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Thursday, January 18, 2018

Claiming Secondary Conditions for VA Disability

For a condition to be eligible for VA Disability, you must be able to prove that it is service-connected. The best way to do this is to provide medical records from your time on active duty showing thorough evidence of the condition, especially its original diagnosis. As long as a condition was first diagnosed and developed while on active duty, it is considered connected to service (the rules are a bit different for Reservists).

However, for any condition that develops more than a year after separation from the military, proving service-connection can be pretty difficult. Unless it is on the VA’s Presumptive List for things like Agent Orange exposure, etc., the only surefire way to ensure service-connection is to prove that the condition was caused by (“secondary to”) another service-connected condition.

What is a Secondary Condition?

A secondary condition is a condition that develops directly because of another condition, not just on its own. Arthritis, for example, can naturally develop on its own from overuse or misuse of a joint over time. It can also, however, develop as a secondary condition. For instance, a spinal injury can result in extra pressure being applied to the hip joints, which could result in arthritis that probably would not have occurred without the spinal injury. The hip arthritis would then be considered secondary to the spinal injury.

In this case, if the spinal injury occurred while on active duty (thus service-connected), and the hip arthritis developed over time and was diagnosed 6 years after service, it should still be considered service-connected since it was caused by a service-connected condition. Military service caused one, which caused the other, so the logic is that military service caused both, even though the secondary condition wasn’t diagnosed until after service.

How to Claim a Secondary Condition

To be able to successfully claim a secondary condition, you must prove that 1.) the original condition was service-connected and 2.) the secondary condition was definitely caused by the original service-connected condition.

If you are submitting a VA Disability Claim for both conditions for the first time, then you must provide proof that the original condition was diagnosed and significantly present while on active duty. Make sure to submit all service treatment records that show the diagnosis and treatment of the condition.

For the secondary condition, submit all records that demonstrate the development, diagnosis, and treatment of the condition and its relationship to the original condition. A NEXUS letter from your physician stating that the secondary condition was “more likely than not” caused by your original condition will also be very helpful to your case. A NEXUS letter is simply a letter from a qualified specialist that medically establishes a link between two conditions. If there is not enough evidence to clearly connect the two conditions, service-connection may be denied. It must be clear that the condition is unlikely to have developed without the original condition.

If you have already claimed the original condition and it was granted service-connection by the VA, then all you have to do to claim the secondary condition is submit VA-Form 21-526b along with all the evidence listed above for secondary conditions.

Rating Secondary Conditions

Once the VA grants service-connection for your secondary condition, it will be rated on the VASRD the same way every other condition is rated. In most cases, it will be assigned a code and given a rating based on the severity of its symptoms.

In some cases, however, the rules of the VASRD may limit a secondary condition’s ability to be rated separately. For example, nephrosclerosis is kidney disease caused by high blood pressure. Although blood pressure and kidneys are technically two separate body systems, the VASRD states that only one or the other can be rated, whichever gives the higher rating. This is because they are so closely connected and their rating requirements so similar, that rating both would violate the Pyramiding Principle.


Even in cases like this, it is undeniably worth it to claim the secondary condition. As long as it is granted service-connection, it qualifies for full medical coverage, it could increase the ratings for the original condition, it could eventually cause its own secondary conditions that would then qualify for their own ratings, etc. Ultimately, it never hurts to submit a claim for a secondary condition.  As long as you carefully construct your claim and provide sufficient evidence, you’ll ensure that you continue to receive the benefits you deserve as your conditions progress.

116 comments:

  1. How does the system work for full time ANG technicians doing their military job during the week? I had to have back surgery for an injury suffered while working on jets.

    ReplyDelete
    Replies
    1. If the condition occurred while on active duty (sounds like it did), then it will definitely qualify for disability. Guards and other Reservists must have their conditions occur in the line of duty in order to be service-connected.

      http://www.militarydisabilitymadeeasy.com/service-connected.html#reservists

      As soon as you are off active duty, you can apply for VA Disability for this condition.

      Delete
  2. I am service connected for sleep apnea. I believe I have a couple of conditions that are likely to be secondary to the sleep apnea as both occurred or started before I started using a CPAP. Are you familiar with this :

    https://www.va.gov/health/NewsFeatures/2013/July/VAs-Telesleep-a-Breath-of-Fresh-Air.asp

    It lists impotence and stroke as conditions that might have been avoided if I had been using a CPAP. I suffered a subarachnoid hemorrhagic stroke in 2009 and ED was first noted in my medical records in 2011 or 12. I finally went on a CPAP in 2015 and inadvertently discovered that sleep apnea could cause so many different conditions after doing a DBQ with a VA contract doctor. Basically he seemed more interested in the fact that I had a stroke than in the sleep apnea.

    ReplyDelete
    Replies
    1. Yes, both ED and stroke have been significantly tied to sleep apnea. Depending on the exact circumstances of your case, the first diagnosis of sleep apnea, etc., it is possible that your conditions are connected and will also qualify for disability. Sounds like the physician correctly recorded the issues on the DBQ, so you should be good to go, depending on your medical evidence.

      Delete
    2. I was diagnosed with sleep apnea in 2005 and had the stroke in 2009,developed ED in 2010. When I had my DBQ exam for a rate increase in 2015 the doctor asked me about scars. When I told him i had one on top of my head where they drilled a hole to drain fluid due to my stroke he became excited and started putting info into the computer he was using. I was wondering why he got excited about that and went home and googled it. That's when I realized the stroke was probably caused by the sleep apnea. However when I requested a copy of the DBQ the question about scars was checked no and there was no supporting notes. When I asked my pulmonologist about sleep apnea causing strokes he didn't seem to think so. He also didn't seem to like that I was getting disability for the sleep apnea. Would you know any doctors in the Dallas, TX area that are familiar with VA disabilities? I would like to get an opinion statement and claim these as secondary conditions.

      Delete
    3. We are a national site, and so can't give local recommendations, unfortunately.

      A second opinion is always a good idea, though, especially since you'll need the seizures directly tied to the sleep apnea in your case. They are not definitively connected, so depending on your evidence, it may not be enough to connect them.

      Scars are only ratable if they are significantly large, so yours is probably not, so I wouldn't be too concerned about that. As long as the VA has the record of that procedure, the scare is not important.

      Delete
  3. Can a claim be changed to a secondary condition after I have already filed, at the discretion of the VA?

    What if I am not sure if something is secondary to an already service connected condition? For example, if I have 10% patella femoral syndrome in one knee, and a secondary 10% sublaxation in the other knee--I am not sure if my low back pain and arthritis would be interpreted as connected to this?

