Understanding VA Secondary Conditions and How to Prove Service Connection

VA secondary conditions can make a major difference in your overall disability rating and monthly compensation.

These are health issues that develop because of an already service-connected condition—and they’re often overlooked.

Understanding how the VA defines, rates, and approves secondary service connection is key to maximizing your benefits and building a stronger, evidence-based claim.

Key Takeaways

• VA secondary conditions are disabilities that develop or worsen because of an already service-connected condition. 

• Proving secondary service connection requires a current diagnosis and medical evidence showing it was caused or aggravated by your service-connected condition. 

• A nexus letter is key evidence for proving a secondary condition, linking it to your service-connected disability and improving your chances of VA approval. 

What are VA Secondary Conditions?

A VA secondary condition is a disability that develops because of another already service-connected condition. 

These conditions can either be caused directly by your primary disability or result from your primary disability, making another condition worse.  

If the VA verifies that connection, the secondary condition can receive its own disability rating and increase your total combined rating. 

For example, if a service-connected knee injury causes an altered gait that leads to hip or back pain, those new conditions may qualify as secondary. 

The VA recognizes two types of secondary conditions: 

• Secondary conditions directly caused by a primary service-connected disability 

• Secondary conditions made worse by (aggravated by) a service-connected disability 

How the VA Rates Secondary Conditions

The VA rates secondary conditions the same way it rates primary conditions, based on the severity of your symptoms and the criteria in the VA Schedule for Rating Disabilities (VASRD).  

The VA assigns each condition with its own percentage and then combines it with your other ratings using VA math.  

Even a lower-rated secondary condition can increase your overall combined rating. 

How are VA Secondary Conditions Calculated?

VA math can be confusing because it doesn’t add percentages together the way you might expect. 

Once the VA assigns a disability percentage to your secondary condition, it’s combined with your other service-connected ratings using the VA’s combined ratings table. 

For example, a 30% rating combined with a 20% rating doesn’t total 50%; VA math brings it to 40%. 

The VA calculates your combined rating using a specific formula that accounts for the impact of multiple disabilities on your overall functioning.

How to Establish Secondary Service Connection

To successfully prove secondary service connection, you need clear medical evidence linking your conditions. 

Proving secondary service connection requires: 

• A current diagnosis – Medical documentation of your secondary condition from a qualified licensed provider. 

• A medical nexus – Evidence showing that your secondary condition was caused or aggravated by your primary service-connected condition. 

Did you know? It’s highly recommended to get a credible Nexus Letter when proving secondary service connection.

• Related: When Do You Need a Nexus Letter for a VA Claim?

Value of a Nexus Letter for Secondary Conditions

A nexus letter for secondary conditions is strongly recommended and is frequently the key factor between approval and denial. 

To prove secondary service connection, you must show your disability is “proximately due to” or “aggravated by” another service-connected condition.  

A detailed nexus letter from an independent medical provider is often the most effective way to demonstrate this link. 

The team at Telemedica specializes in writing strong nexus letters that show how your primary condition caused or worsened your secondary condition. 

How to File a VA Secondary Claim

You can file a VA claim for secondary conditions using VA Form 21-526EZ:  

• Online  

• By mail    

• Via fax  

• In person at a VA regional office 

Conclusion

The VA rates secondary conditions the same way it rates primary disabilities—using the same percentage criteria and evidence requirements outlined in the VA Schedule for Rating Disabilities. Each secondary condition receives its own rating based on severity, symptoms, and functional impact, which can increase your overall combined disability percentage.

To establish secondary service connection, you’ll need strong medical evidence clearly linking your secondary condition to your primary service-connected disability. A credible Nexus Letter from a qualified medical professional is often the most persuasive piece of evidence you can submit—it explains how your conditions are connected and can make the difference between denial and approval.

By understanding how secondary conditions are evaluated and preparing solid medical documentation, you can build a stronger VA disability claim and ensure you’re compensated for the full scope of your service-related health issues.

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?  

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims!  

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim. 

FAQs | Frequently Asked Questions

What are secondary conditions for VA disabilities?

VA secondary conditions are disabilities that develop because of, or are made worse by, a primary service-connected condition.  

How does the VA rate secondary conditions?

The VA rates secondary conditions the same way it rates primary conditions. Each secondary condition receives its own disability percentage based on the severity of your symptoms and the criteria in the VA Schedule for Rating Disabilities. 

What are the most common VA secondary conditions?

Some of the most common secondary conditions include, but aren’t limited to: 

• Depression secondary to chronic pain 

• Migraines secondary to tinnitus

• Gastroesophageal reflux disease (GERD) secondary to mental health

How do you prove VA secondary conditions?

To prove a VA secondary condition, you must have a current diagnosis of your new condition and a medical link connecting your secondary condition to your primary service-connected condition. 

Do you need a current diagnosis for a secondary condition?

Yes, you must have a current diagnosis of your secondary condition to be eligible for a secondary service connection. 

How long does a secondary VA claim take?

Approval times for secondary VA claims can vary, often taking several months. Providing detailed medical evidence and a nexus letter may speed up the process. You can track the status of your claim anytime on VA.gov. 

Do I need a nexus letter for secondary conditions?

It’s highly recommended. You aren’t required to submit a nexus letter; however, they frequently prove to be a vital piece of evidence when proving secondary conditions. A qualified medical professional writes a nexus letter that explains how your secondary condition links to your primary service-connected disability. 

Can secondary conditions increase my overall VA rating?

Yes. If your secondary condition is service-connected and rated, it can increase your combined disability rating, potentially resulting in higher benefits.