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Yes, you can file a secondary VA claim for conditions that are secondary to other secondary conditions!
It might sound like a bit of a tongue twister, but it’s actually a straightforward concept.
There’s no limit to how many layers of secondary conditions you can file for VA disability benefits, if you can establish the necessary medical nexus evidence between each of the two conditions.
Here’s an example of filing secondary conditions to secondary conditions for VA disability benefits:
- #1. You file a VA claim for migraines secondary to tinnitus
- #2. Then, you file another claim for neck pain secondary to migraines
- #3. Next, you file for back pain secondary to neck pain
- #4. After that, you file for knee pain secondary to back pain
- #5. Finally, you file for plantar fasciitis secondary to knee pain
Each layer builds upon the previous one, creating a chain of secondary service connection.
As long as the medical evidence supports the link between these conditions, you can file for and potentially receive VA disability benefits for each secondary condition.
Table of Contents
3-Minute Video: Can You Claim a SECONDARY to a SECONDARY for VA Disability Benefits? YES!
Summary of Key Points
- Secondary Service Connection for VA Disability: Secondary service connection occurs when a service-connected condition causes or worsens another condition. This includes filing for conditions secondary to other secondary conditions.
- Unlimited Layers of Secondary VA Claims: There is no limit to how many layers of secondary conditions you can claim, as long as you establish medical nexus evidence linking each condition in the chain. You can file a VA claim secondary to a secondary to a secondary to a secondary, and so on.
- Example Chain of Secondary Connections: For instance, a knee injury can lead to hip pain, which may cause back problems, sciatica, and eventually anxiety or depression. Each condition builds upon the previous one for a chain of secondary conditions.
- Essential Medical Evidence: Successfully filing secondary claims requires a formal diagnosis, proof of an existing service-connected disability, and a strong Nexus Letter demonstrating the connection between conditions.
What is Secondary Service Connection?
Secondary service connection occurs when a current service-connected condition causes or aggravates a new condition.
Here’s an example:
Let’s say a veteran has a service-connected shoulder injury.
Over time, the limited mobility and chronic pain from the shoulder injury force the veteran to overuse the opposite arm, eventually leading to arthritis in that shoulder.
In this case, the arthritis could be claimed as a secondary condition to the service-connected shoulder injury.
Similarly, if a veteran has a service-connected PTSD diagnosis, it might lead to chronic sleep apnea due to weight gain from medication or severe anxiety-related sleep disturbances.
In this scenario, the sleep apnea could be claimed as secondary to the PTSD.
The essential part of establishing secondary service connection is demonstrating that the secondary condition is either proximately due to, caused, or aggravated by the primary service-connected disability.
Pro Tip: If you’re filing for secondary service connection, a Nexus Letter is highly recommended. Why? Because secondary service connection requires “medical nexus evidence” that your new disability is proximately due to, caused, or aggravated by a current service-connected disability.
How to Prove Secondary Service Connection for VA Disability Benefits
To establish secondary service connection for VA disability benefits, you must meet three key elements:
- #1. Diagnosis of the New Secondary Condition in a Medical Record: You need a diagnosis of the new secondary condition in your medical records, whether from VA healthcare providers or private physicians. It’s beneficial to have a current diagnosis within the past 12 months to show the condition’s ongoing impact.
- #2. Existing Service-Connected Disability Rated at 0% or Higher: You should have an existing service-connected disability rated at 0% or more that you plan to connect the new secondary condition to. You can upload a previous VA rating decision letter or explain in a personal statement the condition name, its current rating, and date of service connection.
- #3. Medical Nexus Evidence Between the Two Conditions: This is the most crucial aspect of secondary service connection. You need medical nexus evidence between the new secondary condition and the current service-connected condition. The best way to help prove this is with a strong Nexus Letter. This independent medical opinion should state that your new secondary condition is “at least as likely as not” proximately due to, caused, or aggravated by your service-connected disability.
Can You Claim a Secondary to a Secondary VA Disability?
Yes, you can!
While it may sound confusing, it’s actually a straightforward process.
Veterans can file VA claims for conditions that are secondary to other secondary conditions—there’s no limit to the layers of secondary connections you can pursue, if you have the required medical nexus evidence.
Here’s another example of how this works—it’s like a chain reaction, similar to dominoes falling, where one condition leads to the next:
- #1. Knee Injury leads to Hip Pain: A knee injury can alter the way you walk or bear weight, causing uneven strain on the hips. Over time, this abnormal gait can result in chronic hip pain.
- #2. Hip Pain leads to Back Problems: Hip pain can shift posture and body mechanics, placing additional stress on the lower back. This often leads to muscle imbalances or spinal issues, such as herniated discs or chronic lower back pain.
- #3. Back Problems lead to Sciatica: Back problems, like a herniated disc or spinal misalignment, can compress the sciatic nerve. This causes sciatica, which is characterized by pain, tingling, or weakness radiating down the leg.
- #4. Sciatica leads to Anxiety and Depression: Living with persistent sciatica can significantly impact daily activities, sleep, and quality of life. The chronic pain and limitations often lead to feelings of frustration, anxiety, and depression.
As you can see, each layer builds upon the previous one, creating a chain of secondary service connection to other secondary conditions as follows:
- Hip pain secondary to knee injury
- Back problems secondary to hip pain
- Sciatica secondary to back problems
- Anxiety and depression secondary to sciatica
If you provide sufficient medical evidence to establish that each secondary condition is caused or aggravated by the prior condition, you can file secondary VA claims and potentially receive VA disability benefits for each one.
Pro Tip: Building a strong case for your secondary VA claim often means getting a Nexus Letter for a secondary condition from a qualified private medical professional to link the two conditions clearly. A Nexus Letter with high probative value can literally be the difference between an approval and a denial!
How to File Your Secondary VA Claim Online
Veterans can follow this simple 4-step tutorial (with screenshots) of how to file a secondary VA disability claim online at VA.gov:
- Step #1: Go to VA.gov and open a new claim using the online VA Form 21-526EZ – Application for Disability Compensation and Related Compensation Benefits
- Step #2: Ensure your new secondary disability condition is medical diagnosed and that the primary disability condition is service connected at 0% or more
- Step #3: Obtain a Nexus Letter from a private healthcare provider to help show the link or connection between the non-service connected secondary disability and the service connected primary disability
- Step #4: File the non-service connected secondary disability condition secondary to the primary service connected disability in VA.gov
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
