Early-2000s Marine veteran • Repeated in-service stomach complaints • Chronic reflux after deployment
The Challenge
The VA denied GERD because there was no formal in-service diagnosis. The STRs contained few notations of “stomach pain” and prescription of antacids.
What Existed Before
- STR notations of GI discomfort
- Post-service GERD diagnosis.
Our Contribution
- Highlighted repeated GI complaints in STRs
- Explained pathophysiology of chronic reflux
- Demonstrated post-service continuity through medical records
- Connected dietary exposure during deployment to symptom onset
Key Takeaway
Once the updated medical rationale and continuity-of-symptom documentation were submitted, the veteran later received a favorable VA decision granting primary service connection for GERD.
Ready to achieve similar results?
Let our expert team help you with your VA disability claim
Get Free ConsultationContent Standards
Written By
Military Disability Nexus Editorial Team
Educational Guidance and Evidence Research
View editorial standardsReviewed For Clinical Accuracy
Military Disability Nexus Clinical Review Team
Clinical Integrity and Accuracy Review
View medical review policyOriginally published December 6, 2025 • Last updated May 22, 2026
Related Insights
Case Study
VA Denied Pre-Existing Knee Condition: How We Rebuilt the Aggravation Argument
Army Veteran • VA Denied Pre-Existing Knee Condition • Aggravation Beyond Natural Progression • Asthma Service Connection
View Case Study
Blog
Do You Still Need a Baseline for Secondary Aggravation After Spicer? What the Law Says vs. What VA Is Doing
The baseline requirement for secondary aggravation claims came from 38 C.F.R. § 3.310(b). The Federal Circuit struck down that regulation in Spicer v. McDonough. The statute (38 U.S.C. § 1110) says nothing about baselines. But as of May 2026, VA has not formally rewritten the regulation, and C&P exam templates still ask examiners to address baseline. Here's the key: the exam templates themselves say the aggravation question must be answered "regardless of an established baseline." The baseline is a rating tool, not a gatekeeping tool. When it can't be determined, §§ 3.22 and 4.22 mean no deduction — the veteran gets the full current rating.
Read Article
Blog
The Anatomy of a Strong Secondary-Connection Nexus Letter After the 2026 But-For Standard
A strong secondary nexus letter after Spicer v. McDonough includes seven sections: provider qualifications, records reviewed, veteran-specific timeline, diagnosis, a nexus opinion addressing all three pathways (causation, aggravation, treatment interference), medical rationale with peer-reviewed citations, and proper signature. The five most common reasons nexus letters get denied are: no mechanism explained, template language, ignoring aggravation, wrong probability language, and failing to address the C&P examiner's negative opinion.
Read Article