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Shoulder pain doesn’t always stop at the shoulder. Over time, your shoulder pain can lead to VA secondary conditions, from neck and back problems to nerve issues and mental health struggles.
These secondary conditions can make daily activities more challenging and may qualify you for additional VA disability benefits and a higher overall VA rating.
In this guide, we’ll cover 5 secondary conditions to shoulder pain, how to file a secondary claim, the value of a nexus letter, and the evidence you need to prove service connection.
Table of Contents
Summary of Key Points
- A VA secondary condition to shoulder pain is a health problem that develops because of (or is made worse by) your service-connected shoulder injury.
- Secondary service connection requires a current primary service connection, a current medical diagnosis of the secondary condition, supporting medical or service records, and a medical nexus linking the two conditions.
- A nexus letter from a qualified medical professional can strengthen a secondary VA claim by clearly linking your condition to a service-connected shoulder disability.
Understanding Secondary Service Connection
Secondary service connection applies when an existing service-connected disability directly causes or worsens another condition.
To prove secondary service connection, you must provide the following:
- A current primary service connection for shoulder pain
- A current medical diagnosis of your VA-ratable secondary condition performed by a qualified healthcare provider
- Documentation of supportive evidence, such as in your medical and/or personnel records, that your provider has reviewed.
- A medical nexus (link) showing documented evidence that your shoulder pain caused or worsened your secondary condition (e.g., a Nexus Letter)
What Conditions are Secondary to Shoulder Pain?
1. Neck Pain
For many veterans, neck pain develops over time as shoulder injuries from service change posture and movement, putting added stress on the cervical spine.
The VA rates neck pain secondary to shoulder pain under the General Rating Formula for Diseases and Injuries of the Spine.
Disability ratings depend on the frequency, severity, and duration of symptoms, including limitation of range of motion (ROM), painful motion, and presence of ankylosis.
See More: How to Get a Neck Pain VA Rating
2. Back Pain
Shoulder pain can change the way you move and carry yourself, often leading to poor posture and muscle strain that develops into back pain.
VA back pain ratings range from 10% to 100% and are based on your range of motion, painful motion, ankylosis, and the degree of functional loss.
Even if your back moves through a full range, the painful motion principle can still qualify you for the minimum compensable rating, typically 10%.
You can find the VA ratings for back pain under the General Rating Formula for Diseases and Injuries of the Spine.
See More: VA Disability Ratings for Back Pain Explained
3. Mental Health Conditions
Living with chronic shoulder pain can take a toll on your mental health, often leading to stress, anxiety, or depression.
The constant pain and limits on daily activities can leave you feeling frustrated, isolated, and emotionally drained over time.
If your service-connected shoulder pain causes or worsens a mental health condition, you may be eligible for VA disability benefits.
The VA rates mental health conditions under the General Rating Formula for Mental Disorders, with potential ratings of 0%, 10%, 30%, 50%, 70%, or 100%.
See More: VA Mental Health Rating Chart Explained
4. Nerve Conditions
Shoulder pain can sometimes lead to nerve compression or irritation, especially when swelling or injury affects nearby nerves.
This can result in numbness, tingling, weakness, or radiating pain down the arm and into the hand.
The VA rates nerve conditions under the Schedule of Ratings for Neurological Conditions and Convulsive Disorders.
Ratings depend on which peripheral nerve is affected (such as the median, ulnar, or radial nerves), whether the impairment is in your dominant or non-dominant arm, and whether the symptoms are considered mild, moderate, severe, or complete paralysis.
5. Limited Use of Hands or Fingers
Shoulder pain can limit the nerves and muscles that control arm movement, making it harder to use your hands and fingers effectively. Over time, this can reduce grip strength, fine motor skills, and overall hand function.
The VA rates limited use of the hands or fingers based on loss of motion, strength, or function, and whether it affects your dominant (major) or non-dominant (minor) hand.
For example, the VA may assign a 20% rating for limited motion in the minor hand, while severe loss of function in the dominant hand could be rated as high as 70%.
Ratings for limited use of hands or fingers are found under the Schedule of Ratings for the Musculoskeletal System.
Evidence Required for Secondary Service Connection
Pro Tip: It is highly recommended to get a credible Nexus Letter when proving secondary service connection.
For secondary service-connected claims, you’ll need to submit medical or lay evidence that shows these are true:
- You have a new physical or mental condition, and
- There’s a link between your new condition and the disability the VA already determined is service-connected (in this case, shoulder pain).
Usually, the VA requires medical records or medical opinions from health care providers to support the link for secondary conditions.
However, in some circumstances, they may also accept lay evidence, like a buddy statement (VA Form 21-10210).
How to File a VA Claim for Secondary Conditions
Online is the quickest way to file a VA claim for secondary conditions to shoulder pain.
However, you can also download and complete VA Form 21-526EZ and submit it in one of the following ways:
- By Mail
- Via Fax
- In person at a VA regional office
The Value of a Nexus Letter for Secondary Conditions
While the VA doesn’t require nexus letters, and they don’t guarantee approval, they can be powerful evidence when filing for secondary conditions related to shoulder pain.
A nexus letter, written by a qualified medical professional, explains how your secondary condition (such as neck pain, nerve problems, or limited hand function) is linked to your service-connected shoulder disability.
A strong nexus letter should provide a clear medical opinion backed by your service records, treatment history, and diagnostic evidence.
See More: What is the Success Rate of a VA Disability Claim With a Nexus Letter?
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Conclusion
VA secondary conditions to shoulder pain can have the potential to impact nearly every part of your life. By understanding how the VA rates secondary conditions and gathering strong evidence, such as a nexus letter, you can significantly improve your chances of receiving all of the VA compensation and benefits you rightfully deserve.
See also our main guide: VA Disability Rating for Shoulder and Arm Conditions
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FAQs | Frequently Asked Questions
What are common VA secondary conditions to shoulder pain?
The VA commonly recognizes conditions like neck pain, back pain, nerve issues, mental health disorders, and limited use of the hands or fingers as secondary to shoulder pain. If supported by strong medical evidence and a nexus letter, these conditions may qualify for additional VA ratings.
Can I get VA disability for shoulder pain and secondary conditions at the same time?
Yes. Veterans can receive a VA rating for a service-connected shoulder condition and additional ratings for secondary conditions if they are proven to be caused or worsened by the shoulder disability. These ratings are then combined using VA math to determine your overall disability percentage.
Do I need a nexus letter for secondary conditions to shoulder pain?
A nexus letter can be powerful evidence in secondary condition claims. It provides a medical opinion linking your secondary condition (such as back pain, depression, or nerve damage) to your service-connected shoulder injury. A strong nexus letter often makes the difference between an approval and a denial.
Related Resources
Shoulder Pain VA Ratings Explained
VA Disability for Shoulder and Arm Conditions [Definitive Guide]
Author
Kelly Olone
Kelly Olone is a military spouse who earned her degree in Psychology from Florida International University. After working in the non-profit sector for several years, she turned to her passion for writing. She aims to contribute to a better understanding of the valuable benefits that veterans deserve. As a mom, Kelly navigates the delicate balance between deadlines and bedtime stories with finesse.
