How to Build a VA Secondary Condition Claim

Mission Brief

Secondary claims unlock the ratings you left on the table. When a service-connected condition snowballs into new diagnoses, the VA owes you for the chain reaction.

This playbook teaches you to diagram the causal chain—primary condition, treatment or biomechanics, secondary condition—then back it with medical nexus language that satisfies 38 CFR §3.310.

You’ll capture everything from prescription side effects to overcompensation injuries and mental health fallout, all while lining up the right lay statements, medical opinions, and forms so the VA can’t shrug it off as coincidence.

• Diagram the chain: show exactly how the primary condition or its treatment causes or aggravates the secondary issue.
• Secure the nexus: get a medical opinion that uses the right language—“at least as likely as not”—and references clinical data.
• Log the impact: track how the secondary condition affects work, sleep, mobility, or relationships just like any primary claim.

Key Takeaways

• Diagram the causal chain from the primary condition or treatment to the secondary diagnosis before you file.
• Secure a medical nexus opinion that uses “at least as likely as not” language and cites supporting records.
• Collect lay statements and side-effect documentation so the VA sees daily impact beyond the original disability.

Situation Brief

Pain shifts your gait and wrecks your back. PTSD keeps you from sleeping and triggers hypertension. Medication torches your liver. All of it can be service connected—if you show the link.

Pro tip: If the primary condition is still unrated, file the secondary claim at the same time so the VA cannot argue it lacks notice.

Secondary Claim Prep Checklist

Run this checklist before filing to confirm you have the medical opinion, records, and narratives that prove the link.

• List every service-connected condition, its rating, and when symptoms or treatments started.
• Request medical records showing diagnosis and ongoing treatment for the secondary condition.
• Secure a nexus opinion (DBQ, IMO, or treating provider letter) that states the secondary condition is “at least as likely as not” caused or aggravated by the primary disability.
• Document medication names, dosages, and side effects that support the causal chain.
• Collect lay statements from family, friends, or supervisors describing how the secondary condition changed your daily routine.
• Decide whether to file via VA Form 21-526EZ (new claim) or VA Form 20-0995 if you are within one year of a decision with new evidence.

Bundle secondary claims that share the same primary condition to keep the narrative clean and reduce duplicate exams.

Step-by-Step Playbook

1. Map the causal chain: Write out primary condition → treatment or biomechanics → secondary condition so every reviewer sees the logic.
2. Gather medical proof: Collect treatment notes, labs, imaging, and medication lists that document the secondary diagnosis and its link to the primary issue.
3. Secure a medical nexus: Ask a provider for a DBQ or letter stating it is “at least as likely as not” that the primary condition caused or aggravated the secondary condition, citing medical literature if possible.
4. Build lay support: Get statements from family, battle buddies, or coworkers that describe the timeline and day-to-day impact of the secondary condition.
5. File and label everything: Submit the claim with clearly labeled exhibits that match your cover memo, and point the rater to the nexus letter in the first paragraph.
6. Track the decision and next moves: Log VA requests, prep for possible C&P exams, and plan follow-on claims if additional complications surface.

If medication side effects are the culprit, attach the drug insert or medical literature proving the known complication—it strengthens the nexus opinion instantly.

Evidence Arsenal

Secondary claims live or die on the nexus. Surround that opinion with records, timelines, and lay statements that reinforce the cause-and-effect story.

Reminder: Label each upload with the exhibit number and the condition it supports so the rater can follow your cover memo without guesswork.

Intel & Tools

Keep your chain of evidence tight from filing to decision—track status, prep for exams, and be ready to escalate if the VA shrugs off the nexus.

• Weekly tracker updates: screenshot VA.gov status, note each call, and document who you spoke with about scheduling exams.
• Exam readiness: use the C&P Exam Playbook to prepare for medical questions about biomechanics, medication side effects, or aggravation.
• Fallback plan: if the VA dismisses the nexus, line up additional medical literature or an Independent Medical Opinion and pivot to a Supplemental Claim without delay.

Keep every timeline chart, nexus draft, and lay statement synced in your binder so the next reviewer can verify the chain in minutes.

Next Actions & Support

Stay in continuous pursuit. Each lane gives you a year—document the deadline the moment the decision hits your account.