VA Secondary Conditions: Causation, Aggravation and Evidence
Quick answer
A secondary condition is a disability caused by, or made worse by, a condition VA has already service-connected. Under 38 CFR 3.310, a disability “proximately due to or the result of” a service-connected condition is itself service-connected, and an increase in a non-service-connected condition caused by a service-connected one (beyond natural progress) can also be compensated. Medical evidence linking the two is the core of the claim.
Two ways to connect a secondary condition
| Causation | Aggravation | |
|---|---|---|
| What it means | The service-connected condition caused the new condition | The service-connected condition made an existing non-service-connected condition worse |
| Regulation | 38 CFR 3.310(a) | 38 CFR 3.310(b) |
| What VA compensates | The secondary condition, rated on its own | Only the increase above a baseline level of severity, minus natural progress |
| Key evidence | Medical opinion explaining the causal link | Medical evidence of the baseline and the increase |
The baseline in aggravation claims
For aggravation, VA needs a baseline: the level of severity of the non-service-connected condition before the aggravation, ideally from medical evidence created before it began (or the earliest available records). VA then rates the current severity and subtracts the baseline and any natural progression. Records that document the condition before and after the change matter.
Evidence that tends to matter
- A diagnosis of the secondary condition.
- Your existing service connection for the primary condition.
- A medical opinion that explains how the primary condition caused or aggravated the secondary one, with reasoning tied to your records. See C&P exams for how VA may obtain one.
- Treatment records showing timing and progression.
How to file
- File a new claim (online or VA Form 21-526EZ) and identify the primary service-connected condition.
- Submit or identify the medical evidence supporting the link.
- Attend any exam VA schedules.
- Once rated, the secondary condition is combined with your other ratings (see how combined ratings work).
Common mistakes
- Claiming a link without any medical reasoning; a diagnosis alone usually isn’t enough.
- In aggravation claims, not providing evidence of the condition’s earlier baseline.
- Treating a worsened primary condition as a secondary claim. That is an increase claim.
Working with someone on your claim? Learn what a VA-accredited representative is and how to verify one before you sign anything.
Common questions
What is a secondary service-connected condition?
A disability that was caused or worsened by a condition VA has already service-connected. VA treats it as service-connected under 38 CFR 3.310.
What is the difference between causation and aggravation?
Causation means the service-connected condition caused the new one. Aggravation means it made an existing non-service-connected condition worse beyond its natural progress; VA compensates only that increase.
Do I need a medical opinion for a secondary claim?
The link between the two conditions is a medical question, so a reasoned medical opinion, from VA’s examiner or your own provider, is usually central.
What form do I use for a secondary condition?
The standard disability application, VA Form 21-526EZ, or the online claim.
Can a secondary condition increase my combined rating?
It can. Each new rating is combined with your existing ratings using VA’s combined ratings table.