    Lastly and somewhat unrelated, if I am filing for 8 separate conditions, it will be up to the VA to determine whether one is related to the other and essentially combine them correct?

    Thank you

    ReplyDelete
    Replies
    1. Yes, the VA will look at all of your conditions and combine them as needed to rate them correctly. That's why it is better to list everything that has been diagnosed than to assume you know how to combine them and end up leaving something off.

      If you can prove service-connection for any condition without needing the secondary connection, then that is always the best. Secondary conditions are only important if they cannot be connected to military service by themselves. So if you have evidence of all of these conditions while in service, then it doesn't matter if they are secondary or not. Just list them all and then provide evidence of their diagnosis while in service, and you'll be good to go.

      However, if you do not have evidence of your back pain and arthritis in service, then you definitely need to establish them as secondary if the VA is going to consider them service-connected. You'll need sufficient medical records and probably a NEXUS letter to do this, because if you are unsure, the VA will be too. They won't consider them secondary unless you can show proof.

      Delete
  4. Colonel,

    First of all, thanks so much for having this wonderful site!

    I was rated 20% for gout in both feet. In addition, I was rated 10% for degenerative arthritis with bone spurs on the spine. It’s been 6-years since I was rated by VA.

    Two years ago I had my right knee operated on for a torn meniscus. The Surgeon stated that I had severe arthritis and would eventually need a knee replacement (looks like within the next year or two). Every six months I receive a series of five Hyalgan Injections to help with the pain in the right knee. Recently my left knee began bothering me with pain and swelling as well. After my surgeon’s examination he stated that I had arthritis in my left knee too. My question: I’ve established gout & spine arthritis issues with the VA. Will the arthritis for both knees qualify for VA compensation (I left the service 11-years ago)? I have good motion with both knees. However, both swell frequently and are painful quite often (5-6 times monthly).

    V/R,
    Steve

    ReplyDelete
    Replies
    1. Hi Steve -

      Unfortunately, the knees won't qualify unless you can prove that they are the direct result of the feet/back issues that are service-connected. And that is going to be tricky at best. Unfortunately, in 11 years, that is plenty of time to knee issues to develop, so it'll be easy for the VA to say that they would have developed regardless. You'll need a strong NEXUS letter from a specialist if your claim is going to be successful.

      Delete
  5. I am currently SC for Meniere's disease and I'm on the process to submit a claim for anxiety and Depression secondary to the Meniere's. Someone told me that you can only claim either anxiety or depression ( not both at once). Also, on my DBQ the ENT wrote Cervicalgia and shoulder pain (decreased range of motion and stiffness) as related to the Meniere's because they aggravate my condition and trigger my headaches and vertigo/dizziness. My question is... Do you think I have a case? Should I go ahead and submit my secondary condition claim. I am 30% for the Meniere's but I suffer of dizziness and vertigo almost every day. Is that something that justifies a request for increase in rating? Thank you.

    ReplyDelete
    Replies
    1. You can list both anxiety and depression, but they are correct that you will only be given a single overall mental health rating. The VA will combine all of your symptoms and just give a single rating that covers everything.

      For your Meniere's, definitely submit for an increase. A 30% rating is only if there is dizziness less than once a month. Daily is 100% if it includes staggering while walking. At minimum, it sounds like you qualify for the 60%:

      http://www.militarydisabilitymadeeasy.com/theears.html#j

      It definitely does not hurt to submit for the cervicalgia and shoulder pain as secondary. Since they aren't caused by the condition, but instead just exacerbate it, they may not be ratable, but doesn't hurt to try.

      Delete
  6. Hello Doctor Johnston,
    Great site. I'm a retired veteran and from time to to I assist other veterans with their claims. Which brings me to this question. I have a veteran that's receiving a va rating of 30% for bronchitis with sarcoidosis (claimed as sarcoid). His records clearly show treatment for sarcoidosis throughout his military career yet his claim was denied for sarcoidosis. Should he submit sarcoidosis as a secondary to bronchitis? He's also being treated for sinusitis, sleep apnea, and thromboid veins which are not service connected.

    Thanks,

    ReplyDelete
    Replies
    1. Since he is already receiving a rating for bronchitis, he cannot receive a second rating for sarcoidosis. Because of the Pyramiding Principle, only a single lung rating can be given at a time, even if multiple lung conditions are present. Since "bronchitis with sarcoidosis" is already rated 30%, both conditions are being covered by that rating.

      So even if you submit sarcoidosis as secondary to bronchitis, the VA won't give him a second rating. They will rate only one or the other, whichever gives the higher rating.

      And they already have it on the claim if they are recognizing the "bronchitis with sarcoid".

      What you should do is check the ratings for Sarcoidosis and see if his test results would qualify him for a higher rating than 30%. If so, then submit for an "increased evaluation" for the bronchitis with sarcoidosis.

      If the sarcoidosis ratings do not qualify him for a higher rating, then just leave as is.

      http://www.militarydisabilitymadeeasy.com/therespiratorysystem.html#w

      Delete
  7. I have a few questions, in 2010 I was diagnosis with prostate cancer due to being sprayed with agent Orange while in Vietnam. Surgery was done 09/2011 for removal of the prostate, I developed incontinence and ED, but as you may know VA rated me at a temporary 100%. But since the surgery I applied for a rating for the residuals already mention, after years of fighting VA for the claim on the residuals Incontinence and ED , I was awarded 40% and 20% for the cancer. if the residuals are from the surgery and I had to make a claim for them, am I entitled to additional compensation for the residuals, even if I'm already 100% total and permanent? I had applied for the residuals before they made me total and permanent, I wear and average of 7 depends a day, make 5 to 6 trips to urinate at night, have to have a bed pad incase I urinate before I can get up. I have type two diabetes I stay thirsty all the time and I'm on 15 different medications for other service connected issues. does VA owe me compensation for those residuals, and by the way they gave me service connected for ED, but because the penis is not deformed I do not get compensated . VA had me go to four C&Ps and each have given the same outcome, all were do to the Cancer and the surgery, even the Chief of surgery (urology) supported my claim.

    ReplyDelete
    Replies
    1. So the cancer is rated 100% temporarily after the surgery is over, then it is rated on residuals. You said you were rated 40% and 20%. What were those for? There isn't a rating for "the cancer" anymore, just the residuals. So if those ratings were for the cancer, then those are for the residuals.

