A Marine Corps veteran rated 70% for post-traumatic stress disorder didn't know his sleep apnea counted as a separate disability. An Army veteran with a service-connected back injury never filed for the knee problems that developed from limping for years. A Navy veteran rated for tinnitus had no idea his depression qualified as a secondary condition.
These veterans left money on the table. More importantly, they missed recognition for disabilities that directly resulted from their service-connected conditions.
Secondary conditions are disabilities caused by conditions the Department of Veterans Affairs already recognizes as service connected. The VA rates them separately and adds the percentage to your overall disability rating. But the VA doesn't automatically grant them. You have to file a claim and prove the connection.
Most veterans don't realize this option exists until years after their initial rating. Some never find out.
What Counts as a Secondary Condition
The basic rule is simple: If a service-connected disability causes or aggravates another condition, that second condition can be rated as secondary.
Sleep apnea from PTSD is the most common example. PTSD causes hypervigilance, nightmares and disrupted sleep patterns. These contribute to obstructive sleep apnea. File with medical evidence linking the two, and the VA can rate the sleep apnea secondary to PTSD.
Knee or hip problems from a back injury follow the same logic. A service-connected lumbar spine condition forces you to walk differently to avoid pain. That altered gait puts stress on your knees and hips. Over time, you develop osteoarthritis or other joint damage. Those joint problems are secondary to the back condition.
Mental health conditions secondary to chronic pain work the same way. Constant pain from a service-connected injury leads to depression, anxiety or worsening PTSD. The mental health condition becomes secondary to the physical injury.
The secondary condition doesn't have to be related to military service directly. It just has to be caused by something that is.
Common Secondary Conditions Veterans Miss
Sleep apnea secondary to PTSD appears in claims constantly, but many veterans don't connect the dots until a sleep study shows moderate or severe apnea. The VA can rate sleep apnea at 0%, 30%, 50% or 100% depending on whether you need a CPAP machine and whether you actually use it.
Joint problems secondary to back, hip or knee injuries are extremely common. Compensating for pain in one area shifts weight and stress to other joints. A veteran with a 40% rating for a left knee injury might develop right knee problems from favoring the injured side. That right knee qualifies as secondary.
Radiculopathy secondary to spinal conditions affects thousands of veterans. Nerve damage from a service-connected back or neck injury can cause pain, numbness or weakness in your arms or legs. Each affected nerve can be rated separately as secondary to the spinal condition.
Mental health conditions secondary to physical disabilities show up across the board. Chronic pain, mobility loss and visible scarring all contribute to depression and anxiety. These aren't just "part of" the physical condition. They're separate disabilities that deserve separate ratings.
Migraines secondary to traumatic brain injury or neck injuries are frequently overlooked. The VA can rate migraines based on frequency and severity, from 0% for less frequent episodes to 50% for very frequent completely prostrating headaches.
How to Establish Service Connection for Secondary Conditions
You need three things: a current diagnosis of the secondary condition, medical evidence linking it to your service-connected disability, and a claim filed with the VA.
The current diagnosis comes from a doctor. Go to sick call at the VA or see a private physician. Get the condition documented. Sleep apnea requires a sleep study. Joint problems need X-rays or MRIs showing damage. Mental health conditions need evaluation from a psychiatrist or psychologist.
The medical nexus is the hard part. You need a doctor to write an opinion stating it's "at least as likely as not" that your service-connected condition caused or aggravated the secondary condition. This is called a nexus letter.
Some VA doctors will write these opinions during compensation and pension exams. Others won't touch them. If the VA examiner won't establish the connection, get a private medical opinion. Veteran service organizations and disability attorneys can help arrange this.
The claim itself is filed through VA.gov, by mail, or with help from a veteran service organization. You're filing for a new condition secondary to an existing service-connected disability. The form asks you to identify the primary condition and explain the relationship.
Why This Matters for Your Overall Rating
The VA doesn't add disability percentages together in a straight line. A veteran with 70% for PTSD and 50% for sleep apnea doesn't get 120%. The VA uses a combined ratings table that produces a lower total than simple addition.
But secondary conditions still increase your overall rating significantly. A veteran at 70% who adds a 50% secondary condition jumps to 90% overall. That's the difference between $1,716.28 and $2,241.91 per month in 2026. Over a lifetime, the gap runs into hundreds of thousands of dollars.
Getting to 100% often requires claiming secondary conditions. A veteran with 70% for one condition and 30% for another might sit at 80% combined. Add three more secondary conditions rated at 10% each, and you could reach 100%. That unlocks full commissary and exchange privileges, ChampVA health coverage for dependents, and property tax exemptions in many states.
The retroactive pay matters, too. If you file five years after developing a secondary condition, the VA can pay retroactively to your effective date depending on when you filed. But you can't get paid for years you never claimed.
What to Do Now
Look at your current service-connected disabilities and ask whether they've caused other problems. Has your back injury led to knee pain? Has your PTSD disrupted your sleep? Has chronic pain from your service-connected condition led to depression?
Get those secondary conditions diagnosed. See a doctor. Get the evaluation done. Document everything.
Then file. The VA won't automatically give you credit for conditions you haven't claimed, even if the connection seems obvious. You have to ask.
If you need help, contact a veteran service organization. DAV, VFW, American Legion and other VSOs employ accredited representatives who help with claims for free. They know which secondary conditions to look for and how to establish the medical connection.
The biggest mistake is assuming the VA already knows about your secondary conditions or that they're already included in your rating. They're not. You have to claim them.
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