Matthew: Hello and welcome to the Hill and Ponton video blog. I’m Matthew Hill here with Carol Ponton. Today we want to talk to you about secondary service connection and how you get disabilities connected to the primary disability that you’re service connected for.
We’re going to talk about specific examples. If you have leg pain or radiculopathy due to your back pain, then your back pain is service connected. But before we get the examples, let’s just go through the mechanics.
First of all, with direct service connection, you got to show that you have a current disability and that there was something that happened in service and that there’s a link between the two. With back pain, let’s say that you tried to pick up a big garage door when you’re in service and it fell and pulled your back. You had to treat for that in service and the pain never went away. When you got out, you were diagnosed with the degenerative disc disease in your back. That’s how you get that primarily service connected or direct service connection.
Secondary service connection involves a disability steaming from a service-connected disability. With that back pain, if you were, as a result, to have the radiculopathy – even if it didn’t happen in service or because of service, it happened because of that service-connected disability. That disability could be secondary service connected.
This is important because a lot of times, a veteran will have a disability that they’re service connected for that might not be that bad and it might not be rated that high. But the results of the secondary disabilities can be high and can be significant, so we wanted to run through a few of them today. We might as well start with the lumbar spine. Carol, what do you see often with those as far as secondary?
Carol: First of all, just so you know, lumbar spine usually get about 10 or 20% rating; 40% is often the highest rating we see for the back. But the real problems with the back also end up being pain and numbness that runs down the leg into the foot. A person could have severe pain or numbness in one or both legs, and then their feet. A lot of times veterans end up with foot drop where they cannot pick up their foot to make a step.
All of these – your right, your left foot drop – are entitled to a separate rating. A lot of times these ratings are higher than the rating you got for your back. I have a veteran who just got a 60% for his right foot. He can’t pick it up. You can get much higher ratings if you know what to ask for. The thing that I see that’s so sad is veterans don’t realize that the things that the service-connected problem causes are things they’re entitled to be compensated for.
Matthew: It can be less obvious and that depression is a big thing. We see how a veteran has a back disability and they can’t do the sports they used to do or the recreational activities or sometimes even work, and that causes them to be depressed. That should be service connected, as well.
Matthew: Going back to what Carol said about the max rating typically being 40% for back. You can actually get up to 100% just for your back, but I have never seen it. It’s impossible to get what’s called a schedule 100%. But a lot of times, we’ll represent veterans for Social Security disability who go on Social Security disability, meaning they cannot work at all due to their back and the VA is only rating them for 40%.
Carol: If that.
Matthew: It’s important to look and see what other problems the back causes and other disabilities.
Another one we see all the time is diabetes. It’s pretty common for us to see a diabetes case where the diabetes itself is treated just with oral medication and the veteran gets a 20% rating for that. But then they’ll have neuropathy which is like what she was talking about with pain down the legs or arms to the back. This is called…
Carol: Peripheral neuropathy. It can affect the hands, the feet, the legs, or all of those. Once again, where you’re only getting 10% or 20% for the diabetes, your rating for these other areas could be much higher because they’re causing you significant problems.
One of the things that Matt and I were talking about is recently I’ve seen two veterans who had diabetes and they had moderate renal failure and they didn’t even know it. That means their kidneys weren’t working. You will find that out by looking at the lab results. The veteran was given a 60% rating just for his moderate renal failure due to diabetes.
Matthew: Even though he had a rating of only just 20% for the diabetes.
Carol: He didn’t even know he had moderate renal failure. No doctor had ever told him even though it was clearly in his charts.
Matthew: Diabetes is really a bad one. You have the kidney problems, you have the problems with the numbness, tingliness in the arms and legs. You could have problems with your eyes.
Carol: Sores that don’t heal. All of these entitle a veteran to a much higher rating. The sad thing is they do not know to ask. With the VA, if don’t file for it, you’re not going to get it.
Matthew: It’s important to always think. When I advice veterans is when they develop that disability. Say the diabetes was diagnosed, they should think about all the other things that crept in and started ailing them after that. Because whether they know it or not, it could be related to diabetes or it could be related to that primarily disability.
The way we look at it, it’s better to file that not, because if you’re entitled to compensation, you should be getting that as far back as possible.
Carol: That’s another reason. When our clients come in, one of the things that we try to do is we try to outline the problems that we have and we put this on a 4138 form and we send it in to the VA so that the VA is made aware of all the problems that the veterans has that we think may be service connected or connected to a problem they already have service connected.
Matthew: A couple of other disabilities that if you have you need to be aware of are multiple sclerosis (MS) or Parkinson’s disease. These are central nervous system diseases. They essentially affect the whole body. A lot of times what we see is a veteran won’t receive a rating just for the diagnosis. Parkinson’s just for being diagnosed is 30%.
It’s not necessarily secondary ratings, but the problems that the Parkinson’s or the MS causes foot drop, inability to use your hands, do the trimmers, inability to speak, swallow, and thinking – all of these things. There should be separate rating for each one of those and not just the diagnosis itself. Those are two big ones where the ratings are missed. They are not necessarily secondary ratings.
Carol: They’re part of it and they need to become compensated. When veterans get a 30% rating for Parkinson’s, they think, “That’s all I’m entitled to.” But that’s not the law. They are entitled to ratings for all of the other problems that Parkinson’s is causing as well.
Hypertension is another one. When people have high blood pressure, it can lead to heart disease or a stroke. If they have heart disease, it’s hypertensive or if they suffer a stroke, they are entitled to service connection for that, as well. That’s another example of secondary service connection.
Matthew: That’s an example of where you could have hypertension rated at 10% and then have a stroke, and there you go, 100% there. It’s really important to understand the concept of secondary service connection. It is important to make sure that when you are filing for any disability, you don’t list just the lower back pain, but you list any problems from that – the pain radiating down the legs, maybe depression, or foot drop. You just need to outline what all the problems you have are.
Maybe you get denied for them. Maybe they’re not related. But at least you put them in there and at least you tried to get them service connected. As a lay person, you don’t know. But if you don’t put it in there, it counts against you.
Carol: One other area I’d like to talk about, because I almost never see veterans realizing they’re entitled to this. Many veterans come out with some type of knee injury. When the knee is injured, it throws off your gate. There are numerous studies that have been done by the VA that show this causes a problem with your back, your hips, and your other knee. You can get secondary service connection in many cases just related to the left knee, for instance, if that’s the one that’s service connected. But once again, veterans don’t know they need to file for this.
Matthew: It’s both knees. It could throw off the other knee, or it could throw off your ankles. We talk to orthopedic doctors all the time. Frankly, they give us a tutorial on how just instability of one knee can really mess up and cause orthopedic issues all throughout the body.
The point here is you need to realize that there could be more to your service connected disabilities than just the primary direct service connected disability. When you’re applying, you need to always think about what other issues you’re having. If there is a remote chance that could be ready to a service-connected disability, you need to apply for compensation for that, as well.