      I'm assuming (maybe incorrectly), that the 40% is for your incontinence. A 40% is given if you have to urinate more than every hour during the day.

      http://www.militarydisabilitymadeeasy.com/thegenitourinarysystem.html#urinary

      As for ED, there isn't a rating for ED at all, so that is correctly rated 0%. However, it does qualify for special monthly compensation K for loss of use of a creative organ.

      http://www.militarydisabilitymadeeasy.com/specialmonthlycompensation.html#k

      Since I'm not sure exactly what your rating breakdown is, so I'm not sure what the 40% and 20% and your P&T 100% are for, but hopefully what I've said applies to your case. If not, please clarify.

      Delete
  8. What if a total combined rating equate to more than 100%, how are the conditions "lowered" to equate to 100%? Are some given 0% service connected?

    ReplyDelete
    Replies
    1. No. Each condition is still rated as is. The total combined is just capped at 100%. You can't receive more than 100% of benefits, but individual condition ratings could qualify you for additional benefits, like special monthly compensation, CRDP, etc. So those remain in case they help you qualify for those other benefits, but you only receive 100% compensation.

      Delete
  9. I have a right elbow injury that limits the range of motion. The limited range of motion caused my right arm to become shorter and I can not reach as far. This condition has caused my right shoulder to drop causing my back to be out of alignment resulting in lower back pain and pain down my leg. would this shoulder and back trouble be considered a secondary condition?

    ReplyDelete
    Replies
    1. Yes, if you can get your physicians to show medical evidence and opinion that the shoulder and back issues are directly due to the limited motion in your elbow, you can definitely claim them as secondary.

      Delete
  10. You've likely heard this a million times but I need advice on how to approach my claims based on the following. I entered the service in 1979, commissioned a 2LT. Throughout my career, I was told by leaders at all levels that I should never give appearance to the troops that I was 'riding sick-call'. Subsequently, many things that have followed me throughout my career are a chronic problem to me, but because of the culture I served in, most of the problems I have are not captured in my records. Do you have advice on how to make legitimate claims for conditions that originated while I was in the military, but cannot claim because they are not in my records? Thanks for the great forum.

    ReplyDelete
    Replies
    1. Yes, you are definitely not alone in this very large problem. Luckily, that culture has started to change, but not until it left too many veterans in a rut.

      The VA legally must have proof that conditions are service-connected before they can grant disability benefits. There are a few different ways to do this. Thoroughly check our Service-Connected page and our VA Presumptive List page:

      http://www.militarydisabilitymadeeasy.com/service-connected.html
      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html

      If you can show proof that your conditions meet any of these circumstances, then the VA will grant service-connection. If not, then there unfortunately, isn't much that can be done.

      Delete
  11. I filed a claim in March 2017, but I was homeless at the time & VA had no way to get in touch w/ me. Since then thanks to the homeless vets program I'm now in a home & filed a new claim w/ the same stuff. My question is can I somehow get retro pay back to my original claim?

    ReplyDelete
    Replies
    1. Hi Nimitz -

      It's just now coming up on a year since you first applied, so you could be able to complete that original claim. Did you find out if they ever processed the claim and made a decision? If that claim was never officially closed out, then it is still active and your application date will still be considered for the start of your benefits.

      If it was closed since they couldn't contact you, then it was technically not their fault that they couldn't process the claim, and so your start date for benefits will be from the submission of the new claim.

      Delete
  12. I am rated for PTSD/Insomnia/Depression at the 70%. I finally got a sleep study done through the VA in 2017 (I left service in 2010 (active) and reserves in 2013). I was told I have sleep apena. I submitted a claim for secondary and it was denied. What can I do to show the link?

    ReplyDelete
    Replies
    1. There is a study that shows a connection between sleep apnea and PTSD. If your circumstances are similar those in the study, you could use it as support for an appeal.

      http://jcsm.aasm.org/ViewAbstract.aspx?pid=30015&_ga=2.21100601.307546957.1520386314-450786716.1520386314

      https://aasm.org/study-finds-high-risk-of-sleep-apnea-in-young-veterans-with-ptsd/

      Delete
  13. This is my second submission of this question, because I'm not sure the first one was published. I have been fighting
    ITP since 2014. The first time I was hospitalized for this problem, my platelet count was undetectable. Since then I have had my spleen removed, but it has not stabilized my problem, it has only made it manageable. My count is like a yoyo, up and down, but never stable. I have filed a disability claim with the VA, because I believe my disease is cause by exposure to Agent Orange in Vietnam from Nov. 1968 to Jan. 1970. Does the VA know that Agent Orange can disrupt the function of the immune system and cause ITP?

    ReplyDelete
    Replies
    1. Sorry we didn't respond to the first. We've been having issues with comments not showing up, so glad you re-posted.

      ITP is not currently included on the VA's Presumptive List for Agent Orange exposure.

      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#herbicide

      Basically, they do not currently automatically consider it connected. You can submit for it, but since it is non-cancerous it isn't covered by any of the conditions that are on the list. However, if you can supply enough proof with your claim, the VA may still grant service-connection.

      Delete
    2. Thanks for your prompt response to my March 7th question. It was not what I was hoping to hear, but you didn't tell me that I didn't have a chance either. I have submitted a fair amount of evidence
      to support my claim. Probably the best piece I have is a Korean study that shows, that with higher
      exposure to Agent Orange, the number of cases increased.

      I noticed that ITP has a diagnosis code of 7705. It also has four disability ratings starting at
      100% and going down to 0%. Based on the descriptions for 100% disability, I would most closely fit that category.

      Based on the fact that the VA has four levels of disability for ITP, they must have accepted responsibility in a few cases. Can you shed any light on that?

      Gene Blomberg

      Delete
    3. ITP is not only caused by Agent Orange exposure, so the VA can cover any case that can prove service connection. Thus, the majority of cases that are covered are ones that can prove service-connection in other ways, not by connection to Agent Orange.

      Delete
    4. Your March 21 response to my question about ITP is very intriguing. I do not need to win this disability claim because of exposure to Agent Orange, I just need help in establishing that ITP can be service related. Now I have to say that the only thing that I know I was exposed to in the service was Agent Orange. Do you have a list of other causes for ITP? I will eagerly await your response. Thank you for continuing to provide me with information.

      Sincerely,
      Gene R. Blomberg

      Delete
    5. "Idiopathic" means "of unknown cause", so the cause of idiopathic thrombocytopenic purpura is generally unknown. However, if it meets any of the requirements for service-connection, it can qualify:

      http://www.militarydisabilitymadeeasy.com/service-connected.html

      Delete
    6. Thanks Dr. Johnson,

      I was exposed to Agent Orange for 14 months. That's still the best I can come up with, but I'll
      keep watching for other possible secondary causes.

