What Is a Secondary Service Connection—and Why It Matters
Imagine this: you injured your right knee in the military and got it service-connected. Years later, your left hip starts hurting. This isn’t just aging—it might be arthritis that developed because you adjusted how you walk due to that knee injury.
The Department of Veterans Affairs (VA) recognizes that some conditions don’t appear immediately after service but emerge over time as a result of an already service-connected disability. This is called a secondary service connection, and it’s covered under 38 CFR 3.310. According to this regulation, you can receive compensation if:
- The secondary condition was proximately caused by a service-connected condition, or
- It was aggravated (made worse) by a service-connected condition beyond its natural progression.
But these claims aren’t granted automatically. You need medical evidence showing the link between the two conditions.
Arthritis as a Secondary VA Disability
Arthritis, particularly osteoarthritis, is one of the most common disabilities among veterans. It often arises from altered biomechanics—how your body compensates for pain or dysfunction. For example, limping due to a knee injury can shift pressure to the opposite hip, causing degeneration over time.
According to the VA Annual Benefits Report (2024), musculoskeletal conditions like arthritis are consistently among the top three most commonly compensated service-connected disabilities.
Common service-connected conditions that may cause secondary arthritis include:
- Knee injuries (e.g., ACL tears, instability, meniscus removal)
- Ankle fractures or chronic sprains affecting gait
- Hip replacements or injuries changing posture
- Lower back issues impacting weight distribution
- Foot problems like flat feet or plantar fasciitis, altering the kinetic chain
Example:
A veteran with a service-connected right ankle injury develops pain in their left knee years later. Medical imaging confirms osteoarthritis. If a physician explains that the altered gait caused by the original injury led to joint overuse on the other side, this could qualify as arthritis secondary to VA disability.
What You Need: The Nexus Letter and Supporting Medical Opinion
The most critical piece of evidence in a secondary claim is a medical opinion, often referred to as a nexus letter.
A nexus letter must come from a qualified healthcare professional who has reviewed your records and can clearly explain the cause-effect relationship between your conditions.
Why This Knowledge Matters for Your Claim
Many denied claims aren’t due to a lack of medical problems—but a lack of clear linkage between those problems.
Understanding the concept of secondary service connection helps you:
- Speak more effectively with your doctors about potential connections
- Ensure your medical records reflect symptom progression and compensatory changes
- Avoid gaps in documentation that could cause your claim to be denied
Arthritis doesn’t always begin in service—but it may still be tied to your service-connected conditions.
Remember, veterans deserve the support they’ve earned. If you want to learn more about medical evidence, contact our team of experts. Start your FREE Medical Evidence evaluation today or watch real testimonials and stories of our clients.
