If you’re only rated for one condition with the VA, there’s a good chance you’re leaving compensation on the table. Many veterans don’t realize that conditions caused by or aggravated by an already-service-connected condition can be claimed on their own — and rated on their own — through what’s called a secondary service connection.

Below are five commonly approved secondary conditions, what typically causes them, and how to build a claim the VA won’t just deny on sight.

What Is a Secondary Condition, Exactly?

Under 38 CFR § 3.310, a secondary condition is one that was caused or made worse by a condition you’re already service-connected for. The key difference from a direct claim is the link you have to prove: instead of connecting a condition straight back to your time in service, you’re connecting it to a service-connected condition you already have.

That link — usually established through a nexus letter or your medical records — is what separates an approved secondary claim from a denied one. And because secondary conditions are rated independently, they can meaningfully raise your combined rating, sometimes by 10, 20, or more percentage points.

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The 5 Conditions

1. Sleep Apnea

Sleep apnea is one of the most frequently approved secondary conditions, and it’s commonly linked to:

• PTSD or other mental health conditions
• Weight gain caused by limited mobility from an orthopedic condition
• Certain medications prescribed for service-connected conditions

A sleep study showing obstructive sleep apnea, combined with medical evidence connecting it to your primary condition, is typically the core of this claim.

2. Depression / Anxiety

Chronic pain, tinnitus, and orthopedic conditions can all take a real toll on mental health over time. When a primary physical condition leads to a diagnosed mental health condition, that mental health condition can often be claimed secondarily — and mental health ratings can climb quickly depending on how significantly they affect daily functioning.

3. GERD / IBS

Gastrointestinal conditions like GERD and IBS are frequently tied to:

• PTSD and chronic stress
• Long-term use of NSAIDs or other medications for orthopedic pain

If you’ve been prescribed pain medication for a service-connected condition and later developed stomach or digestive issues, that connection is worth documenting.

4. Erectile Dysfunction

ED is commonly secondary to:

• Diabetes
• Certain PTSD medications
• Back and spine conditions affecting nerve function

Even when rated at 0%, a secondary ED claim can qualify you for Special Monthly Compensation (SMC), which is a separate form of additional compensation — so it’s worth claiming even if the percentage itself looks small on paper.

5. Peripheral Neuropathy

Nerve-related conditions like peripheral neuropathy are often connected to:

• Diabetes
• Back conditions where nerve compression or damage is present

Because neuropathy is rated per limb, this is one of the secondary conditions that can add up the fastest across a combined rating.

How to Actually File a Secondary Claim

Filing the claim itself isn’t complicated — building the evidence behind it is where most veterans lose ground. A few things that make the biggest difference:

• Get a nexus letter. This is the document that explicitly connects your secondary condition to your primary one. Without it, you’re relying on the VA to make that connection themselves, which they often won’t.
• Gather supporting medical evidence. Diagnosis records, treatment history, and any notes from your provider about the relationship between the two conditions.
• File using VA Form 21-526EZ, and clearly state which condition you’re claiming and which service-connected condition it’s secondary to.
• Watch for common denial reasons — vague nexus language, missing diagnosis documentation, or no clear medical opinion connecting the two conditions.

Don’t Have a Nexus Letter Yet?

We put together a free Nexus Letter Directory as a starting point for finding providers who write these letters. A couple of things worth knowing before you use it:

We don’t vet or endorse any provider listed in the directory — it’s simply a resource to help point you in the right direction. Always do your own due diligence, and remember you can absolutely use your own personal doctor too if they’re willing to write one. Either way, make sure whoever writes it actually reviews your records and speaks to the medical link — not just your account of it.

More Free (and Paid) Resources

If you’re working through your own claim strategy, a few other things on the site might help:

• Brainstorm Self-Assessment (free) — work through your own conditions and spot claims you might be missing
• VA Claims Dashboard (paid) — organize your full claim strategy across direct, secondary, presumptive, and appeals in one place
• Facebook Group — connect with other veterans working through claims and ratings together