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VA disability process / Secondary conditions
Secondary Service-Connected Conditions
Can a condition be service connected because another service-connected condition caused or worsened it?
A secondary condition is a current disability that is proximately due to, the result of, or aggravated by a service-connected condition. VA can recognize either causation or aggravation, but the relationship must be supported by evidence. A condition is not automatically secondary just because it appeared after another diagnosis.
Causation and aggravation are separate theories
Causation means the service-connected condition caused the claimed condition. Aggravation means it increased the severity of a separate condition beyond its natural progression. VA's regulation addresses both. For an aggravation claim, records showing the condition before and after the worsening may help establish the baseline and change.
Examples sometimes raised include radiculopathy related to a back condition, depression related to chronic pain, GERD related to medication, or sleep apnea claimed in connection with PTSD. These are examples only: VA does not presume the relationship in every case, and medical evidence may be needed to explain the specific link.
What the evidence should show
A medical opinion should address your records and explain why the primary condition caused or aggravated the secondary condition. A conclusion without reasoning may not resolve the issue. VA may request a C&P exam or opinion.
- A current diagnosed condition or other evidence of current disability.
- An already service-connected primary condition.
- A reasoned medical link showing causation or aggravation, when medical evidence is needed.
- For aggravation, evidence about the condition's baseline and how it worsened.
How to file
A secondary condition can be claimed with VA Form 21-526EZ. Name the condition and state which service-connected disability you believe caused or aggravated it. Include treatment dates, medical records, and any nexus opinion or lay statement that helps explain when the condition began and how it changed.
Do not wait for every possible record if a deadline is approaching. An Intent to File may preserve a potential effective-date anchor while you finish an eligible claim, but you must submit the complete claim within VA's time limit.
VA Form 21-526EZ: New and secondary conditions · VA: Intent to File · Evidence for a VA claim
Common mistakes
- Listing a secondary condition without identifying the service-connected primary disability.
- Assuming timing alone proves that one condition caused another.
- Using a template nexus letter that does not address your medical history.
- Failing to explain whether the theory is causation, aggravation, or both.
- Ignoring the decision-review deadline if VA denies the secondary claim.
Official sources
Related resources
This page is general information, not legal or medical advice. VA rules and procedures can change, and deadlines or eligibility depend on your records and circumstances. For help with your case, contact VA or a VA-accredited representative. For medical decisions, talk with your health care provider.