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A secondary condition is a disability that was caused or aggravated by an already service-connected condition. The VA often grants separate ratings for these, yet many veterans never file for them because the connection is not obvious. If your knee injury leads to back problems, or your PTSD leads to hypertension, those secondary conditions may be compensable.
The key to a successful secondary claim is medical evidence showing a causal link. A nexus letter from a treating physician is usually the most persuasive document. It should explain the medical mechanism — for example, how a service-connected ankle condition altered your gait and caused degenerative changes in your hip or lower back. The more specific the explanation, the better.
Common secondary conditions include sleep apnea linked to PTSD or weight gain from medications, depression secondary to chronic pain, and radiculopathy caused by a service-connected spine condition. Some conditions, like erectile dysfunction secondary to prostate cancer or diabetes, are presumptively linked under certain circumstances.
Filing for a secondary condition uses the same forms as an initial claim or increase — typically VA Form 21-526EZ. You do not need to prove the original service connection again; you only need to prove the relationship between the established condition and the new one. If you have been rated for a primary condition for years, it is worth asking your doctor whether any current health issues may be connected.