Secondary Conditions

Let's begin by defining a couple of terms in simple language.

Nomenclature is very important when working with VA so it helps for you to understand the language.

The term condition is used to describe any physical or mental health problem you may have.  A condition is an injury or an illness that occurred during your military service. The condition may be disabling or not. You may have had a condition like a fungal infection that was treated and cleared up with treatment. That isn't disabling but it may be rated as service connected at 0% disabling.

Or you may have had a significant injury such as a gunshot wound. Even though it was treated, that wound may have left you with only a partial use of the affected limb and a big scar. That's a disabling condition and will likely be awarded an appropriate rating for purposes of compensation.

 

The term "service connected" implies that the illness or injury occurred during your service or if it shows up later in your life, was caused, contributed to or aggravated by your service.

The condition doesn't have to be from combat or even while you're performing a military duty. You're military 24 x 7 so anything that happens before you have that DD 214 in hand counts.

These conditions can be physical illnesses or mental health problems.

Some service connected conditions are pretty easy to understand. If you lose a finger or a toe in an accident or in combat, you'll get a clear cut rating for the loss
of the digit. That loss isn't pleasant but it isn't very likely to disrupt your life to any great extent and it won't lead to any other physical problems for you.

Then again, you may be diagnosed with an illness or incur an injury that can cause other problems.

If you have a service connected condition and that condition leads to other physically or mentally disabling conditions, you may have a reason to file a claim for a secondary condition.

There's a lot of misunderstanding about how the VA looks at secondary conditions.

For example...

Veterans who served in Vietnam are known to have been exposed to agent orange. Agent orange is known to cause or contribute to a variety of health problems. Your VA cedes that many health problems that occur in Vietnam veterans may be caused by the exposure to agent orange. In fact, there's a well defined list of these presumptive conditions.

One of the common conditions that may be seen in the Vietnam veteran is adult onset diabetes, often called Type 2 Diabetes or DMII. Any Vietnam veteran who receives a diagnosis of DMII should file a claim for disability compensation. The claim is likely to be awarded without too much fuss if the veteran has his paperwork in proper order.

Once an individual is diagnosed with DMII his health care team will begin to watch for conditions that are known to be secondary to the diabetes. Medical science recognizes that diabetes can be a brutal disease and it may cause other physical health problems. Most of these problems may be avoided or minimized with good medical care like a proper diet and medicines.

Some manifestations of DMII will come up for some veterans though. These may be viewed as secondary conditions and when they occur, they should be claimed as service connected and secondary to the primary DMII.

Diabetes (DMII) as a primary condition  

Diabetes is known to be very hard on the human vascular system. The veteran who has diabetes will be monitored for diseases of the arteries of the heart, the neck, the kidneys and the legs. If diabetes affects those arteries the veteran may develop ischemic heart disease, carotid artery disease, renal artery disease or peripheral artery disease.

Those diagnoses may lead to heart attack, stroke, kidney failure and difficulty in walking or even loss of a leg.

If there is a diagnosis of DMI and that diagnosis is rated by VA as service connected, vascular diseases that are diagnosed later will be viewed as secondary conditions and will deserve an award of compensation.

Interestingly, the diagnosis of service connected DMII must come first. If a veteran claims carotid artery disease in 2006 and is denied and then in 2009 he is diagnosed as having service connected DMII, the original denial is likely to remain as is.

For a claim of a secondary condition, the primary service connected condition must be of record first.

If the veteran has service connected diabetes, he or she may consider filing for;

Peripheral Artery Disease  

Ischemic Heart Disease  

Carotid Artery Disease  

Stroke  

Kidney Disease  

Hypertension  

Diseases of the Eye  



There are many more conditions that may be caused by service connected diabetes.
  

In our example of DMII, not all other conditions can be successfully claimed.

This is a common error made by many veterans.

Veterans who have a service connected condition like DMII will often begin to try to claim all other conditions as secondary to that DMII.

I receive frequent emails asking if I think that a claim of arthritis, mental conditions like depression, various cancers and so on can be claimed as secondary to the DMII. The answer is always "No".

Veterans are allowed to make any claim they believe is appropriate. My answers are based on whether or not I believe the veteran will be awarded the claim or if he is wasting his time.

Many claims of a secondary condition may be won with a well written nexus letter from an expert medical doctor.

The secondary condition benefit is an important one to you.

Other examples that may be secondary are:

If you have a rated hip condition and it affects your back, you may want to file for the back pain as a secondary condition.

If you take medications for service connected PTSD, you may be eligible to file for erectile dysfunction. Many psychiatric medicines will cause or contribute to ED.

If you are rated (service connected) for hearing loss, don't overlook the tinnitus that may accompany acoustic trauma. Severe hearing loss may also lead to mental health conditions like depression.

If you have a condition that has caused significant disability to a leg, that injury may affect the other leg, the hip or your back.

The VA will almost certainly deny your secondary condition. You should consider obtaining an IME/IMO at your earliest convenience.