      I threw quite a few things in with my initial claim, I'll see how that does. Mean while, if anyone else
      has any info that would help, they can send it to you and if you think it has merit, I will hope to see it in this blog.

      If I lose, I do plan to appeal if I find an attorney that will take the case. I don't give up easily! If I didn't believe that Agent Orange was the root of my problem, I wouldn't be pursuing this case with such determination.

      Thanks for all your help!

      Gene R. Blomberg

      Delete
    7. Good luck! Just be prepared that it's going to be a tough battle.

      So far, ITP has never been directly connected to Agent Orange before, and all previous cases trying to link the two have been denied:

      https://www.va.gov/vetapp99/files1/9908083.txt
      https://www.va.gov/vetapp10/files3/1020063.txt

      If you have any success, definitely share it so that others might benefit as well.

      Delete
  14. My spouse has service connected atrial fibrillation. He went for a sleep study through the VA many years after retiring from the military. He had been snoring/gasping for breath many years before retirement, but back then, nobody ever heard of sleep apnea. After his sleep study, he was diagnosed with severe sleep apnea. We were advised to claim sleep apnea as secondary to atrial fibrillation (as there are many well-accepted medical reports linking them). The examiner at my spouse's C&P exam did not conclude one was linked to the other. Is this something we should argue?

    ReplyDelete
    Replies
    1. Your advice was correct: the best way to get compensation for the sleep apnea would be as secondary to atrial fibrillation. It is unfortunate that the examiner didn't connect them. I'm assuming that you got the VA's decision back and they denied it? If so, then you can submit an appeal. Make sure, however, to include a NEXUS letter from a physician clearly drawing the connection between the two conditions. This will give your case a higher chance of success.

      Delete
    2. Thanks so much for your reply! We are working with our VSO and he is preparing a NOD. We will include a NEXUS letter from my husband's cardiologist with the NOD. Next week, we will meet with our VSO and he can show us in VBMS what the examiner said in her report. Thanks so much for your blog and great assistance you provide to so many people.

      Delete
  15. I'm service connected axiety and depression can i service connnect my sleep apnea

    ReplyDelete
    Replies
    1. Anxiety and depression can make sleep apnea worse, but there is no solid evidence that they cause sleep apnea. Because of this, it will be difficult, if not impossible, to claim sleep apnea as secondary to anxiety and depression. If you can get a Nexus letter from a physician, however, it may still be worth submitting a claim.

      Delete
  16. I filed a claim for my left shoulder, left bicep tear & rt shoulder for over-use. I found out later that I also have cervical stenosis. Can I get service connection for that (cervical stenosis) due to over-usage also or would it be a secondary condition for my shoulders? Also I'm register gulf war vet how is Degenerative disc disease rated & how can I prove service connection?

    ReplyDelete
    Replies
    1. For all of these conditions to be granted, you'll need to prove service-connection. Anything diagnosed on active duty will be considered service-connected, but things diagnosed after may not be. You can claim things as secondary to conditions that the VA considers service-connected, so if they have granted service-connection for your shoulders, you can then submit your cervical stenosis as secondary to your shoulders. The same goes for your DDD, if it was diagnosed after separation, you have to prove that it is secondary or qualifies for service-connection in another way. DDD is not on the presumptive list for Gulf War vets.

      http://www.militarydisabilitymadeeasy.com/service-connected.html
      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#gulf

      If service-connected, DDD is rated as intervertebral disc syndrome:

      http://www.militarydisabilitymadeeasy.com/thespine.html#inter

      Delete
  17. I have hearing loss and tinitis whitch I believe accured during my time in Vietnam. I was attached to a huey outfit and also spent time at an airbase with f-104, & f-111 aircraft taking off and landing at all hours. jet engines can produce db levels up to 150.
    how do I fill out a claim and what proof do I need?
    thank you for helping

    ReplyDelete
    Replies
    1. Both hearing loss and tinnitus are automatically service-connected if your MOS is on the Noise Exposure Listing.

      http://www.militarydisabilitymadeeasy.com/theears.html#noise

      If it is on the list, then just submit proof of your MOS and all medical records tied to your hearing loss and tinnitus.

      If it isn't, then you need to show further proof that you worked in the circumstances noted that exposed you to high levels of noise. A letter from your commander would be beneficial.

      Then just follow the instructions on how to submit a claim and include this evidence.

      http://www.militarydisabilitymadeeasy.com/vadisabilityclaim.html

      Delete
    2. My husband and I were both denied service connected tinnitus. Our MOS is on the NEL. I find your comment about being automatically connected interesting.

      Delete
    3. All MOS are on the listing, so I definitely wasn't clear in my previous post. What was it listed as? Anything listed as at least moderate or high is usually considered service-connected. If it is low, then it is usually denied.

      Delete
  18. Hello, I was awarded at 90% in October. I would like to submit an NOD. When I do, is there a chance my rating will decrease?

    ReplyDelete
    Replies
    1. No. They won't decrease your rating. They'd only increase it if they feel that your argument and evidence does support a higher rating.

      Delete
  19. Can knee pain and ankle pain be connected to low back pain and hammer toes?

    ReplyDelete
    Replies
    1. It's definitely possible. Conditions that affect the way you stand and walk can lead to pain in various joints. As long as you have a physician write a NEXUS for your conditions, you should be able to get these as secondary unless there is clear evidence of a different cause.

      Delete
  20. Can knee and ankle pain be secondary to low back pain and hammer toes?

    ReplyDelete
    Replies
    1. It's definitely possible. Conditions that affect the way you stand and walk can lead to pain in various joints. As long as you have a physician write a NEXUS for your conditions, you should be able to get these as secondary unless there is clear evidence of a different cause.

      Delete
  21. Hi, thank you for your time. I am 73 And served in the Army 63 to 66 in Germany as a switchboard operator Mos 724. I filed for compensation for hearing loss and Tinnitus in 2013. Received SC 50% for hearing loss and 10% for Tinnitus. Over the last 2 years I have developed and been diagnosed Meniere by doctor and would like to file for the Meniere but have seen that it’s not possible to have Meniere secondary to hearing loss. I was wondering that i developed at so late in life if I would be able to prove it.

    ReplyDelete
    Replies
    1. Hi Rodnek -

      You're correct that there is no evidence to support that Meniere's can be caused by hearing loss. It is usually the other way around. Since it has been so long since your service, there is really very little to no evidence that it was caused by your service.

      You can always try to apply for it, but the likelihood of proving it effectively is slim. If you try and it doesn't work, then the next option would be to just apply for an increase in your hearing loss rating if your hearing loss is worse. They still won't rate the Meniere's, but they can increase your hearing loss rating if it is worse.

