DISABILITYVA program

Secondary Service Connection Claim

Veterans may claim secondary service connection for a new condition that is caused or aggravated by an already service-connected disability; for example, knee arthritis secondary to a service-connected back injury.

View on VA.gov

Step-by-step guide

What VA looks for: Caused by a service-connected condition

A condition you have nowA new physical or mental condition, shown by medical records, or by lay evidence of lasting or recurring symptoms that others can see or observe.
A condition VA already service connectedThe condition you think caused the new one is service connected. It did not need to be service connected, or even diagnosed, when the new condition started.
A link between the twoUsually medical records or a medical opinion that the service-connected condition caused the new one. In some cases VA also accepts lay evidence.

Source: VA Form 21-526EZ (opens in new tab); VA.gov: evidence needed for your disability claim (opens in new tab); 38 CFR 3.310(a) (opens in new tab); M21-1 V.ii.2.D (opens in new tab)

Which kind of claim is this?

Caused by a service-connected condition
A condition that results from a condition VA already service connected, or that would not have happened without it, is service connected too. VA treats it as part of the original condition. The claim goes on VA Form 21-526EZ.
Source: 38 CFR 3.310(a) (opens in new tab); M21-1 V.ii.2.D (opens in new tab); VA.gov: evidence needed for your disability claim (opens in new tab); VA Form 21-526EZ (opens in new tab)
Made worse by a service-connected condition
A condition that did not come from service can be service connected for the part a service-connected condition made worse. That includes a condition that is more severe than it would have been because the service-connected one got in the way of treating it. The worsening does not have to be permanent. VA rates only the part above the baseline, and if the baseline and the current level fall at the same percentage, VA still grants service connection at 0 percent.
1. How severe it was before it got worseMedical evidence from before the worsening began, or the earliest medical evidence after it began. Statements from you and others can support this baseline but may not be enough alone. If no baseline can be set after VA has helped look for one, VA denies this kind of claim.
2. Worsening caused by the service-connected conditionMedical evidence that the condition got worse, or is more severe than it would have been, because of the service-connected condition.
Source: 38 CFR 3.310(b) (opens in new tab); M21-1 V.ii.2.D (opens in new tab); VA.gov: evidence needed for your disability claim (opens in new tab)

What to gather, and what it shows VA

Documents for this benefit: what each is, what it shows VA, and how VA gets it
Document	What it shows	How VA gets it	Have it?
Your current rating decision The VA decision letter that lists the conditions VA already service connected.	Which condition VA already rates	VA mails it after each decision and already holds it in your file. You can download decision letters on VA.gov.	Yes
Medical records of the new condition VA and private treatment records of the new condition, including older records from before it got worse.	The new condition, and how severe it was before and after	VA will request your VA records for you once you file. For private records, send copies to VA or complete VA Form 21-4142 and VA Form 21-4142a so VA can request them.
Written opinion from your provider A written opinion from a health care provider on whether the service-connected condition caused the new one or made it worse, with the reasons.	The link between the two conditions	Your provider writes it, and it goes to VA with your claim. VA orders its own exam and opinion when the evidence shows the conditions may be linked but is not enough to decide.
Statements about your symptoms Your own account of the new symptoms and how they relate to the service-connected condition, and statements from people who see them.	Symptoms others can see, and when they started	Your own statement can go on VA Form 21-4138, and others can use VA Form 21-10210. They go to VA with your claim.
VA claim exam and opinion An exam and medical opinion VA orders when the evidence shows the new condition, the service-connected one, and a sign they may be linked, but not enough to decide.	Whether the two conditions are linked	VA schedules it if it needs one. For a made-worse claim, the VA examiner reports the current severity, whether the service-connected condition made it worse, and the reasons.

Records and statements go to VA. BeneVets never asks you to upload or type them here.

Steps, in order

Get free help from a VSO
Free help: an accredited VSO can file this with you. Find one near you in the BeneVets VSO directory at Find an accredited VSO near you.
Source: VA.gov: accredited representatives (opens in new tab)
Gather records of the new condition
Include older records from before the condition got worse, if you have them; for a made-worse claim they can set the baseline. VA will request your VA records once you file. For private records, send copies or complete VA Form 21-4142 and VA Form 21-4142a.
Source: 38 CFR 3.310(b) (opens in new tab); 38 CFR 3.159(c)(1) (opens in new tab); 38 CFR 3.159(c)(2) (opens in new tab); VA Form 21-4142 (opens in new tab); VA Form 21-4142a (opens in new tab)
Ask your provider about a written opinion
If your provider will write an opinion on the link, it goes to VA with the claim. VA weighs an opinion by the reasons it gives.
Source: M21-1 V.ii.1.A (opens in new tab)
File VA Form 21-526EZ
List the new condition and name the service-connected condition it comes from. The form's own example reads: left knee, secondary to right knee.
Source: VA Form 21-526EZ (opens in new tab)
Go to any exam VA schedules
VA asks for a claim exam only when it needs more information. To change the time, call the number on your appointment letter at least 48 hours ahead. Missing an exam can delay the claim, and VA may then decide on the evidence it already has.
Source: VA.gov: VA claim exam (opens in new tab)

Good to know

The compensation card has the full secondary track

The VA Disability Compensation card covers secondary claims in full, next to first claims and increases. This card is the short version for a new condition tied to one VA already rates.

Source: 38 CFR 3.310(a) (opens in new tab); M21-1 V.ii.2.D (opens in new tab)

What a link opinion needs

VA decides each fact on whether it is at least as likely as not, and a close call goes to the veteran. An opinion VA can weigh says whether the service-connected condition at least as likely as not caused the new one or made it worse, and gives its reasons: the records it relied on and the medical reasoning. An opinion that only repeats your history, with no reasons, carries no weight. VA lists its Medical Opinion DBQ as not for public use.

Source: M21-1 V.ii.1.A (opens in new tab); 38 CFR 3.102 (opens in new tab); VA public Disability Benefits Questionnaires (opens in new tab)

Links the rules make for you

Heart or other cardiovascular disease that develops after a service-connected amputation of one leg at or above the knee, or of both legs at or above the ankles, is treated as caused by the amputation. After a service-connected moderate or severe TBI, the same applies, unless clear evidence shows otherwise, to Parkinsonism, unprovoked seizures, certain dementias that appear within 15 years, and hormone deficiency diseases that appear within 12 months. Depression counts if it appears within 3 years of a moderate or severe TBI, or within 12 months of a mild one. Outside those limits, VA decides the claim on the evidence.

Source: 38 CFR 3.310(c) (opens in new tab); 38 CFR 3.310(d) (opens in new tab); VA.gov: evidence needed for your disability claim (opens in new tab)

BeneVets is informational and is not an accredited representative. Free help: an accredited VSO can work through VA benefits with you at no cost. Find an accredited VSO near you