't go away, no matter what I throw at it. I still have more serious issues than the VA will admit to and sadly still at 0 rating.   

Hang in there you will have what you need to fight the VA low ball.