      Delete
  22. Dr. Johnson,

    I had issues noted on exit medical exam (ankle & lungs), considered and noted at C&P exam, but denied (Feb 2018) due to no diagnosis. After separation I moved overseas for work and will be submitting Notice of Disagreement (NOD).

    Question: With the NOD, should I included the additional information (some or all) - tests, diagnosis, and Nexus LTRs supporting or wait until contact from Decision Review Officer?

    Any insight appreciated. Thanks.

    ReplyDelete
    Replies
    1. Definitely go ahead and submit any and all additional evidence you have with your NOD. They need proof that your conditions were officially diagnosed, so anything you can give them that shows and official diagnosis is essential right away.

      Delete
  23. Dr. Johnson
    I was diagnosed with breast cancer (L) and as a result now have Lymphedema, pleural thickening and chronic neuropathy. I'm told that these are all considered secondary to the breast cancer but can't seem to find any information nor rating for those diagnosis.

    ReplyDelete
    Replies
    1. Since they are secondary, they will definitely be rated. The VA will rate them on the the closest codes that best cover the symptoms.

      Pleural thickening will probably be rated on code 6825 since diffuse interstitial fibrosis also causes scar tissue in the lungs.

      http://www.militarydisabilitymadeeasy.com/therespiratorysystem.html#x

      The Neuropathy will be rated on the main nerves affected (arms, legs, etc.)

      http://www.militarydisabilitymadeeasy.com/lowernerves.html

      Lymphedema is rated under code 7121 as a post-phlebitic syndrome.

      http://www.militarydisabilitymadeeasy.com/thearteriesandveins.html#j

      Delete
  24. Greetings,

    I wanted to asked can you received a separate rating for medical collateral Ligament laxity and Lateral collateral ligament laxity under code 5257?

    ReplyDelete
    Replies
    1. No. Only a single rating can be given under code 5257. A single rating is given under this code if there is instability in the knee, regardless of how many ligaments are affected.

      Delete
  25. Dr. 2 questions, I was retired 10 years before I filed my claims,awarded 10% for multiple level buldging discs (L2-S1)with stenosis with 20% for sciatic radiculopathy, filed a claim for hip arthritis but came back not service connected. After discussing conditions with a few friends, they say I should refile the hip arthritis as a secondary due to it is the same hip that has the sciatica and radiculopathy, so with a nexus written from an orthopedic doctor or rheumatologist, it has a good chance of being awarded. Second question deals with presuptive of IBS, had some symptoms a few years after returning from Desert Sheld / Storm, but never really said what it was, fast forward to last 3 years and have been diagnosed by my gastrointologist of IBS of both types, with a clear colonoscopy
    What's the best way to approach this since I read the date to claim it has been extended, is a Nexus better to get , but as I've read presumptive mean just that, but I did also read that about 85% of IBS claims are being denied.

    ReplyDelete
    Replies
    1. Yes, claiming the arthritis as secondary with a nexus letter is definitely the way to go.

      You can claim IBS as the presumptive list has been extended to 2021. However, IBS is an official diagnosis. The presumptive list is for Gulf War Syndrome, which is a collection of conditions with no official diagnosis. This is why the majority of these claims are denied. You can still apply, but just know that it may be denied since it is an official diagnosis.

      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#gulf

      Delete
  26. Ben
    Doctor, I just got service connection for my right hip that I had a hair I fracture on the femoral neck back in 1996. I originally put both hips left and right hip along with my right knee and ankle because they have been in a lot of pain since 2001. The original claim was denied so I appealed because I had to prove service connection to the right hip first. Now, that the right hip is proven to be service connected. Can I place another claim with a Nexus letter from my doctor and ex rays that show the damage to those joints. The claim would be filed as a secondary service connection.

    ReplyDelete
    Replies
    1. Yes, put a new claim listing them as secondary conditions to your service-connected condition. The Nexus letter will definitely help support your claim.

      Delete
  27. I am service connected for left shoulder. Because my left shoulder was frozen I had to overuse my right shoulder. I started feeling a lot of pain and stiffness in my right shoulder for the past couple of months. I went to the VA and I had a MRI done. I was diagnosed with shoulder impingement and a partial tear of my rotator cuff. I asked if the doctor there could write me a nexus and he said no. I was wondering what would be the chances of it being approved for secondary disability and what would be the best way to strengthen my case.

    ReplyDelete
    Replies
    1. Hi Antonio -

      The issue you are facing is the diagnosis in the right shoulder. Both shoulder impingement and rotator cuff tear aren't conditions usually seen from overuse of the shoulder as a result of overcompensating for the other shoulder. They are more usually the result of an injury or repetitive over-the-shoulder movements. These types of movements aren't typically done in compensation for the other shoulder.

      This is probably why the physician didn't feel comfortable writing a Nexus.

      You could always get a second opinion from a civilian physician. If you can find a doc who feels that they are connected and will write a Nexus, that would be the best way to strengthen your case.

      Delete
    2. do you know where I could possible find more information about injuries caused for overcompensation of one shoulder. I've been trying to find information but I can't.

      Delete
    3. There is definitely less evidence out there since shoulders are non-weight bearing. For legs, if one doesn't work as well, there is a clear load being put on the other, often leading to arthritis, etc. For the shoulders, this is less the case. If you happen to be in an occupation that requires a lot of lifting, and you have to do it all one-armed, then there could be a case for arthritis or other shoulder issues. But this will be based on the movements/requirements of those motions, not necessarily compensation for the other arm.

      Ultimately, it's tricky, and the connection is inherently weak, but not nonexistent, depending on your particular circumstances.

      Delete
  28. I have a service connected disability for chronic pelvic pain/endometriosis and hysterectomy. Unfortunately my pain has not gotten better and I am required to have surgery every 2-3 years to remove painful peritoneal adhesion's. In 2010 I was diagnosed with a frozen pelvis.
    Should I claim adhesion's as a secondary disability?
    Should or will these be rated separately from my endometriosis?

    ReplyDelete
    Replies
    1. Hi Nadine -

      It depends on what your main symptoms are. If pain is the only symptom, then that is already covered by your endometriosis rating. However, it sounds like your condition causes more than just pain, so those additional symptoms could probably be rated separately.

      Also, you would qualify for a 100% rating during your recovery period for each of those surgeries:

      http://www.militarydisabilitymadeeasy.com/vasrdprinciples.html#hospital

      Although some symptoms are already covered by endometriosis, others may qualify for separate rating, so I definitely recommend applying and giving it a shot.

