Citation Nr: 21042205 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 19-14 401 DATE: July 12, 2021 ORDER A 10 percent rating, but no more, for gastroesophageal reflux disease (GERD) is granted, subject to the criteria governing the award of monetary benefits. The appeal for entitlement to a rating compensable rating for unspecified anxiety disorder is dismissed. FINDINGS OF FACT 1. The Veteran served on active duty from May 1992 to February 1994 and from October 1997 to May 2016. 2. GERD has been manifested by subjective complaints of reflux, vomiting and regurgitation; objective findings include daily medication for control but no dysphagia, substernal, arm or shoulder pain; severe impairment of health due to GERD has not been shown. 3. At the September 2020 hearing before the undersigned, prior to the promulgation of a decision in the appeal, the Veteran indicated his desire to withdraw his appeal for an increased rating for unspecified anxiety disorder. CONCLUSIONS OF LAW 1. The criteria for a 10 percent rating, but no more, for GERD, have been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. § 4.114, Diagnostic Code (DC) 7399-7346 (2020). 2. The criteria for withdrawal of a compensable rating for unspecified anxiety disorder have been met. 38 U.S.C. § 7105 (2012); 38 C.F.R. §§ 20.202, 20.204 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In September 2020, the Veteran testified at a virtual hearing held before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Increased Rating for GERD Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. GERD is rated as noncompensable pursuant to DC 7399-7346. There is no diagnostic code specifically applicable to GERD, and this disability has been rated by analogy to hiatal hernia under DC 7346. Under DC 7346, a 10 percent rating is warranted for hiatal hernia with two or more of the symptoms for the 30 percent rating of less severity. A 30 percent rating is warranted for hiatal hernia with persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of a considerable impairment of health. A 60 percent rating is warranted for hiatal hernia with symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia, or other symptom combinations productive of severe impairment of health. 38 C.F.R. § 4.114, DC 7346. At the time of the Veteran's June 2016 VA esophageal conditions examination, he reported that he required continuous medication (Nexium) for GERD. There was no evidence of considerable impairment of health, dysphagia, pyrosis, reflux, regurgitation, persistent epigastric distress, or substernal, arm or shoulder pain. There was also no sleep disturbance, nausea, vomiting, hematemesis, or melena. The examiner opined that the GERD symptoms did not affect the Veteran's ability to work. The VA and private treatment records do not reflect any additional complaints or symptoms related to his GERD. The Veteran testified that a higher rating is warranted because although he was fine on medication, if he missed even one dose, he had additional symptoms such reflux, regurgitation, and eventually vomiting. He also indicated that he was unable to eat certain foods. In giving the Veteran the benefit of the doubt, the above evidence reflects that the GERD symptoms more nearly approximate those contemplated by a 10 percent rating under DC 7346. In this regard, he stated that while his symptoms were controlled by medication, he still experienced reflux, and choking or vomiting if he missed taking his medication. Because the Veteran has provided competent evidence of regurgitation and heartburn, with eventual vomiting, the evidence is at least evenly balanced as to whether his symptoms more nearly approximate the criteria for a 10 percent rating under DC 7346. Nonetheless, a rating in excess of 10 percent is not warranted. Specifically, he does not contend, and the evidence of record does not suggest, that he experiences symptoms of dysphagia, or that his symptoms are productive of a considerable impairment of health, nor is there evidence of material weight loss and hematemesis or melena with moderate anemia, or other symptom combinations productive of severe impairment of health. As reasonable doubt is resolved in favor of the Veteran, entitlement to a 10 percent, but no more, is warranted for GERD. In granting a higher rating, the Board has considered the Veteran's lay statements regarding his symptoms as well as the evidence provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. In sum, after a careful review of the evidence of record, a 10 percent rating, but no more, for GERD is granted. Withdraw of the Appeal for an Anxiety Disorder The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.204. Withdrawal of a claim must be "explicit, unambiguous, and done with a full understanding of the consequences of such action." DeLisio v. Shinseki, 25 Vet. App. 45, 47 (2011). At the September 2020 Board hearing before the undersigned, the Veteran explicitly and unambiguously withdrew his appeal on the issue of an increased rating for unspecified anxiety disorder. The hearing transcript has been reduced to writing and is of record. Hence, there remains no allegation of error of fact or law for appellate consideration with regard to this issue. Thus, the Board does not have jurisdiction to review the appeal of this issue and it is dismissed. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Redman, 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.