The Most Overlooked Secondary Claims Veterans Never File (And Why They're Missed)

Most veterans who've been through the claims process know the phrase "secondary condition." Far fewer have actually filed one for the conditions quietly sitting in their medical records right now. The gap isn't evidence — it's awareness. Here are the secondary claims that get left off applications most often, and the specific reasons each one slips through.

What actually counts as an overlooked secondary claim?

Under 38 CFR § 3.310, a secondary condition is anything caused or made worse by a condition you're already service-connected for — including side effects from its treatment. That definition is broad by design. The conditions below all fit squarely inside it, and all of them show up repeatedly in veterans' medical records without ever making it onto a claim.

Which secondary claims do veterans skip the most, and why?

Why does erectile dysfunction get left off so many claims?

This is the single most commonly missed claim in the disability system. ED and Female Sexual Arousal Disorder are frequently secondary to PTSD and depression medications (SSRIs/SNRIs), to hypertension medications (beta-blockers, diuretics), and to diabetes itself. The condition usually rates 0% on its own — which is exactly why veterans skip it. But loss of use of a creative organ triggers Special Monthly Compensation under 38 CFR § 3.350, an additional tax-free monthly payment (around $139.87) paid on top of every other rating, for life. The 0% schedular rating and the SMC-K payment are two separate things — filing gets you the second one even when the first one is zero.

Why do hypertension and GERD get overlooked as PTSD secondaries?

Because the connection isn't obvious from the outside. Chronic hyperarousal keeps stress hormones elevated, which raises blood pressure over time — hypertension secondary to PTSD is a recognized, frequently granted claim, but veterans tend to file hypertension (if at all) as its own unrelated condition rather than connecting it back to service-connected mental health. GERD follows the same pattern from a different angle: SSRIs and SNRIs relax the esophageal sphincter, and chronic stress itself increases stomach acid and disrupts digestion. A veteran taking a psychiatric medication for years who later develops reflux often never thinks to mention the medication when the GERD diagnosis shows up — so the file never makes the connection a nexus opinion needs to state explicitly.

Why does mental health secondary to scars almost never get filed?

Visible scarring or disfigurement is a legitimate, ratable service-connected condition on its own — and it's also a documented cause of depression, social withdrawal, and anxiety. This secondary claim is rare not because the medical link is weak, but because veterans are reluctant to describe how a scar affects them emotionally, or simply don't think an old visible injury still "counts" as something worth a new claim. It rates under the same mental health criteria as any other psychiatric claim once it's filed and connected.

Why do opposite-side joint conditions get missed?

A knee, hip, or ankle injury changes how you walk. Years of favoring one side puts abnormal, uneven stress on the joints on the other side of the body — a well-documented mechanism, not a stretch. Veterans with one bad knee frequently develop arthritis in the other one and file it as a new, unrelated condition, or assume it's ordinary aging. It's neither: it's a textbook secondary claim, and when both sides of a paired joint end up rated, 38 CFR § 4.26 (the bilateral factor) can add a small additional bump to the combined rating that's easy to miss if the second side never gets filed at all.

Why do veterans avoid filing new claims in general?

A quieter reason sits underneath all of the above: some veterans deliberately avoid filing anything new once they have a rating in place, worried that opening a new claim reopens the whole file to scrutiny. That risk is real in a narrow sense — a rater reviewing a new claim can notice an existing condition with no recent treatment and question it. But the answer isn't to leave money on the table; it's to keep treatment records current for the conditions you already have, so that a new secondary claim doesn't create an inconsistency for a rater to flag.

Bottom line

The claims that pay the most and go unfiled the most aren't complicated to prove — they're simply never connected out loud. If you take a medication for a service-connected condition, have a rating on one side of a paired joint, or live with a visible scar, ask a provider directly whether it could be linked to something you're already service-connected for. The nexus has to say it explicitly; it won't say it on its own.

Sources: 38 CFR § 3.310 (secondary service connection), 38 CFR § 3.350 (special monthly compensation ratings), 38 CFR § 4.26 (bilateral factor), VA.gov — eligibility for disability benefits.