      Delete
  29. Dr. Johnson,

    I'm looking for a VASRD code for pseudotumor cerebri also written in my records as idiopathic intracranial hypertension. Currently they group it with hypertension code 7101 and since I don't have High Blood Pressure they rated me at 0%. No one seems to be able to point me in the right direction in finding the correct labeling/grouping of my conditions. I also have headaches and papilledema, but since they aren't my "unfitting" condition they weren't considered. Thank you in advance.

    ReplyDelete
    Replies
    1. Hi Karol -

      Thanks for your inquiry. The DoD will only rate conditions that make you unfitting, but the VA will rate every service-connected condition, including your headaches.

      Since this is such a rare condition, there isn't a "correct" code. The VA can choose whichever code they feel best represents your overall symptoms. I agree, however, that hypertension isn't necessarily the best since your main symptoms are headaches and papilledema.

      If there is any decreased vision, then you should be rated for that probably under code 6026 for optic neuropathy.

      http://www.militarydisabilitymadeeasy.com/theeyes.html#optic

      This doesn't cover headaches, though, so that should receive a second rating under code 8100.

      http://www.militarydisabilitymadeeasy.com/centralnervoussystem.html#headaches

      The VA is supposed to choose the codes that best rate the main symptoms, so if I had done the rating, these are probably the codes I would have chosen.

      I suggest appealing that their rating choice didn't cover the symptoms of the condition.

      Delete
  30. I had submitted a claim and it was denies in 1999 for chronic bronchitis. Now I have been Diagnosed with Bronchiectasis. I deployed to Saudi Arabia in 1996-1997 though not considered a burn pit area. However I did not work exclusively on the main base due to my job in munitions. Is there any likelihood that the bronchiectasis diagnosis could be considered service connected. all of the testing/labs I have had done has shown no known etiology.
    Thank you

    ReplyDelete
    Replies
    1. Unfortunately, it doesn't sound like you have a strong case for service-connection. Without your bronchitis being service-connected, they aren't going to service-connect your bronchiectasis. If you had treatment records of bronchitis while in service or something similar, there would be a higher chance, but without those and no other solid evidence linking the bronchiectasis, it is very unlikely to be service-connected.

      Delete
  31. I know you’re not asking me but it could be rheumatoid or auto immune related. Rheumatologist could test for that or Sjogren’s.

    ReplyDelete
    Replies
    1. Those have been ruled out.....

      Delete
  32. Dr. Johnson,

    I was diagnosed with IBS when I left the army in 2006 and received an increase last year from 10 to 30%. I was diagnosed with anxiety and MDD due to my IBS. Both the psychiatrist and psychologist both wrote that diagnosis in the notes and I’m taking meds for both. Do you think I have a good claim to claim anxiety and depression as secondary to my IBS? It’s been bad lately but have only seen the psych for a few months. Would I need a nexus letter?

    Thanks for any input doctor!!

    ReplyDelete
    Replies
    1. Hi Janet -

      Yes, you can apply for your mental health conditions as secondary to your IBS. Make sure to definitely have a nexus letter clearly connecting the conditions. If your evidence is strong enough it should be granted. This is a unique connection, however, so without fairly strong evidence, it could be denied.

      Delete
  33. Hello. I submitted a claim for Sjogren's, with some of the supporting evidence being my eye problems with MGD, blepharitis, and dry eye.

    I did NOT claim my eye conditions as secondary to Sjogren's and I see now that I may qualify under Code 6025 Lacrimal Apparatus??

    Is this something that the VA could add to my claim even though I did not claim it separately? Or do I need to add it myself? If the latter, is it too late now that I have submitted my FDC?

    THANK YOU!!

    ReplyDelete
    Replies
    1. The VA will never add a condition for you. They will rate whatever you include on a claim. So if you want something rated, you need to include it.

      However, dry eye is a symptom of Sjogren's, not a separate condition. So the VA will consider it when rating Sjogren's. If you are diagnosed with a separate lacrimal apparatus condition, then you will need to submit that separately, but since this a symptom of Sjorgren's, you do not.

      Delete
  34. Sir, I served six years in the Army Reserves, honorably discharged. In 1973, I fractured the 2nd metatarsal shaft, right foot while taking basic training. Through the years I've dealt with pain in this foot especially when barefooted or standing for long periods of time. Talked with my doctor about it and he feels arteritis has developed. I have my Army medical records to support the claim fracture happened while I was undergoing training. Would I be justified in filing a claim with the VA? Thanks

    ReplyDelete
    Replies
    1. Yes, since the initial injury occurred directly in the line of duty, the VA will consider it service-connected. As long as you get a letter from your physician stating that they believe the condition is "more likely than not" caused by that injury, your claim has a high chance of being successful.

      Delete
  35. This comment has been removed by the author.

    ReplyDelete
    Replies
    1. Hi Thomas -

      Tricky situation. The bladder cancer is not on the Presumptive List, so they correctly denied that. But prostate cancer is. The basic rule they follow when rating prostate cancer is to rate whatever conditions it clearly causes separately. Since it is going to be difficult to prove how much of the incontinence is due to the prostate cancer, they may deny that. But they will rate other things. Ultimately, you can definitely include urinary incontinence if you end up needing to apply for prostate cancer, and they might just rate it.

      Delete
  36. Sir,
    I'm already getting compensation for my back and radiculopathy for my right side lower extremeties. But not for my left side, I am planning on submitting a new claim for left side but not sure if I should go with a secondary or service connected. When I first did my claim I mentioned my left leg but I was neither denied nor given a 0% rating. It's been over a year now and my pain and symptoms have gotten worse. I reviewed my c file and the evidence is there plus I have new evidence to confirm my syptomns. My question is, how should I go about in submitting this claim?

    Thank you

    ReplyDelete
    Replies
    1. Either claim should be successful, but I suggest submitting the one you have the most evidence of. So if you have plenty of in-service evidence of left radiculopathy, then just submit a new claim. If you have some, but not a ton, then maybe a secondary claim would be stronger as long as you can show full proof that the radiculopathy is directly caused by your spine condition. Go with whichever case is most solid.

      Delete
    2. Thank you for the quick response. I'm going to go with the service connected route, since I have more evidence in my military records with new evidence to support the claim.

      Delete
  37. Dr. Johnson

    I will file a claim entitlement to migraines, vertigo, and tinnitus, secondary to sinusitis (30%), allergic rhinitis (0%), and sinus headaches (0%). I separate the nexus letter in two parts.

