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How to Increase VA Rating Through Secondary VA Claims

How to Increase VA Rating Through Secondary VA Claims

Video Transcription

Nick Briggs: Welcome to CCK Live, everyone. My name is Nicholas Briggs and I’m joined today by Kaitlyn Degnan and Alex Gamache. In this video, we’re going to explain how veterans can increase their ratings through filing claims for secondary service connection. First, to get us started, Alex, could you tell us a bit about what secondary service connection is?

Alex Gamache: Sure. I’ll first talk about service connection in general. Service connection is the acknowledgement that your current disability is related to, caused by, or aggravated by your time and service. A grant of service connection entitles a veteran to certain benefits from VA, depending on their assigned disability rating. If a client has a secondary service connection, that’s basically a condition that is caused by or led by your service-connected disability.

We have a couple examples that we wanted to go over to kind of put the picture together. The first would be PTSD. Sometimes PTSD can cause increased stress and anxiety, which can later lead to hypertension. So, clients can file hypertension secondary to their PTSD.

Nick: Perfect. Thanks, Alex. Now that we know a bit about how secondary service connection claims work, Kaitlyn, can you tell us how to apply for these benefits? Is that, at all, different from a traditional claim?

Kaitlyn Degnan: Filing for secondary service connection involves the same process as requesting service connection for any other initial claim. A veteran is going to fill out and submit a VA form 21-526 EZ, and that’s just VA’s application for disability compensation and related compensation benefits. And just like any other initial service connection claim, a veteran can do this online using the eBenefits portal, in person at their local regional office, via the mail, or with the help of an accredited veteran’s advocate or attorney.

When you are filing this claim, you are going to need to demonstrate, basically, two things in order to establish service connection. One, you need to show that you have a current diagnosis of a secondary injury, illness, or disability. And then you also need to show medical evidence showing a link between your service-connected condition and that secondary condition that you’re claiming for. We should also note that you can file multiple secondary service connection claims and become service-connected for multiple secondary conditions. Just because you’ve been service-connected for, say, diabetes and you get service connection for that peripheral neuropathy as secondary to that, that doesn’t preclude you from also claiming secondary claims for other issues that might be secondary to that diabetes. So, you’re not just limited to one. You can have multiple.

Nick: Yeah. And like you mentioned, with diabetes, in particular, it’s not just the neuropathy but it might be hypertension, it might be chronic kidney disease. There are loads of different recognized residuals that come with diabetes, in particular. And oftentimes, the rating schedule will technically instruct raters to consider those separate ratings as a part of the underlying condition, but it’s always safer to file that secondary service connection claim because you want to get VA’s attention. Submit their form, play by their rules, at least initially, and then they’ll start adjudicating your claim, hopefully.

With that in mind, one of the key things that you mentioned is, sort of, the shift from the three traditional elements of service connection to two. We don’t really need to worry about the in-service element here because the primary service-connected disability stands in for the in-service element. We’re really talking current diagnosis and then a nexus medical opinion linking that condition to what you’re currently service-connected for.

With that in mind, when you’re thinking about the types of evidence you want to submit in support of your secondary VA claims, first and foremost, we need to be thinking about medical evidence. This can come both from your VA healthcare providers or any private physicians that you see. But it really is going to be important that both show that you’ve been diagnosed with these conditions. And if possible, get a nexus opinion from your private examiner or from your VA physician.

But realistically, this is a situation where VA’s duty to assist is going to kick in. If you put them on notice that you think you have conditions related to your service-connected disability, odds are, they’ll provide you with a compensation and pension exam. But either way, medical evidence is a great place to start and hopefully, get that process kick-started.

Alex, with that in mind, are there any other types of evidence that might be helpful in establishing secondary service connection?

Alex: Yes. So, lay evidence may also be helpful in helping you demonstrate service connection. Veterans can submit lay statements outlining how their already service-connected conditions caused or impacted their secondary condition. Those close to the veteran, such as family members, co-workers, fellow service members, they can also submit statements corroborating what the veteran’s claim is and describing any symptoms they may have witnessed. Notably, as of January 2021, VA does require that lay evidence be submitted using VA form 21-10210.

