Secondary disabilities are defined as those illnesses or injuries that are caused or aggravated by a service-connected disability. See our blog for a more in-depth definition of Secondary Service Connection here. There are two distinct categories; secondary service connection and secondary service connection by aggravation. So, first let’s define them then discuss what you need to file a claim for them.
Secondary Service Connection
This means that a service-connected illness or injury caused another illness or injury. For example, diabetes is one of the most common service-connected illnesses. If a veteran with diabetes develops complications from diabetes such as stroke, kidney failure, peripheral neuropathy, vascular disease, etc., those could then be claimed as secondary to a service-connected disability. There must be evidence that the service connected disability directly caused the secondary illness or injury. So, you cannot claim that diabetes caused Parkinson’s Disease, but you can claim it caused blindness or loss of a limb if you have evidence showing the diagnosis and progression.
Secondary Service Aggravation
Secondary service aggravation is a little different in that it is not something that was directly caused by the service-connected illness or injury but was aggravated by it enough that it is now an issue of its own. An example of this would be that someone has flat feet diagnosed in service and is service connected for that illness. Now, several years later they are diagnosed with rheumatoid arthritis in their back and as time goes on it progresses to the point where they have to have surgery and possibly assistance walking such as with a cane or walker. Now, while rheumatoid arthritis is genetic, and therefore cannot be service connected; it can be aggravated by the abnormal gait caused by the flat feet condition. Also, something to note, while the initial service connected disability may have a low rating, the aggravated secondary condition may get a much higher one. In this case, the flat feet may have only been rated at 0-10% but the debilitating effects of rheumatoid arthritis in the back being aggravated may have now caused loss of independence and could possibly be rated up to 100% or warrant unemployability, aid and attendance, or special adaptive home grants.
Progression
Progression is shown by first having a primary diagnosis that is service connected. Second, you must show treatment for that primary diagnosis and either the onset of the new illness or injury or the aggravation of the existing one. There must be a diagnosis of the new/aggravated illness or injury before you can file the claim. For example, you can’t file for blindness secondary to diabetes just because you may go blind, only once you have already gone blind. Having statements from your treating physicians showing how the existing illness/injury caused or aggravated the other will give you the best chance at a positive claim outcome.
Not all Secondary Conditions will Receive a Rating
Often times, because every person is different, someone will develop an illness that may be related to a service-connected disability but they are not awarded secondary connection for it. This could be the case in such issues as depression caused by diabetes or sleep apnea caused by a cervical condition. Unless you have a nexus letter from your doctor that can convince the VA of the connection, it is rare that anyone is awarded secondary service connection for issues that are not normally associated with the service connected issue. Sometimes medical personnel can find new and emerging studies and journal articles that can support the connections which will help a claim. Also, be aware of whether you are claiming that the injury or illness was caused by or aggravated by the service connected disability. If you have a genetic or hereditary issue you can not claim it was caused by the S/C issue, only aggravated. Sometimes, simple mistakes like this can cause a claim to be denied and be tied up for years in appeals until someone finds the mistake, then effective dates are lost because the claim was not filed appropriately and now a new claim must be filed. Be sure to review this with your representative or attorney when you are filing for secondary issues.
