A secondary service-connected disability is a condition caused or made worse by a disability the VA has already connected to your military service. These conditions may qualify for additional compensation, and a medical opinion can help show the connection. Silverman, Tokarsky & Forman, L.L.C., handles VA disability claims for veterans in the Johnstown area. We help veterans support secondary claims with medical opinions and treatment records.
Common Secondary Condition Pairs
Some secondary conditions are easy to spot, such as a knee injury that leads to problems in the opposite hip. Others involve different parts of the body. Common examples include:
- Post-traumatic stress disorder (PTSD) leading to obstructive sleep apnea
- Tinnitus leading to migraines or depression
- Diabetes leading to peripheral neuropathy in the feet
- Long-term pain medication for a service-connected back condition leading to stomach or kidney disease
Medication side effects can also count. A condition caused by medicine you take for a service-connected disability can still qualify as secondary. Your VA pharmacy records can help show when you started the medication and when the new condition appeared.
What Must a Nexus Letter Say?
Under 38 C.F.R. § 3.310, a condition may qualify for secondary service connection when a service-connected disability causes it or makes it worse beyond its natural progression. A private medical opinion, often called a nexus letter, should explain that connection and the medical findings that support it:
- The Standard: The doctor states the condition is “at least as likely as not” caused or worsened by the service-connected disability.
- A Records Review: The letter lists the service records and VA records the doctor reviewed.
- Medical Reasoning: The letter explains how one condition led to the other, ideally citing published research.
- Credentials: The letter includes the doctor’s signature, medical specialty, and license number.
- An Aggravation Baseline: For claims that a condition was made worse, the doctor estimates how severe it was before the service-connected disability affected it.
A letter saying a condition “could be related” or “may be connected” is often too uncertain to prove the connection. “At least as likely as not” means a 50% or greater likelihood, but the opinion should also explain the medical reasoning behind that conclusion.
How Does VA Math Combine Ratings?
VA disability ratings do not simply add together. The VA applies each new rating to the portion of the “whole person” that is not already rated. For example, if you have a 50% rating and receive a new 30% rating, the VA takes 30% of the remaining 50%, which is 15%. That brings the combined rating to 65%, which rounds up to 70%.
Adding a 10% secondary condition to a 70% rating results in 73%, which rounds back down to 70%. A small secondary rating may not raise your monthly payment on its own. However, several secondary ratings together can help you reach a higher combined rating or qualify for Total Disability Individual Unemployability (TDIU), which pays at the 100% rate when your conditions keep you from working.
Local Help for Cambria County Veterans
The Johnstown VA Clinic at 598 Galleria Drive provides primary care and can document your symptoms. The James E. Van Zandt VA Medical Center in Altoona offers additional specialty care. The Cambria County Veterans’ Services Office in Ebensburg provides free help with filing claims and requesting records.
Put Our VA-Accredited Attorney on Your Secondary Claim
Our firm has a VA-accredited attorney who reviews nexus letters and handles denied secondary claims through Higher-Level Review and appeals to the Board of Veterans’ Appeals. We represent veterans throughout the Laurel Highlands. Call (814) 536-8600 or send your decision letter through our online contact page.
