The One Key to Achieving 100% VA Disability Ratings Every Veteran Should Know
Welcome to the second installment of our five-part series, where we meticulously dissect the five-step process that guides veterans toward achieving a 100% VA disability rating—or at the very least, securing the appropriate rating, whether that’s 90%, 60%, 40%, or whatever accurately reflects your condition. In this post, we dive deep into secondary VA disability claims, exploring not just the common secondary conditions but also how to identify potential secondary conditions that may be overlooked.
The five-step process includes: increases, secondaries, denials, new claims, and presumptive/intermediate conditions. Today, we’re focusing on the second step—secondaries. Unlike increases, which can be researched using resources like the VA’s 38 CFR, secondary claims lack a definitive list linking conditions to one another. This absence of a clear resource makes secondaries, in my view, the closest thing to a “secret” in navigating VA disability ratings. Many veterans simply don’t know what secondary conditions they might be eligible for.
Understanding Secondary VA Disability Claims
While there’s no official VA list for secondary conditions, I’ve compiled a common secondary conditions list that you can download via the link in the pinned comments below. Feel free to share it with fellow veterans. More importantly, this post will guide you through the process of determining whether you have a potential secondary VA disability claim.
For this series, we’re following a hypothetical veteran, “John Doe,” in a one-on-one scenario. We’ve already covered increases in the first post, and now we’re examining secondaries. I’ve tailored John’s case to maximize the impact of secondary claims, adding and removing claims to illustrate the process effectively.
Example: Secondary Claims for PTSD
Let’s say John Doe has a service-connected PTSD rating—whether it’s 0%, 10%, 30%, 50%, 70%, or 100%. Any service-connected condition can have secondary claims. Using our common secondary conditions list, we find that PTSD is associated with conditions like:
- Sleep Apnea
- GERD
- IBS
- Hypertension
- Migraines
- Erectile Dysfunction (ED) or Female Sexual Arousal Disorder (FSAD)
- Asthma
- Coronary Artery Disease (CAD)
- Chronic Fatigue Syndrome (CFS)
- Diabetes
- Obesity
- Alcohol Use Disorder
- Bruxism
Some of these, like ED/FSAD, may result in a 0% rating but still provide additional compensation through Special Monthly Compensation (SMC-K). Others, like bruxism, may serve as intermediate steps to other conditions.
How to Identify a Secondary Claim
To determine if you have a secondary claim, follow these steps:
Step 1: Confirm a Diagnosis
No diagnosis, no claim—this rule is non-negotiable for secondary claims. For example, if John Doe has PTSD rated at 70%, I’d ask, “Do you have sleep apnea?” If he responds, “I don’t know, but I snore a lot,” I’d explain what sleep apnea is and ask if he’s had a sleep study. If not, the next step is clear: get a clinical diagnosis. I’d recommend John speak with his primary care provider (VA or private) about his snoring, fatigue, and PTSD symptoms to secure a sleep study.
Only after a diagnosis is confirmed can we proceed. For instance, if John is diagnosed with sleep apnea, I’d note: “Sleep Apnea – Secondary to PTSD” and advise submitting the claim only with a diagnosis in hand.
Step 2: Gather Evidence
Once diagnosed, the focus shifts to evidence. Can John’s provider write a nexus letter linking sleep apnea to PTSD? Are there correlating factors like obesity? A nexus letter from a healthcare provider is ideal, as it establishes the connection between the primary condition (PTSD) and the secondary condition (sleep apnea).
Another Example: Tinnitus and Secondary Claims
Let’s consider tinnitus, a common condition often rated at 10%. Our common secondary list highlights conditions like migraines, vertigo, or nerve damage as potential secondaries. If John Doe has tinnitus, I’d ask, “Do you experience migraines?” If he says no, we move on. But if he mentions dizziness or nausea in elevators, we explore vertigo.
Vertigo secondary to tinnitus can be a stretch, but it’s possible with strong evidence. I’d ask John if he has other causes of vertigo, like head trauma. If not, I’d recommend: “Vertigo – Secondary to Tinnitus” and advise him to get a diagnosis while discussing his tinnitus symptoms with his provider to build the nexus.
Building the Nexus for Secondary Claims
For secondary claims, the “big three” requirements differ from direct claims:
- Primary Service-Connected Disability: E.g., tinnitus or PTSD.
- Current Chronic Diagnosis: A confirmed diagnosis of the secondary condition.
- Nexus: A medical link between the primary and secondary conditions, not directly to military service.
When meeting with a healthcare provider, communicate symptoms clearly. For example, if John’s tinnitus causes dizziness and nausea, he should say, “My tinnitus is severe, and when it flares up, I feel dizzy, nauseous, and sometimes vomit. Could this be vertigo?” This lays the foundation for a nexus, which can be formalized through a nexus letter from the provider.
Resources for Nexus Letters
If your provider can’t provide a nexus letter, consider services like American Medical Experts or Dr. Chadha, a board-certified psychiatrist. These are trusted options, though you’re free to explore others. Additionally, tools like Veteran AI can help generate nexus letters or personal statements to support your claim.
Applying the Process to Other Conditions
The same logic applies to other conditions, like bilateral pes planus (flat feet). Common secondaries include ankle conditions, shin splints, or knee issues. If John has flat feet rated at 30%, I’d ask about ankle pain and recommend a diagnosis while linking symptoms to his flat feet.
By systematically reviewing your service-connected conditions against the common secondary list, you can identify potential claims. Always start with a diagnosis, then build the nexus through medical documentation or professional support.
The Path to 100% Disability
Veterans often reach a 100% VA disability rating through a combination of increases and secondaries. This five-step series—covering increases, secondaries, denials, new claims, and presumptive/intermediate conditions—provides a roadmap. Check the pinned comments for links to the full series and the common secondary conditions list.
Key Takeaway: For every potential secondary condition, get a diagnosis first. Then, work with your healthcare provider to link it to your primary condition. Use resources like nexus letters and professional services to strengthen your claim.
Disclaimer: Portions of this article may reflect the author’s opinions based on experience and observations. Always consult with a qualified professional or VA representative when pursuing disability claims.
