Many veterans take daily medications to manage service-connected conditions such as chronic pain, joint injuries, or PTSD. While these treatments improve quality of life, some can lead to new digestive symptoms over time, such as acid reflux, heartburn, or trouble swallowing.
When these symptoms appear or worsen after starting a long-term treatment, VA reviewers may consider this GERD as secondary to medications. This is an application of the Medication Bridge concept, which helps show a medical link between your original service-connected condition, the treatment for it, and the resulting health change.
- For a complete overview of VA GERD claims, including direct service connection, diagnostic testing, and rating criteria, see our companion article: VA Disability for Gastroesophageal Reflux Disease (GERD).
The Domino Effect: A Simple Mental Picture
Imagine your health journey as a row of standing blocks:
- First Domino: A service-connected condition (e.g., chronic knee pain).
- Second Domino: Medication taken to manage that condition (e.g., NSAIDs).
- Third Domino: New digestive changes that appear later (e.g., GERD).
In this chain, the medication acts as the “bridge” between your service-connected injury and new digestive symptoms. Documenting this sequence clearly in your medical records is key for VA reviewers.
Why Timelines Matter in Your Records
Under 38 C.F.R. § 3.310, the VA may recognize a condition as “proximately due to” a service-connected condition or its treatment. Reviewers look for a Medical Nexus, which is a pattern of evidence across your records showing:
- Pharmacy History: How long and how frequently medications were taken, which can be verified through your VA Blue Button Report.
- Symptom Onset: Dated provider notes that show when digestive symptoms began after medication use.
- Aggravation: Evidence that existing GERD symptoms became worse after starting treatment.
Note: We provide medical evidence consulting to help identify these patterns. We do not file claims, represent veterans, or guarantee outcomes. Veterans remain in control of how their records are used.
Major Changes: How the VA Rates GERD in 2026
Effective May 19, 2024, GERD is no longer rated by analogy to hiatal hernias. It now has its own rating under Diagnostic Code 7206, emphasizing esophageal strictures (narrowing) and dysphagia (difficulty swallowing).
2026 GERD Rating Criteria (DC 7206)
| Rating | Evidence Required |
| 0% | Documented history with no daily symptoms or need for medication. |
| 10% | Symptoms requiring continuous medication for control, with or without documented narrowing. |
| 30% | Narrowing requiring dilation up to 2 times per year. |
| 50% | Narrowing requiring dilation 3 or more times per year or a stent. |
| 80% | Severe narrowing causing ≥20% weight loss or risk of food aspiration. |
Even without narrowing, veterans may qualify for a 10% rating if daily medications are required to control symptoms caused or worsened by service-connected medications.
Key Legal Update: Ingram v. Collins (2025)
A 2025 court case clarified that VA reviewers must consider baseline severity:
- Ratings must reflect your true symptom severity, independent of any helpful effects of medication.
- If symptoms appear controlled only because of medication, documentation of baseline severity is crucial for VA review.
Medications Commonly Linked to GERD
Pain and Inflammation Meds (NSAIDs)
- Examples: Ibuprofen, Naproxen, Aspirin
- Mechanism: Long-term use can reduce stomach lining protection, allowing acid reflux or inflammation.
- Evidence: BVA Decision A25015703 (2025) recognized GERD secondary to NSAID use.
Mental Health Medications (SSRIs)
- Examples: Zoloft, Paxil
- Mechanism: Relaxation of the lower esophageal sphincter can allow acid to leak upward.
- Evidence: Documented digestive symptoms over time can support secondary claims.
Whether you take NSAIDs for chronic pain or SSRIs for mental health, long-term medication use can sometimes contribute to digestive issues like GERD. The key is documentation. Medical records, pharmacy history, symptom logs, and provider notes all work together to form the “Medication Bridge” between your service-connected condition and your new digestive symptoms.
Understanding this bridge helps you:
- Track how your medication timeline corresponds to symptom onset.
- Provide evidence for VA reviewers under 38 C.F.R. § 3.310.
- Support a secondary claim with clear medical nexus documentation.
Even if your medications are prescribed correctly and necessary, the VA can still recognize their role in causing or aggravating GERD, as shown in recent Board decisions like A25015703 (2025) and reinforced by Ingram v. Collins (2025).
Important Notice:
This article is educational only and reflects publicly available information, including VA regulations, medical literature, and court decisions. It does not constitute legal, medical, or claims advice.
All veterans should consult qualified medical and legal professionals when preparing claims or interpreting their own medical records. Official VA guidance can be found at VA.gov.
