VA Disability for GERD Secondary to Migraine Medications

Many veterans with migraines take medications that, while effective for pain relief, can irritate the digestive tract and lead to the development of GERD. Common migraine medications, including NSAIDs and certain triptans, are known to cause acid reflux and heartburn over time.  

How to Service Connect GERD and Get a VA Rating

Veterans experiencing GERD because of long-term migraine medication use may qualify for a secondary service connection if they can demonstrate that their GERD was caused or worsened by the treatment for their migraines. They will need to provide:

• A diagnosis for both conditions 
• A professional opinion from a doctor about how medications caused or worsened GERD (a nexus letter)
• Lay evidence such as statements from the veteran, their family and fellow service members detailing the observed effects of migraine treatments on the veteran’s digestive system

The VA Ratings for GERD

VA may rate GERD secondary to migraine medications at 0%, 10%, 30%, 50% or 80%, depending on the daily symptoms, medication use and required treatments.

• 0% – GERD has no daily symptoms or requirement for daily medications 
• 10% – Esophageal stricture(s) requiring daily medications to control dysphagia 
• 30% – Recurrent esophageal stricture(s) causing dysphagia and requiring dilatation no more than 2 times per year 
• 50% – Recurrent or refractory esophageal stricture(s) causing dysphagia and requiring at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement 
• 80% – Recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube

 See also what to expect at the C&P exam

Case Example: GERD as Secondary to Use of NSAIDs for Migraines

In this case, a veteran who served in the U.S. Army from September 1989 to September 1992 filed a claim for disability benefits due to multiple conditions, including gastroesophageal reflux disease (GERD) secondary to service-connected migraines. The veteran believed that his use of non-steroidal anti-inflammatory drugs (NSAIDs) for migraine relief had caused or aggravated his GERD. Initially, the veteran’s GERD was not service-connected, but the veteran pursued an appeal. 

The Board of Veterans’ Appeals ultimately granted service connection and a VA rating for GERD as secondary to the veteran’s service-connected migraine headaches. The Board recognized the veteran’s long-term use of NSAIDs for migraines, which contributed to his GERD symptoms, providing sufficient grounds for secondary service connection. 

How This Claim Was Won 

• Medical Nexus Linking GERD to Migraines: A private medical opinion strongly supported the claim by explaining how the veteran’s long-term use of NSAIDs for migraines, such as Excedrin, aspirin, and Motrin, likely caused or worsened the veteran’s GERD. 
• Diagnosis and Medical Evidence: The veteran’s GERD was confirmed through medical testing, including a fluoroscope in 2013. This diagnosis provided a solid foundation for the claim and showed a persistent condition that developed over time, correlating with his migraine treatments. 
• Secondary Service Connection Criteria: The Board concluded that the veteran met the criteria for secondary service connection under 38 C.F.R. § 3.310, as the GERD was determined to be caused or aggravated by a service-connected condition (migraines), with evidence from both VA and private medical sources supporting this link. 
• Expert Testimony and Documentation: The veteran’s representative submitted compelling medical documentation and testimony at the appeal hearing, showcasing the impact of the migraine medication on his GERD, which contributed to the Board’s decision in favor of the veteran. 

This case demonstrates how veterans can successfully claim GERD as secondary to service-connected conditions like migraines, especially when long-term medications contribute to the development of GERD symptoms. Medical evidence and expert opinions linking the primary condition to the secondary one are crucial for building a strong case. 

My Claim Was Denied, What Can I Do?

Choosing the best path to appeal a VA decision depends on the specifics of your case and why the VA denied your claim. For guidance on your next steps, contact us for a free review of your case. We’ll help you understand your options and how to move forward.