The other two helpful pieces of evidence may include service and employment records. Service records are important evidence in secondary claims. They usually include the veteran’s DD214, which details the locations in which they served, performance evaluation, and service medical records. Additionally, employment records can further demonstrate how the secondary disability impacts the veteran. Maybe it causes them to miss substantial amounts of work or has resulted in poor focus or job performance, all of which should be reflected in the veteran’s employment records.

Nick: Great. Thanks, Alex. Up to this point, we’ve largely talked about how to go about getting service-connected for secondary disabilities. But Kaitlyn, could you tell us a bit more about what happens once service connection for a secondary condition is granted?

Kaitlyn: Sure. Once secondary service connection is established, VA is going to assign a disability rating to that secondary condition just like with any other condition. VA will rate that secondary disability the same way it rates other conditions that are service-connected on a direct basis using VA’s schedule for rating disabilities. Each condition is rated using a diagnostic code in the rating schedule and VA is going to look at the severity of your symptoms and the level of resulting impairment to determine the percentage in the diagnostic code that best approximates to your level of disability. And that’s what they will use to decide your disability rating.

If you have multiple service-connected conditions, those ratings are going to be added together using the combined ratings table or, what some might like to call, VA math. The combined disability rating is going to determine what your monthly benefit amount will be.

Nick: Thanks, Kaitlyn. Like you mentioned, this is sort of where VA math comes into play. It’s nobody’s favorite subject by a long shot, but it’s important to understand because as veterans get more and more secondary conditions granted, they tend to just assume that, “Oh, I was at 50 before and I have 40 more now, I must be at 90.” But unfortunately, that’s not how the combined rating process works.

When calculating a combined rating, VA starts with the premise that a veteran is 100% efficient, or not disabled. If a veteran has a disability of 20%, then VA sees them as 80% non-disabled and then 20% disabled. With that baseline 20 in mind, if an additional disability is granted at, say, 10%, VA is only going to take that 10% from the remaining 80% efficient individual and then combine the result of that 10% and the original 20%. So, rather than a veteran being 20 plus 10 equals 30, they’re actually only going to be 20 plus 8 equals 28.

Now at such low ratings, that doesn’t mean too much because either way, you’re going to be rounded up to 30% and you’re going to get the same combined rating either way. But as you get higher and higher and there’s less and less of the “efficient person” left to add from, it becomes harder and harder to get to that next level of combined rating.

It’s a complicated subject and we have many more Facebook lives or CCK lives available for you to go through that process in more detail. But with combined ratings and VA math in mind, Alex, how do secondary service connection claims help you increase your rating?

Alex: Yeah. If a veteran files for and is granted service connection on a secondary basis, they’ll get a separate rating, like Nick explained. And also like Kaitlyn explained, you can get secondary service connection for more than one condition. You’re not just limited to one. The more conditions you have that are service-connected, the higher your combined rating, therefore, your higher, greater disability compensation monthly.

To calculate your combined rating instead of doing the math, like Nick had talked about, we do have a VA calculator that’s linked below, which, easily, you’ll be able to put in your ratings for each condition, and then what your total rating should be.

Additionally, if your disabilities prevent you from working, a grant of secondary service connection might also help you meet the qualifications for schedular TDIU. We have a ton of Facebook lives on how to get schedular TDIU. But essentially, TDIU compensates veterans at the 100% level even if their combined rating does not equal 100%. The amount of compensation for veterans getting the 100%, or TDIU, is about $3300 a month.

Nick: Great. Thanks, Alex. Thank you both for taking the time out of your day to go over these important subjects with us. Is there anything else about secondary service connection and combined ratings, generally, that you’d like to share with our audience?

Kaitlyn: I would say, Nick, as you mentioned before, there are certain diagnostic codes that require the VA to look into the secondary issues. But this is, yet again, one reason why it’s so important that if you’re going in for that C&P, if you’re seeing your treatment provider, it’s so important to make sure that you’re telling them about all of the effects of your disabilities. Because even if you may not realize that something is something that could be secondary to your service-connected disability, this is how you can discover it. So, it’s so important to be honest with your C&P examiner, to be honest with your treatment provider, to make sure that all of that gets documented and into the record.

Nick: Absolutely. Thanks for that, Kaitlyn.

Thank you all for joining us. Be sure to explore our website for more information on this and other subjects. I do especially recommend our videos on VA math. Like I said, it gets complicated very fast. And don’t forget to subscribe to our YouTube channel so that you’ll never miss a video. Thank you all for joining us.