VA Conditions Secondary to PTSD
Post-traumatic stress disorder, or PTSD, is a common service-connected condition among veterans of the armed forces. The mental and physical strain of living with PTSD symptoms often causes or exacerbates other health conditions, ranging from depression and anxiety to heart disease.
These illnesses can be PTSD secondary conditions under the U.S. Department of Veterans Affairs’ guidelines. To qualify for a VA disability rating increase for a secondary condition related to their service-connected PTSD, a veteran must submit medical documentation linking the secondary condition to their PTSD.
Veterans Guide can assist you with a claim for a secondary condition so you can access the additional benefits you deserve.
Common Secondary Conditions Caused by PTSD
Secondary conditions are disabling injuries or illnesses that develop from service-connected disabilities. Multiple mental and physical illnesses can be secondary conditions to PTSD. Some of the most common include:
- Depression
- Anxiety
- Substance use disorders
- Heart disease
- Hypertension
- Erectile dysfunction
- Gastrointestinal disorders
- Insomnia
- Sleep apnea
Not everyone with PTSD will develop a secondary condition, but those who do can file a claim for a VA disability rating increase that may entitle them to additional benefits.
Mental Health Conditions Secondary to PTSD
Living with PTSD symptoms is emotionally challenging, and the condition itself causes structural changes in the brain. PTSD impairs the brain’s ability to regulate emotions and mitigate the fear response. Thus, the condition may make an affected individual more vulnerable to mental health challenges, including the following:
- Depression: Dealing with PTSD may lead veterans to develop depression. If you feel down more days than not or have lost interest in activities you used to enjoy, you may have depression secondary to PTSD.
- Anxiety disorders: If you have anxiety secondary to PTSD, you may struggle with ongoing worries or fears that interfere with your daily life. PTSD and anxiety share neurobiological features, so it’s not surprising that patients with PTSD can also develop diagnosable anxiety disorders, such as generalized anxiety, social anxiety, and phobias.
- Substance use disorders: According to the National Center for PTSD, about 40% of adults with PTSD also struggle with drug and alcohol misuse. A person with PTSD may turn to substances as a way to distract from symptoms, only to develop an addiction.
Any of these secondary mental health conditions can reduce your ability to function beyond the already-established effects of your PTSD.
Physical Conditions Secondary to PTSD
Trauma and its effects place significant strain on the body. Veterans who report PTSD symptoms are more likely to seek medical attention and rate their health as poor. Doctors aren’t sure what causes the connection between PTSD and physical illness, but that connection is real for patients.
Common secondary physical conditions include the following:
- Heart disease: Studies have shown that individuals with PTSD have a significantly increased risk of cardiovascular illness. Some researchers believe that the connection may be related to changes in the brain. PTSD causes heightened stress responses and inflammation, both of which increase the risk of major cardiac events.
- Hypertension: PTSD increases a veteran’s risk for hypertension, or high blood pressure. Hypertension secondary to PTSD may be more likely in veterans with severe combat injuries, with inflammation and lifestyle choices possibly also playing a role.
- Erectile dysfunction: According to a study published in the medical journal Advances in Sexual Health, veterans with PTSD experience sexual performance issues more often than those without the disorder. Erectile dysfunction secondary to PTSD may develop because of additional secondary problems and their effect on the body. Medications that treat PTSD may also increase the risk of erectile dysfunction.
- Gastrointestinal issues: Research shows that individuals with PTSD have a 25% risk of gastrointestinal conditions, including Crohn’s disease, inflammatory bowel disease, and gastroesophageal reflux disease, or GERD. GERD secondary to PTSD is more common than reflux in the general population and in veterans without PTSD.
Sleep Disorders Secondary to PTSD
Most people with PTSD struggle with getting consistent, high-quality sleep. Many develop sleep-related conditions, such as the following:
- Insomnia: Approximately 70% of individuals diagnosed with PTSD also experience insomnia. Those with insomnia secondary to PTSD tend to have poorer sleep quality and less consistent sleep compared to individuals with insomnia alone. Scientists believe the heightened stress response of PTSD may be to blame.
- Sleep apnea: Obstructive sleep apnea is more prevalent in individuals with PTSD than in the general population, potentially because of the heightened tendency to arousal in people with post-traumatic stress. Sleep apnea secondary to PTSD may also worsen trauma-related sleep symptoms, including nightmares and nighttime waking.
Significant mental and physical consequences can happen because of a lack of sleep. Veterans with these secondary conditions may develop new or worsening struggles with concentration, memory, thinking, and mood. If sleep symptoms affect your daily functioning, consider filing a claim for your sleep condition as secondary to PTSD.
These and other sleep conditions may further increase the risk of other secondary conditions, including depression, anxiety, heart disease, hypertension, and kidney disease. Keep track of your symptoms and see a doctor if you experience any issues related to your service-connected condition.
Filing for Secondary Service Connection
If you have received a VA disability rating for a service-connected condition, filing a secondary claim can qualify you for additional benefits. The process involves the same steps as your initial claim. Thus, you must do the following:
- Gather medical evidence: To receive additional benefits for your secondary condition, you must establish that it was caused or exacerbated by a service-connected injury or illness. Plan to submit all medical records related to the secondary condition. Include documentation of the cause.
- File your claim: Use VA Form 21-526EZ to file a secondary claim. Include all other necessary VA Forms, such as records authorizations and support statements. All forms must be complete and accurate. If you have any questions, consult with a professional.
- Respond to a denial if necessary: Applicants may receive VA claim denials if the application was incomplete, filed incorrectly, or insufficient to prove the claim. If you have additional evidence supporting your claim, you may appeal with a supplemental claim including that documentation. Otherwise, if you disagree with the decision, you may request a higher-level review of your case.
Frequently Asked Questions About Secondary Conditions and PTSD
Can You File for Secondary Conditions Even if Your PTSD Is Already Rated?
Yes, you can file for a secondary condition if you have already received a rating for the primary illness or injury. If your secondary condition qualifies for a rating, the VA will combine that rating with your rating for PTSD to determine a new, higher rating.
What Happens if My Claim for Secondary Conditions Is Denied?
You may file a VA appeal for a secondary claim, just as you can for the denial of a primary one. Submit a supplemental claim if you have additional evidence. Otherwise, you may request a higher-level review or Board Appeal.
Can Secondary Conditions Help Me Get TDIU?
Yes, a secondary condition can qualify you for the Total Disability Individual Unemployability program, or TDIU, entitling you to the equivalent benefits of a 100% VA disability rating. To qualify, your service-related conditions must prevent you from working, and you must have one disability rated at 60% or multiple disabilities combining to 70%, with one at 40%.
Do I Need a Nexus Letter for Secondary Claims?
It is best practice to include a nexus letter with your secondary claim. This letter should explain the connection between your secondary condition and your service-connected disability. It should come from a medical professional with a credential related to your condition.
Maximizing Your VA Disability Benefits by Claiming Secondary Conditions
It’s essential to consider secondary conditions when filing for disability benefits. Including secondary injuries or illnesses can increase your rating and provide you with greater benefits and monthly compensation.
Whether you are filing an initial or secondary claim or appealing a denial, Veterans Guide is here to help.
Contact us today to get started.
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