Secondary service connection
Conditions secondary to PTSD
Veterans with service-connected PTSD often claim other conditions as caused or worsened by it. This page lists those conditions, what VA needs to grant them, and how they fared when veterans appealed to the Board of Veterans' Appeals.
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of the secondary condition.
- PTSD is already service connected.
- Medical evidence linking them (a nexus opinion): the secondary condition was caused by PTSD (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
Conditions claimed secondary to PTSD
Conditions the Board decided at least 300 times as secondary to this disability, highest appeal grant rate first. Open one for the evidence and reasons behind the decisions.
- Major depressive disorder secondary to PTSD305 decisions · 62.0% granted
- Migraine secondary to PTSD1,732 decisions · 37.1% granted
- Sleep apnea secondary to PTSD11,479 decisions · 31.7% granted
- Erectile dysfunction secondary to PTSD1,645 decisions · 30.3% granted
- Gastroesophageal reflux disease (GERD) secondary to PTSD1,237 decisions · 25.3% granted
- Irritable colon syndrome (spastic colitis mucous colitis) secondary to PTSD380 decisions · 24.2% granted
- Diabetes mellitus secondary to PTSD551 decisions · 20.3% granted
- Hypertension secondary to PTSD3,194 decisions · 16.5% granted
All Board decisions on PTSD, direct and secondary: PTSD grant rates.
Rules that apply to secondary claims
- 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - M21-1 V.ii.2.D
Secondary service connection and aggravation of non-service-connected disabilities
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer - 38 CFR 4.130 · DC 9411
Schedule of ratings: mental disorders
Read it in VA Law Explorer - 38 CFR 3.304(f)
Service connection for PTSD
Read it in VA Law Explorer - M21-1 V.iii.13
Mental disorders: scope of the claim, change of diagnosis, reductions
Read it in VA Law Explorer - M21-1 IV.i.3.B.1.d
Reviewing a mental health examination report
Read it in VA Law Explorer
Research your secondary case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.