    First, I discussed the entitlement to migraines, secondary to sinusitis, allergic rhinitis, and sinus headaches.

    Secondly, I discussed the entitlement to tinnitus and vertigo, secondary to sinusitis, allergic rhinitis, and sinus headaches.

    I will submit the following medical literature:
    a. WebMD, Migraine or Sinus Headache b. Mayo Clinic, Diseases and Conditions, Sinus Headaches c. American Migraine Association d. Medscape Medical News from the American Headache Society (AHS) e. Vertigo, Silverstein Institute, Is There a Link Between Your Allergies? f. Vertigo, Boots WebMD Partners in Health g. Vertigo, Healthline Newsletter, Allergies and Dizziness: The Cause and the Treatment h. Vertigo, New York Sinus Center i. Can a Sinus Infection Cause Tinnitus? South Florida ENT Associates and the American Tinnitus Association

    Do you think I have a chance of these secondary conditions approved by VA?

    Thanks,

    LEG

    ReplyDelete
    Replies
    1. A NEXUS letter can't be written by you. It must be written by a doctor with the right specialties to have a viable opinion on your case. You can still submit your letter along with the evidence, but in order to make your case stronger, you'll need a NEXUS from a physician.

      Delete
    2. Thanks for the quick reply.

      Delete
  38. Dr. Johnson,

    I was rated 70% for PTSD. I suffer from many other issues such as Migraines, Hypertension, Sleep Apnea, Diabetes and IBS. The psychiatrist suggested these are all secondary conditions of the PTSD diagnosis. No told me to claim them as secondary to PTSD. Should I file for a secondary for each one and file them all together at the same time? Thank you for your BLOG and help...

    ReplyDelete
    Replies
    1. Yes, you can submit a single claim for all the conditions. Make sure to include that they are secondary to PTSD, all the evidence to support this claim, and a NEXUS letter from your physicians (ideally from both the psychiatrist and those treating your other conditions).

      Delete
  39. On my final physical before retirement, as a Marine for 27 years, One of the questions was: do you have numbness and tingling in your extremities? My answer was "yes, I have numbness and tingling in my hands and feet, and when I sit down for a while, my left leg goes numb, and I cannot feel it. I listed this on my original claim as "Numbness and Tingling upper extremities" and "Numbness and Tingling Lower Extremities". I received a rating decision about 6 months later, which was a denial for service connection because they said I had "No diagnosis while in service for this condition". My question is: 1) How much weight is the VA supposed to give for the Final Physical, and if I reported the problem before exiting the service, how can it be denied? 2) Also, I am service connected for Degenerative disk disease at 10% for cervical and thoracolumbar spine. Is this enough by itself to get service connected for upper and lower radiculopathy or do I have to provide a medical opinion letter?

    Thank You sir

    ReplyDelete
    Replies
    1. Tricky situation. They basically just needed the radiculopathy to be officially diagnosed, not just listed on your exam as numbness and tingling. The final physical is not really a diagnostic exam.

      When did you have it officially diagnosed? If it was within the first year, you should be able to get that decision overturned with an appeal. Just submit evidence of the official diagnosis, and you should be good.

      If it was diagnosed after the year mark, then you can still get it added now as secondary to your DDD. A NEXUS letter will definitely strengthen your case.

      Delete
    2. I had it officially diagnosed on 05-09-2018, which is when I had the electrophysiological study with a Neurologist. I'm not real sure if I have a diagnosis or not though because of the way it is written. It states "No definite evidence for widespread polyneuropathy affecting the lower extremities. There is a possible right lateral planar neuropathy, with no potential elicited in the right lateral planar nerve. The remaining plantar nerves are normal bilaterally. The upper nerve study says "This electrophysiological study shows mild decrease ulnar nerve amplitude bilaterally, but no evidence for ulnar nerve denervation on the EMG study of the left upper extremity. The median nerves are normal bilaterally. Then she states on another page "Neurologic exam is nonfocal. Definite evidence for neuropathy found on nerve conduction studies of the lower extremities, but this does not definitely rule out a small fiber neuropathy". Can you decipher this and let me know if I have a diagnosis of Neuropathy or radiculopathy? Thank You!

      Delete
    3. I can't give you a full medical opinion as I'm not a neurologist, though she does say that there is evidence of neuropathy (basically the same as radiculopathy), so I personally say that was a diagnosis. If the VA won't accept this, then what you need is a statement from her or a medical record basically stating: "Diagnosis of peripheral neuropathy of the lower extremities caused by lumbar DDD."

      Delete
    4. Yes sir. Thank you very much. I did get a copy of my C & P exam, and I also saw the medical opinion that the C & P examiner had to provide to the VA. The C & P examiner stated "It is at least as likely as not 50/50 that the Veterans neuropathy is caused due to military service because it is a valid secondary condition caused by degenerative disk disease, which the Veteran is service connected for". I'm hoping this will suffice to the VA Rater who will be deciding my claim. Do you think I have a pretty good chance for success?

      Thank You

      Delete
    5. Yes. That is exactly what you needed. You should be good to go.

      Delete
  40. Hi Doctor
    I am having trouble getting statements from my husbands doctor he passed away but I have been told to link the right knee service connection to the left knee conditions he was having. Although he did not have a diagnosis of left knee injury in the military he was diagnosed with the left knee arthritis in fact its listed as more on the left side on some of the paperwork and some says bilateral but he was only rated for the right. How do I do handle that.

    ReplyDelete
  41. Hi Dr. I have CAD as service connected at 30%. I filed a claim for Coronary bypass surgery and the VA denied it. I now understand it was because of pyramiding (I think); but they then downgraded my CAD rating to 10% without any medical information given by me. The VA Dr. talked to me for several minutes and then typed on his computer for 90% of the time. How do I handle this. Thanks for your time.

    ReplyDelete
    Replies
    1. All heart conditions are rated on the Basic Rating System:

      http://www.militarydisabilitymadeeasy.com/theheart.html#system

      If you have proof in your medical records that your current heart condition qualifies for a rating higher than 10% under this rating system, then you can definitely appeal to have your rated corrected.

      Delete
  42. Hi Doctor, I have a VA disability rating 50% for hearing loss and 10% for Tinnitus. I was thinking about filling for compensation for unemployability. Do you think I could qualify for it. I also have Ménière’s syndrome. Thank you for your time

    ReplyDelete
    Replies
    1. Hi Rodneck -

      If your only ratings are the 50% and 10%, then you do not qualify for Unemployability.

