If you’re a veteran with a service-connected disability, you may find that your condition has led to other health issues over time. In these cases, you can file a secondary VA claim.
This claim is to seek compensation for conditions that have developed or worsened due to your primary disability.
A secondary claim allows veterans to expand their benefits by recognizing the broader impact of their service-related conditions.
In this blog, we’ll walk you through what a secondary VA claim is and the step-by-step process for filing one successfully.
What Is a Secondary VA Claim?
A secondary VA claim is a claim for a condition that has developed as a result of, or has been aggravated by, an already service-connected disability.
A primary claim is where a veteran seeks compensation for a condition directly caused by military service. Meanwhile, a secondary claim addresses how an existing disability impacts other parts of the body or mental health.
For example, a veteran with a service-connected knee injury might develop chronic back pain due to altered walking patterns. In this case, the back pain would be considered secondary to the knee injury.
The VA considers these secondary disabilities for compensation if the veteran can demonstrate a medical link (known as a nexus) between the two conditions.
Secondary claims can apply to both physical and mental health conditions. For instance, a veteran with PTSD might experience depression or anxiety. The latter could be filed as secondary to the former mental health condition.
The key in filing a secondary VA claim is proving that the primary disability either caused or worsened the secondary condition.
This system allows veterans to receive compensation for the full range of health issues connected to their service-related disabilities. It ensures they are adequately supported.
How to Know If Your Disability Is a Secondary Condition
To determine if your disability is secondary, consider whether your primary condition has contributed to the development or worsening of another health issue.
Secondary conditions typically arise when the primary disability affects your body in ways that lead to additional complications. For example-
- Veterans with a service-connected leg injury may develop problems with their hips or back due to altered posture or gait.
- Similarly, veterans experiencing chronic pain from a service-related injury might develop mental health issues like depression or anxiety.
The best way to confirm whether your condition is secondary is to consult a medical professional. They can evaluate your current health and provide a nexus letter linking the two conditions.
Keep detailed records of symptoms, treatments, and any changes in your health to support your case.
Step-by-Step Guide: How to File a Secondary VA Claim
Filing a secondary VA claim is a detailed process. It involves providing medical evidence to prove how your service-connected disability has led to or aggravated another condition.
The process can seem overwhelming, but with the right steps and proper documentation, you can effectively navigate the system.
Below is a step-by-step guide to help you through the process of filing a secondary VA claim.
Step 1: Gather All Medical Evidence
Before filing your secondary VA claim, it’s essential to collect all relevant medical records. They must show how your service-connected disability has affected your secondary condition.
This includes-
- Current diagnoses for the secondary condition.
- Treatment history, including visits to specialists, physical therapy, or mental health treatment related to both the primary and secondary disabilities.
- Nexus letters from your doctors, which state how the primary condition caused or worsened the secondary condition. This letter is the most crucial evidence here.
Your doctor’s letter should be detailed and show that the secondary condition wouldn’t have occurred without the primary disability.
If you can, also include imaging results (X-rays, MRIs) or lab tests that support the worsening of the secondary condition due to the primary one.
Step 2: Complete VA Form 21-526EZ
The next step is to file the claim itself by completing VA Form 21-526EZ. This is the standard form for submitting a claim for both primary and secondary conditions.
In the form, you will-
- Provide your personal information, service details, and primary disability information.
- Specify the secondary condition you are claiming and explain how it is linked to your service-connected disability. Be as specific as possible.
- Include a description of how the secondary condition affects your daily life, work, and overall functioning. This will help the VA assess the severity of the condition.
Make sure all the information is accurate and complete to avoid delays.
Step 3: Submit Supporting Evidence
Along with Form 21-526EZ, you must submit the medical evidence you’ve gathered. The more thorough your evidence, the stronger your claim will be.
If the secondary condition is related to a mental health issue like depression or anxiety caused by chronic pain, be sure to include-
- Mental health evaluations
- Therapy notes or
- Diagnoses
-to support the claim
Step 4: Attend a Compensation and Pension (C&P) Exam
Once the VA receives your claim, they may schedule a Compensation and Pension (C&P) exam.
This exam is an evaluation to assess the severity of your secondary condition. It is conducted by a VA healthcare provider or a contracted medical professional.
Here’s how to prepare for the exam-
- Be honest with the examiner about the symptoms of your secondary condition, how it impacts your daily life, and any functional limitations.
- Bring your medical records and any additional supporting evidence you have. The examiner will review this documentation, but having it on hand can help reinforce your claim.
- Stay focused on the connection between the primary and secondary conditions. Explain how the former has led to the latter.
Step 5: Wait for the VA Decision
After you’ve submitted your claim and attended the C&P exam, the VA will review your case and issue a decision. The review process typically takes several months (normally 3-6 months, but it can vary).
While waiting, you can check the status of your claim through eBenefits or by contacting your VA regional office.
If you receive a decision letter, it will include the VA’s findings and any ratings assigned for your primary and secondary disabilities.
Step 6: Appeal If Necessary
If the VA denies your secondary claim or assigns a lower rating than you believe you deserve, you have the option to appeal. There are several ways to appeal a decision, including-
- Requesting a Higher-Level Review, where a different VA employee reviews the case.
- Appealing to the Board of Veterans’ Appeals, which is the next step if you disagree with the higher-level review.
Appeals may require additional evidence or even a hearing, but they are an option if you believe the decision was incorrect.
How to Write a Statement in Support of a Secondary Disability Claim
Writing a personal statement in support of your secondary VA claim can significantly strengthen your case. You can provide additional context about how your primary disability has caused or aggravated your secondary condition.
The statement should be clear, detailed, and focused on the connection between the two conditions.
Key Elements to Include
- Introduction: Start by briefly identifying your primary service-connected disability and its history. For example, mention your knee injury and how it’s affected your daily life.
- Describe the Secondary Condition: Explain how the secondary condition (e.g., back pain, depression, etc.) developed as a result of the primary disability.
Be specific about when you began experiencing symptoms of the secondary condition.
- Link Between Conditions: Clarify how the primary disability has either caused or worsened the secondary condition. For instance, explain how an altered gait from a knee injury led to back pain.
- Impact on Your Life: Detail how the secondary condition affects your ability to work, perform daily activities, and manage your health.
This can include limitations in mobility, cognitive challenges, or emotional distress.
- Supporting Evidence: Mention any supporting documents, such as doctor’s notes, that provide additional proof of the connection.
Conclusion
Filing a secondary VA claim can be an essential step in receiving the compensation you deserve for all service-connected conditions, not just the primary disability.
Remember that a detailed nexus letter from your doctor and supporting personal statements will help establish the connection.
If needed, don’t hesitate to seek assistance from a VA-accredited representative or look for credible information online.