Secondary Conditions: Building a Chain for Maximum VA Compensation

When most veterans file for VA disability benefits, they focus on the obvious—the injury or illness directly caused by their time in service. But what many don’t realize is that disabilities rarely exist in isolation. Over time, a service-connected condition can cause or aggravate other health problems. These are known as secondary conditions, and when filed correctly, they can significantly increase your overall VA rating and compensation.

This blog will break down what secondary conditions are, how to connect them to your primary disabilities, and why they’re one of the most powerful tools in maximizing your benefits.

What Is a Secondary Condition?

A secondary condition is a disability that arises as a result of another service-connected condition. It doesn’t have to be caused during your time in uniform—it just has to be linked to something that was.

According to the VA, you can claim a secondary condition when:

“A service-connected condition caused or aggravated another medical issue.”

This allows you to build a claim chain, stacking connected conditions together to elevate your combined rating.

Common Examples of Secondary Conditions

Let’s take a look at how this plays out in real life. Here are a few examples of common secondary connections:

The possibilities are vast. If your health problems are connected—even indirectly—you may be leaving benefits on the table by not exploring secondary claims.

Why Secondary Claims Matter

Here’s the truth: most veterans won’t reach 100% based on one condition alone. But by documenting how one issue has led to others, you create a domino effect that builds a stronger case.

Let’s say you have:

• 30% for PTSD

• 50% for migraines caused by PTSD

• 10% for tinnitus related to loud noise exposure

• 10% for GERD from stress and medications

That combination could get you to a combined rating of 80% or more, which means significantly higher monthly payments—and access to additional VA programs like CHAMPVA and education benefits for dependents.

How to Prove a Secondary Condition

The key to winning a secondary claim is showing the medical connection between your primary and secondary condition. This is known as a nexus.

To establish this, you’ll need:

1. A Current Diagnosis

You must have a documented, diagnosed condition. A general complaint isn’t enough.

2. A Primary, Service-Connected Condition

Your secondary condition must link to a condition the VA has already rated or will rate.

3. A Medical Nexus

A doctor (often through a nexus letter) should state that your secondary condition is “at least as likely as not” caused or aggravated by the primary one.

Real Veteran Story: Building a Strong Claim Chain

Lisa, an Army veteran, was initially rated at 30% for PTSD. Over time, her condition led to chronic sleep problems and migraines. She also began gaining weight from medications, which resulted in joint pain and sleep apnea.

By filing secondary claims, she was eventually rated:

• 30% PTSD (primary)

• 50% Migraines (secondary to PTSD)

• 30% Sleep apnea (secondary to PTSD and weight gain)

• 10% Knee pain (secondary to weight gain)

Her combined rating rose to 90%, and she was later awarded TDIU, bringing her monthly compensation to the 100% level.

What Evidence Strengthens a Secondary Claim?

✔ Medical Nexus Letter
This is your strongest piece of evidence. Ask your doctor to clearly link the secondary condition to the primary one using specific language recognized by the VA.

✔ VA and Private Medical Records
Consistent documentation of both conditions—and their connection—adds credibility to your claim.

✔ Lay Statements
Statements from family, coworkers, or friends describing how your secondary condition has impacted your life.

✔ Symptom Journal
Daily logs showing how one condition contributes to another (e.g., how poor sleep from PTSD worsens migraines).

Secondary Aggravation: You Don’t Need to Prove Causation

Sometimes a condition doesn’t cause another, but it makes it worse. That’s called aggravation, and the VA still compensates for it.

For example:

• Your PTSD doesn’t cause your hypertension—but stress and panic attacks make it worse.

This is still a viable claim, and the nexus letter should use terms like:

“The veteran’s [secondary condition] is at least as likely as not aggravated by their [primary condition].”

Tips to File a Successful Secondary Claim

• File early. Don’t wait for conditions to worsen—file as soon as the connection becomes clear.

• Use VA Form 21-526EZ for new secondary claims or increases.

• Be specific in your wording. Identify both the primary and secondary condition and clearly state the relationship.

• Don’t underestimate the impact. Even if a secondary condition seems “minor,” multiple 10% or 20% ratings can add up fast.

Secondary Conditions and TDIU

When secondary conditions combine to prevent you from maintaining gainful employment, you may qualify for TDIU (Total Disability Individual Unemployability).

To qualify, you typically need:

• One condition rated 60% or more
  OR

• A combined rating of 70%, with one condition rated at least 40%

Secondary conditions often help meet these thresholds. TDIU pays at the 100% rate even if your total rating is lower.

Don’t Let Your Claim End at One Condition

Many veterans file for one issue, accept their rating, and never revisit their claim. That’s a mistake.

Veterans’ health is dynamic. One injury affects the body over time. One mental health condition can derail physical wellness. Medications meant to help can cause new complications.

Your VA claim should evolve with your health. It’s not about exploiting the system—it’s about recognizing the true cost of your service.

Final Thoughts: You Served as a Whole Person. Get Compensated Like One.

The VA rating system often compartmentalizes injuries—your knees here, your sleep over there, your mental health in another category. But you lived through service as a whole person. Your injuries, visible and invisible, are connected.

By understanding and leveraging secondary conditions, you don’t just get more compensation—you get validation. You ensure that your full experience is recognized, respected, and supported.

So don’t settle for partial justice. Build your claim. Connect the dots. And fight for the benefits you’ve earned.