      You have to have a single condition rated 60% or multiple conditions that combine to 70%.

      http://www.militarydisabilitymadeeasy.com/permanentandtotalunemployability.html#iu

      If you have the Meniere's rated additionally, then you may qualify as that could boost your ratings to meet the minimum requirements.

      Delete
  43. I have already been rated for several items. One of these is sleep apnea at 50%. If I do a secondary (1) ED to sleep apnea, (2) Hypertension to sleep apnea, (3) Diabetes Mellitus to sleep apnea and (4) Vascular issues (atherosclerosis and abdominal aortic aneurysm) secondary to the hypertension...do I have to a new DBQ for each of these? I have already been diagnosed by the VA for these conditions, but I have never filed them as secondary conditions.

    ReplyDelete
    Replies
    1. The VA physician will fill out a DBQ for each of the body systems affected. You can find the complete list of DBQ's here.

      https://www.benefits.va.gov/compensation/dbq_ListByDBQFormName.asp

      If two conditions are covered by a single DBQ, then only one will be submitted for both.

      Delete
  44. Hi Doc,
    I am service-connected patellar femoral pain syndrome, I submitted a claim for metatarsalgia; secondary to PFPS. Is it true that a knee problem can't "cause" a foot problem? I was told by the C&P examiner that only a foot problem can cause a knee problem, not the other way around. Although, he did briefly mention that my knee problem could "aggravate" my metatarsalgia. Your thoughts?

    ReplyDelete
    Replies
    1. That depends on the condition. If the knee condition clearly causes you to walk abnormally on the foot, it potentially could cause a problem. However, this is rare. Even if you limp or walk oddly, knee conditions usually still allow normal motion of the foot. Ultimately, it depends on your exact symptoms and how the foot is being used.

      Delete
  45. Dr. Johnson,
    I'm about to file a VA disability claim for a nose deformation, a painful scar due to an ingrown toenail and Tinnitus. I am reasonably confident that I should be awarded these disabilities.
    In my research I've begun to wonder if my other "issues" may be service connected as well due to my two 6 month tours in the Persian Gulf. (Southwest Asia)
    In the last 3 years I've been diagnosed with Spherocytosis, Cirrhosis of the liver (i don't drink or do drugs) and diabetes. Due to the Spherocytosis my RBC's are on the low end of the range. Dips below once in awhile. My platelets are steadily dropping...currently at 45,000. I had to have my gall bladder removed. I still create stones that get lodged in my bile duct. I've had 4 trips to the ER due to stones and had to have (2) ERCP's to remove the stones.
    White WBC's are down to 2.1 as well.
    None of my doctors can pinpoint why I've come down with these ailments. Spherocytosis can be hereditary in 75% of cases but i have a twin brother who was checked and is clear so it would seem i'm in the 25% category. Not sure what could have caused this to manifest.
    There is no clear evidence that these issues were caused in my civilian life.
    I find it "interesting" that all of these issues have manifested themselves all within a short period of time. I've been out of the military for 20 years.
    My question to you is how should I file for these conditions? I've read that you need to be careful on how you file based off of the diagnosed illness or the subsequent symptoms.
    I've noticed that the Gallbladder, Cirrhosis, Diabetes & Thrombocytopenia are on the VA presumptive list. I can't guarantee that I was at 10% within the first year after discharge since I never had any symptoms till my gall bladder had to come out. I very well could of been at 10% for the cirrhosis and the spherocytosis w/o knowing it. Gulf War Syndrome states that you may not have any symptoms until 2021 and still qualify for benefits. Could these fall under the Gulf War Syndrome umbrella?

    ReplyDelete
    Replies
    1. The key to a successful claim is to claim them in a way that clearly demonstrates that they meet the requirements on the Presumptive List.

      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#gulf

      You have to show that you meet the requirements for deployment/exposure as well as the requirements for diagnosis or non-diagnosis (in the case of Gulf War Syndrome).

      http://www.militarydisabilitymadeeasy.com/gulfwarsyndrome.html

      Remember, Gulf War Syndrome is a group of unrelated symptoms with no diagnosed caused. Conditions with clear diagnoses will not be considered here.

      Delete
  46. Thanks Doc.
    I've read both of those links many times before my initial post.
    I understand the reasoning and clearly see the "catch 22" in determining a diagnosed illness vs and a non-diagnosed illness. Explains why the VA can deny 80% of these claims.

    So that being said....
    Can I consider my Cirrhosis and my low platelet count as being non-diagnosed illness's? Neither one of these issues have any symptoms that I can readily see or feel at this point. They were discovered while investigating my Spherocytosis issue. My Cirrhosis will eventually lead to a liver transplant and could eventually kill me. The low platelet count (45K) could kill me as well due to possible internal bleeding. Especially if I need to have ERCP's done every couple of years. Both of these issues are also on the Chronic disease list of the VA Presumption List so they're obviously known issues for vets. My doctors don't know what the cause is for either of these issues. So I would consider these unrelated symptoms with no diagnosed cause.

    Just curious how you see these issues in your professional opinion. I fully understand the uphill challenge and intend to get a lawyer involved but at least want to start off on the right foot and file the initial paperwork correctly.

    Thanks for your time!

    ReplyDelete
    Replies
    1. There is some potential with these two conditions, however, most symptoms labeled as Gulf War Syndrome are fairly superficial: high blood pressure, nightmares, anxiety, stomach cramps, headaches, etc.

      Since yours are very significant and serious conditions, they are more likely to have a definitive cause that has just not been found as yet. You can attempt to apply for them as Gulf War Syndrome, but you'll want a physician backing you up, which may be hard.

      Delete
  47. I had an x-ray that diagnosed me with cervical arthritis in September 1993; 12 years prior to my retirement. I had another x-ray done in 2018 which also showed arthritis of the cervical spine and I continue to have neck pain and stiffness. Can I claim that and would it be considered service connected?

    ReplyDelete
    Replies
    1. Potentially. Did you have any regular treatments or checkups that show that this was a continued disability? Since it was definitely present while in service, they may grant it regardless, however, sometimes the VA will deny arthritis if it didn't cause a significant enough disability within 1-year of separation.

      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#chronic

      Delete
  48. Hey doc,
    Have you heard about the Saunders v. Wilkie ruling from April 2018? According, to that ruling, chronic pain can now be considered a disabilty. What's your interpretation of this ruling?

    ReplyDelete
    Replies
    1. So far, the ruling hasn't made a real difference to VA ratings yet. The VA has always rated pain with motion with most musculoskeletal conditions, however, this may eventually encourage them to change their policy to extend minimum pain ratings to all conditions. Again, nothing has been officially changed from what they already do, but this could be a precedent for future adjustments.

      Delete