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.
