GASTROESOPHAGEAL REFLUX DISEASE (GERD)

Summary

The Veteran, who served from June 1988 to April 1991, appeals the denial of service connection for gastroesophageal reflux disease (GERD) as secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder. The Veteran submitted a private psychological opinion from Dr. T.D. in February 2025, concluding that the GERD was at least as likely as not secondary to his mental health conditions, supported by medical literature. A VA advanced practice registered nurse also indicated in March 2025 that the Veteran's GERD symptoms were likely worsened by his alcohol use disorder, citing literature on alcohol's effects on the esophagus. The Board found the evidence to be in equipoise, noting that while VA opinions attributed GERD to obesity, they also acknowledged alcohol's role in aggravating reflux. Applying the benefit of the doubt, the Board granted service connection for GERD as secondary to the Veteran's service-connected mental health conditions, finding the private and VA nurse opinions sufficiently rationalized.

Rationale

Evidence in equipoise; Private and VA nurse opinions supported secondary connection; Benefit of the doubt applied

Full Decision Text

Citation Nr: A26034919
Decision Date: 04/15/26	Archive Date: 04/15/26

DOCKET NO. 260113-623199
DATE: April 15, 2026

ORDER

Entitlement to service connection for gastroesophageal reflux disease (GERD) as secondary to service-connected major depressive disorder with anxious distress and alcohol use disorder is granted.

FINDING OF FACT

Resolving all reasonable doubt in the Veteran's favor, his currently diagnosed GERD is secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder.

CONCLUSION OF LAW

The criteria for service connection for GERD as secondary to service-connected major depressive disorder with anxious distress and alcohol use disorder are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from June 1988 to April 1991.

In the February 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.  Therefore, the Board may only consider the evidence of record at the time of the May 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Finally, insofar as the Veteran listed the issues of entitlement to service connection for hypertension and obstructive sleep apnea on the February 2026 VA Form 10182, those issues were initially appealed in a May 2025 VA Form 10182, and they were separately addressed in a February 2026 Board decision.

Service Connection

The Veteran claims entitlement to service connection for GERD as secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder.

Initially, the Board notes that the medical evidence of record reflects a current diagnosis of GERD.  See, e.g., April 2025 VA Examination Report.

In December 2024, the Veteran submitted a number of medical articles that discussed the relationship between GERD and mental health problems.

In February 2025, the Veteran submitted a private medical opinion completed by Dr. T.D., a psychologist, who concluded that it was at least as likely as not that the Veteran's GERD was secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder.  Dr. T.D. then discussed a number of medical articles which describe connections between mental health difficulties and gastrointestinal disorders.

In March 2025, the Veteran submitted a letter from a VA advanced practice registered nurse who noted the Veteran's diagnoses of GERD and his mental health disability, and she indicated that his symptoms were likely worsened due to his history of alcohol use disorder.  She noted that literature had shown that alcohol can cause or exacerbate reflux by inducing lower esophageal hypotension.

An April 2025 VA medical opinion concluded that it was less likely than not that the Veteran's GERD was caused by his service-connected major depressive disorder with anxious distress and alcohol use disorder.  Instead, the examiner attributed the Veteran's GERD to his obesity.  However, the examiner then went on to note that drinking certain beverages, including alcohol, was a risk factor for GERD.  Thus, the examiner concluded that, while the etiology of the Veteran's GERD was more likely his obesity, the aggravation of his reflux was his alcohol use disorder.

Another April 2025 VA medical opinion concluded that it was less likely than not that the Veteran's GERD was caused by his service-connected major depressive disorder with anxious distress and alcohol use disorder.  However, the examiner then went on to say that mental health problems could contribute to the development or worsening of GERD symptoms.  Nevertheless, the examiner did not provide an opinion as to whether the Veteran's GERD was aggravated by his service-connected major depressive disorder with anxious distress and alcohol use disorder.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's GERD
 of the Veteran's GERD was more likely his obesity, the aggravation of his reflux was his alcohol use disorder.

Another April 2025 VA medical opinion concluded that it was less likely than not that the Veteran's GERD was caused by his service-connected major depressive disorder with anxious distress and alcohol use disorder.  However, the examiner then went on to say that mental health problems could contribute to the development or worsening of GERD symptoms.  Nevertheless, the examiner did not provide an opinion as to whether the Veteran's GERD was aggravated by his service-connected major depressive disorder with anxious distress and alcohol use disorder.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's GERD is secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder. As noted above, the VA medical opinions suggest that the Veteran's GERD was aggravated by his service-connected major depressive disorder with anxious distress and alcohol use disorder.  Moreover, the February 2025 opinion from Dr. T.D., as well as the March 2025 opinion from the VA advanced practice registered nurse are supported by sufficient rationale. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for his GERD as secondary to his service-connected major depressive disorder with anxious distress and alcohol use disorder is warranted. 38 U.S.C. § 5107.

 

 

Leetra J. Harris

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	James R. Springer, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.