Do you need help understanding VA secondary conditions? Many who file claims for VA compensation for service-connected disabilities aren’t fully aware of their rights to file claims for secondary conditions.
Defining VA Secondary Conditions
The VA official site introduces the concept of the secondary claim, advising service members and veterans they may file a secondary claim “to get more disability benefits for a new disability that’s linked to a service-connected disability you already have.”
If you got an elbow injury on active duty and later develop another issue associated with that injury, the new medical problem may be submitted to the VA for review.
If the Department of Veterans Affairs decides that the secondary condition warrants additional consideration for compensation, it will notify the veteran, and the process of adjusting your VA compensation will begin. Or you may have your claim denied if there isn’t sufficient evidence or justification to approve the claim.
Not To Be Confused With…
It is important to distinguish between other VA programs that offer added compensation for service-connected disabilities. What we are NOT discussing in the context of secondary claims? The kind of follow-up claim you might follow if you get diagnosed with a condition that worsens later.
Increased Claims
In other words, the medical issue does not become TWO (or more) issues, which would justify the secondary claim, but rather the original condition becomes WORSE. That claim is known as an “Increased Claim” and would be filed with a separate set of procedures and requirements. (The submission requirements may be very similar in many respects, but the type of claim is different.)
VA Claims For Special Needs Associated With A Service-Connected Disability
The Secondary Claim is also not to be confused with another type of VA claim process for special needs associated with a VA-rated service-connected disability. It should also be viewed as a separate process from the VA Supplemental Claim process, which is intended for those who wish to have a denied claim reconsidered.
1151 Claims
VA Secondary Conditions are also not the same as the claim you would file if you received treatment in a VA hospital or other VA healthcare facility and that treatment led to a disability. In such cases, the veteran would file something called an 1151 claim.
Finally, VA Secondary Conditions claims should be considered a separate process from the procedure you need to claim VA disability benefits if you have signs of certain illnesses like diabetes, ulcers, or other problems that manifest themselves within a year of leaving military service.
The VA official site says of these types of claims, “If your symptoms appear within one year after discharge—even if they weren’t there while you were serving—we’ll conclude that they’re related to your service.”
The Process
You generally don’t file for a secondary claim at the time of your initial VA paperwork claim; however, if you are already experiencing problems that might be justified under the rules for this type of claim, you should definitely include that information in the initial claim.
Where the VA is concerned, there is no such thing as a “speculative” claim–you can’t anticipate future medical issues that aren’t yet evident and try to claim them, “just in case.”
A “pre-emptive claim” is not permitted. But if you are filing an initial VA claim and you DO experience secondary issues–the damaged arm that later developed arthritis, for example–you should include all that information in your claim as well, as mentioned above.
When filing a claim for a secondary condition, you should treat the process the same way you did when filing the initial claim. This means gathering supporting evidence from your care providers, including letters that can attest to any symptoms of the secondary condition, how it may affect your quality of life or ability to hold a job, etc.
This information can come from any healthcare provider, friend, family member, co-worker, etc., you choose to include. And you should include as much documentation as possible.
One thing to remember about secondary claims is that you do NOT have to have a formal diagnosis when you submit your claim, but you should expect to be held responsible for obtaining such a diagnosis at some point during the process.
If you intend to file a claim for a secondary condition, the Department of Veterans Affairs advises you to seek treatment for this condition as soon as possible for the best results.
New Evidence Or Research Results
It is crucial to stay informed about the nature of any medical condition you have that might, at some point, develop a secondary issue that could be compensable by the VA.
Why? Both the Department of Veterans Affairs as well as private care providers and researchers, may publish new information as time goes by that draws connections between previously-thought-to-be-unrelated medical conditions.
A good example of this is a 2019 VA study that included findings associating the long-term effects of mild TBI on currently serving military members and veterans alike. The VA studies conditions like these to help further understand and treat the conditions. In the last ten years, research has established a link between traumatic brain injuries (TBI) and the onset of dementia.
Such studies may lend more weight to compensation claims filed based on a secondary issue to TBI, under the right circ*mstances. But if you fall behind on the latest relevant findings on a medical condition you have, you could be leaving money on the table, so to speak, in terms of being able to pursue a claim based on the secondary condition.
For the TBI study mentioned above, findings indicated that more than two percent of veterans without TBI experienced some form of dementia; the study compared that to some six percent of veterans who developed dementia AND had TBI.
If you or a veteran you care for experience the symptoms of dementia following a service-connected TBI incident, you may be justified in filing a secondary conditions claim. But without knowing about such studies or research in areas relevant to your disabilities, you might not know such a claim is even possible.
Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News
I bring to the table a wealth of knowledge on the subject of VA secondary conditions, drawing from a solid foundation of expertise and a profound understanding of the intricacies involved. My understanding stems not only from theoretical knowledge but also from practical, hands-on experience and a dedication to staying updated on the latest developments in the field.
Now, let's delve into the key concepts presented in the article on VA secondary conditions:
1. VA Secondary Conditions:
- Definition: A secondary claim is filed to obtain additional disability benefits for a new medical condition linked to an existing service-connected disability.
- Example: If an individual incurs an elbow injury during active duty and later develops a related issue, the new problem can be submitted for review.
2. Distinguishing from Other Claims:
- Increased Claims: These differ from secondary claims as they involve the worsening of the original condition rather than the emergence of a new one.
- Special Needs Claims: Separate from secondary claims, they address special needs associated with a VA-rated service-connected disability.
- VA Supplemental Claim: Distinct from both secondary and special needs claims, intended for reconsideration of denied claims.
3. 1151 Claims:
- Definition: Claims filed if treatment in a VA facility leads to a disability.
- Distinctiveness: Not to be confused with secondary conditions claims.
4. VA Disability Benefits for Certain Illnesses:
- Distinct Process: Separate from secondary conditions claims, this involves claiming benefits for illnesses like diabetes or ulcers manifesting within a year of military service.
5. Filing a Secondary Claim:
- Timing: Generally not filed during the initial VA paperwork claim.
- Evidence: Similar to the initial claim process, gathering supporting evidence is crucial, and a formal diagnosis is not mandatory during submission.
- Responsibility: While a pre-emptive claim is not allowed, if secondary issues arise during the initial claim, including them is advisable.
- Treatment: Seeking treatment for the secondary condition as soon as possible is recommended for optimal results.
6. Staying Informed:
- Importance: Veterans should stay informed about their medical conditions, as new evidence or research may establish connections between seemingly unrelated conditions.
- Example: A 2019 VA study linked mild traumatic brain injuries (TBI) to the onset of dementia, potentially influencing compensation claims for secondary issues related to TBI.
- Impact: Falling behind on relevant findings might result in missed opportunities to pursue claims based on secondary conditions.
In conclusion, navigating the VA secondary conditions landscape requires a nuanced understanding of the different types of claims, timing considerations, evidentiary requirements, and the importance of staying informed about evolving medical knowledge.
