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Patton

GERD and IBS Claim questions

Question

I am preparing to file a claim that include GERD and IBS. I am SC for GERD (10%) but believe my rating should be higher. While at my C&P exam for GERD, the Examiner stated that I should file a claim for IBS. The Examiner was very clear on the differences between GERD and IBS. I have read Court of Appeals cases (on Hadit) where they awarded the Veteran for both GERD and IBS separately. I have also read other cases where it states that rating them separately would constitute pyramiding. So with that said, how do I file the claim? Separately or An increase rating for GERD with IBS. Any tips for file a GERD / IBS claim is greatly appreciated.

Thanks,

Patton

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Welcome to Hadit!

Can you post a link to the Court of Appeals case stating they should be rated separately?

I was awarded separate ratings for GERD and IBS, but later they were combined due to pyramiding. I highlighted the sentence the VA uses to justify it.

https://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5

Quote

§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.

7319   Irritable colon syndrome (spastic colitis, mucous colitis, etc.):  
Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress 30
Moderate; frequent episodes of bowel disturbance with abdominal distress 10
Mild; disturbances of bowel function with occasional episodes of abdominal distress 0
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

However, the second sentence indicates they are supposed to rate under the higher rating which matches the disability picture. For example, if you meet the 30% rating under 7319, you could file a claim for it. If you win, they would simply the percentage from that diagnostic code instead of the 10% from 7346.

 

 

 

 

 

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Thanks for the reply Vync.

I don't think it states that it should be rated separately, but they did award them separately. Below is the link:

Dealing with the VA, has been a battle, but I have found a lot of good information on Hadit to win that battle. Hopefully all my research will payoff. I think that it maybe safer to file it as a increase rating for GERD with IBS. It is documented in my Military and VA records that I have both conditions. I have had Polyps removed from both ends and had a stomach hernia repaired. Then I received Ibuprofen from the VA that caused my stomach to bleed. Has there been any studies (research) done to support my claim?

Thanks,

 

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It looks like what the court did was attribute each condition to separate causes. However, they did not apply the §4.114 pyramiding rule that gets most of us.

The big question is did that ruling set precedent? We can refer to court rulings, but the VA will often discount them if they did not set precedent.

It would be worth a shot to try - all they can do is either deny, approve and apply the §4.114 pyramiding rule, or hopefully approve both as separate. However, try to make sure that your GERD and IBS are not related to each other.

 

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I would file as an Increase, easier that way, and the VA will group the issues and they are in the same family of issues.   My 30% for Crohns, includes GERD and Barretts Esophagus. Sorry to hear of your issues. Good luck and God Bless

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I will claim them separately and lets see what happens. My VA Gastro Doctor did say something about my GERD and IBS conditions were cause by different reasons (I will have to look why). I have a appointment with a private Doctor on July 30th and I am going to ask him to complete the DBQ for me (he has done so for other Veterans). I would like to get the "Statement in Support of Claim" done before the appointment. 

Navy04 - It looks like you have more issues than me. I know that I would go down hill really quick if I could not work. I am only: 10% for Tinnitus, 10% for GERD and 30% for Persistent Depressive Disorder (Dysthymia) with Anxious Distress. I also have a NOD (dated January 2017) pending for my ankle, feet, knee and back. I had a C&P Exam for my ankle, knee and Back. Looking at my C-File, I should get something for those 3 items. The C&P also stated that I have nerve damage due to a herniated disc.

This claim I plan on filing for is an increase for GERD, IBS and Sleep Apnea. Then I want to talk with the Doctor about scars and my shoulder. The VA wants to do surgery on my shoulder but it is not SC, although I fell off a ladder (in Iraq as a Contractor), because my ankle gave out on me, which should be SC. 

After I get all of this completed, I will need a vacation!

Thanks for all the information!

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