How do I get a condition secondary service connected?

To get a condition secondary service-connected, you must show three things: (1) a current diagnosis of the secondary condition, (2) a primary condition that is already service-connected, and (3) medical evidence linking the two.

What "Secondary Service Connection" Means

A secondary service connection is when the VA recognizes a new disability as service-connected because it was caused by (or made worse by) a disability you already have that is service-connected. ¹²

The Three Requirements

1. You Must Have a Service-Connected Primary Condition

• The primary (first) condition must already be service-connected. ¹²
• The primary condition does not need to have been formally diagnosed or service-connected at the time the secondary condition started. ¹
• Example: You had back pain for years before it was formally diagnosed as radiculopathy and service-connected, but you can still claim a shoulder injury as secondary to that back condition if you show the link. ¹

2. You Must Have a Current Diagnosis of the Secondary Condition

• You must have a current medical diagnosis of the condition you are claiming as secondary. ¹²

3. You Must Show Medical Evidence Linking the Two

• You must provide medical evidence (such as a doctor's opinion) that shows the secondary condition was caused by, or would not have occurred but for, the primary service-connected condition. ¹²
• This is called "but-for causation" — meaning the secondary condition would not have happened if the primary condition had not existed. ¹
• The evidence does not need to prove the primary condition caused permanent worsening; even temporary or partial worsening counts. ¹

Special Rule: Aggravation of a Non-Service-Connected Condition

If you are claiming that a service-connected condition made a non-service-connected condition worse, you must also:

• Establish a baseline (the severity level before it got worse) using medical records created before the worsening started, or the earliest records available. ¹²
• Show that the worsening was caused by the service-connected condition, not by the natural progress of the non-service-connected condition. ¹²

Important Notes

• Lay evidence (your own statement) alone may not be enough to establish a baseline, but it can support the claim and may require the VA to develop more evidence. ¹
• The VA will apply a broad "but-for" standard of causation, not a stricter standard. ¹
• Once secondary service connection is granted, the secondary condition is considered part of the original service-connected condition. ²