How To Prove a Secondary Condition
Secondary conditions can significantly impact a veteran’s disability claim. If approved, these conditions can increase your overall monthly compensation and give you access to greater benefits.
- Secondary conditions are disabilities caused or aggravated by a service-connected condition. They can significantly increase the total disability rating and overall compensation.
- For a successful secondary condition claim, you must confirm your primary condition is service-connected by gathering strong medical evidence, such as treatment records and a nexus letter.
- A well-supported nexus between the primary and secondary conditions is essential. Medical documentation and expert opinions significantly improve your chances of approval.
- A dedicated advocate can guide you through the claims process, ensuring forms are accurate and evidence is complete. They can help interpret VA decisions, respond to denials, and navigate appeals.
If you or your loved one developed a secondary condition related to your primary service-connected condition, our team can help you apply for a disability rating increase. Contact Veterans Guide today to schedule an initial consultation.
Understanding Secondary Conditions
In the context of veteran disability claims, secondary conditions are injuries or illnesses caused or aggravated by an existing service-connected disability.
For example, a veteran may have been diagnosed with post-traumatic stress disorder, also known as PTSD, caused by their service. Over time, the symptoms of PTSD can lead to the development or aggravation of an anxiety disorder.
Similarly, a back injury sustained during active service can lead to additional mobility issues affecting a veteran’s daily life. With sufficient evidence connecting the two conditions, a veteran may be able to secure an increased VA disability rating and additional benefits.
How To Prove a Secondary Condition
VA regulations allow disability claims for secondary conditions. Under 38 CFR § 3.310, if a veteran develops a new condition because of a service-connected condition, the new condition can also be recognized as service-connected and be eligible for VA disability compensation.
It is important to note that this includes the aggravation of non-service-connected disabilities. However, to establish a secondary service connection by aggravation, the following must be shown:
- The veteran has a current non-service-connected disability.
- That disability has been aggravated beyond its natural progression by a service-connected disability.
- Medical evidence supports the causal or aggravating relationship.
Gathering Medical Evidence
Medical evidence is a crucial part of proving a secondary condition. VA doctors and independent medical professionals can provide expert testimony, attesting to the connection between your conditions. Similarly, medical documentation, like a nexus letter, can increase the likelihood of approval.
Establishing the Nexus Between Conditions
Veterans must show that their secondary condition was caused or worsened by their primary service-connected condition. This may include presenting a clear, logical argument supported by medical research, opinions, or clinical studies.
Filing the Claim
Filing a VA disability claim for a secondary service-connected condition involves the following key steps:
- Show proof of an existing primary and secondary condition: The veteran must have an existing primary condition that is already service-connected. To support the secondary claim, they must gather medical evidence, including a current diagnosis of the secondary condition and a medical nexus opinion linking the secondary condition to the primary one.
- Collect additional documentation: Treatment records and lay statements can strengthen a claim. The veteran must complete and submit VA Form 21-526EZ, clearly indicating that the claim is for a secondary condition and specifying the related primary condition. Supporting documents, including the nexus letter and medical records, should be submitted with the form, either online through VA.gov, by mail to the VA Claims Intake Center, in person at a VA Regional Office, or with the help of an accredited Veterans Service Organization.
- Attend a C&P exam: After submission, the VA may schedule a Compensation and Pension, or C&P, exam to evaluate the claimed secondary condition. Once the VA reviews the evidence, it will issue a decision assigning a disability rating based on the severity of the condition and its impact on the veteran’s life and, if granted, pay monthly compensation.
Common Mistakes To Avoid
Veterans can make several common errors when filing a secondary condition claim, resulting in a denial. The most typical of these is failing to include sufficient medical evidence, not explicitly linking the secondary condition to the service-connected disability, and submitting incomplete forms.
If the documentation you provide in your claim fails to fully connect the two conditions, the VA may view this as insufficient evidence. Additionally, before submitting your claim, review every form and check for missing information. Even if your evidence is strong, an incomplete form can harm your case and vice versa.
What To Expect During the VA Review Process
To begin, the VA will verify the existence of your primary service-connected disability. Once confirmed, they will evaluate the evidence you provided connecting the secondary condition to your primary condition. This includes reviewing any submitted medical records, nexus letters, and treatment history.
The VA may schedule a Compensation and Pension exam to assess the severity of the secondary condition and determine whether a medical relationship exists between the two conditions. Following this, the VA will review the claim, determine whether there is a connection to the primary condition, and issue a VA disability rating if applicable.
The VA’s process for reviewing secondary condition claims can take several months for you to hear back on whether your case was approved or denied. The key to a successful claim is patience, as delays are common. If you receive the news that your claim was denied, you have several options for next steps.
It is vital to review the denial letter closely and identify the VA’s reasoning for it. You can then file a Supplemental Claim with new and relevant evidence, request a Higher-Level Review by a more senior reviewer, or appeal to the Board of Veterans’ Appeals. Working with a seasoned legal professional during this process can ensure your claim includes all the necessary evidence before submission.
Need Help Proving Your Secondary Condition?
To succeed in a claim for a secondary condition, you must submit sufficient, supportive evidence. Without an advocate by your side, this can be a daunting task. Fortunately, Veterans Guide has a compassionate team with the knowledge and experience needed to help you navigate the process from start to finish.
For more information and to get started on building a compelling claim, contact Veterans Guide today.
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