Secondary Service Connection
The Hidden Path to Higher VA Disability Benefits
Cynthia Gomez
By Cynthia Gomez
For countless veterans, the journey toward receiving the correct VA disability rating doesn’t end with their first claim. Many service-connected conditions lead to additional health problems over time—and those new problems are often eligible for secondary service connection. Yet surprisingly few veterans know how powerful secondary claims can be or how much they can increase overall compensation.
Understanding secondary service connection can be the difference between a low rating and a life-changing award. This guide explains what secondary conditions are, why they occur, and how veterans can successfully file and win secondary claims.
What Is a Secondary Service-Connected Condition?
A secondary condition is a disability that develops because of an already service-connected condition.
The VA allows veterans to receive compensation for conditions that are:
Caused by a primary condition
Aggravated by a primary condition
Made worse over time due to a service-connected illness or injury
This is covered under 38 CFR § 3.310.
Examples:
Knee or hip pain caused by an altered gait from a service-connected foot injury
Depression caused by chronic pain
Radiculopathy caused by a service-connected back condition
Sleep apnea aggravated by PTSD
Migraines triggered by service-connected tinnitus
Secondary claims help veterans receive compensation for the full impact of service-related injuries and illnesses—not just the initial diagnosis.
Why Secondary Service Connection Matters
Many veterans only receive compensation for the original injury, unaware that related conditions can be claimed as well. Secondary service connection is often the fastest and most reliable way to increase a VA rating, especially for conditions that worsen over time.
Secondary claims can:
Raise a veteran’s combined disability rating
Help veterans reach 100% or Individual Unemployability (TDIU)
Provide access to additional medical care
Recognize the full health impact of military service
For veterans seeking a just rating, secondary service connection is essential.
Common Secondary Conditions for Veterans
Military service puts a tremendous strain on both body and mind. As a result, many service-connected conditions lead to additional medical complications.
✔ Secondary to Back Pain
Sciatica / Radiculopathy
Hip, knee, or ankle pain (altered gait)
Depression and anxiety
Sleep disturbances
✔ Secondary to PTSD
Sleep apnea
GERD / stomach issues
Depression
Anxiety / panic disorder
Substance use disorder
✔ Secondary to Tinnitus
Migraines
Anxiety
Sleep disturbance
✔ Secondary to Joint Injuries
Arthritis in adjacent joints
Chronic pain syndrome
Mobility issues
✔ Secondary to Diabetes
Peripheral neuropathy
Kidney problems
Erectile dysfunction
Vision issues
The list goes on—many conditions can be linked with strong medical evidence.
How to Prove Secondary Service Connection
The VA requires three elements to approve a secondary claim:
1. A Current Diagnosis
From a medical provider (VA or private).
2. An Already Service-Connected Primary Condition
You must have at least one condition that the VA has officially rated.
3. A Medical Nexus Linking the Two Conditions
This is the key.
A medical provider must show the new condition is:
Caused by, or
Aggravated by
the primary service-connected disability.
What counts as good nexus evidence?
Private doctor’s opinion
Independent Medical Opinion (IMO)
Disability Benefits Questionnaire (DBQ)
VA progress notes
Specialist reports
Without a clear nexus, VA claims are often denied—even if the condition is clearly related.
Using DBQs and IMOs to Strengthen Your Claim
Secondary claims are significantly stronger when supported by:
✔ Independent Medical Opinion (IMO)
A private doctor explains how and why your primary condition caused the secondary one.
✔ Disability Benefits Questionnaire (DBQ)
Documents severity, symptoms, and functional impact.
These documents often help overturn denials or avoid them entirely.
Examples of Strong Nexus Statements
A provider might write:
“The veteran’s chronic knee pain is more likely than not caused by abnormal gait due to the service-connected ankle injury.”
“The veteran’s depression is at least as likely as not aggravated by chronic back pain.”
“It is my professional opinion that the veteran’s migraines are secondary to his service-connected tinnitus.”
Clear, medically supported statements like these can win a claim.
Filing a Secondary Service Connection Claim
Veterans file secondary claims using:
VA Form 21-526EZ
(Disability Compensation and Related Compensation Benefits)
Or file online through VA.gov.
You should include:
Diagnosis records
Treatment notes
Nexus letter / IMO
DBQ
Personal statement (lay statement)
Supporting evidence such as buddy letters
The more evidence, the stronger the claim.
Why Secondary Claims Are Often Denied
The most common reasons:
No medical nexus
VA believes condition is due to aging
Insufficient evidence
Inconsistent medical history
Symptoms not documented clearly
These issues can be resolved through supplemental claims and new evidence.
Appealing a Denied Secondary Claim
If denied, veterans can file:
✔ Supplemental Claim — provide new evidence
✔ Higher-Level Review — request a senior reviewer
✔ Board Appeal — take your case before a judge
An IMO or DBQ often turns a denial into an approval.
Final Thoughts from Cynthia Gomez
Secondary service connection is one of the most powerful tools available to veterans seeking fair disability compensation. The VA often overlooks how one injury leads to another—but you don’t have to. By understanding the process, gathering strong evidence, and documenting the impact of your conditions, you can obtain the benefits you deserve.
Your service had consequences.
Your health matters.
And the VA should recognize the full picture of what you’re living with.