If your VA claim was denied or you didn’t receive the disability rating you deserve, you may benefit from a nexus letter.
A nexus letter helps connect your condition to your military service while providing validity to your VA claim.
In this post, we’ll explore how a nexus letter for sleep apnea secondary to depression can be the key to winning your VA claim and how the team at Telemedica can assist you.
A nexus letter for sleep apnea secondary to depression connects your service-related depression to the development or worsening of sleep apnea, providing essential medical evidence to support your VA claim.
Sleep Apnea and Depression Are Linked: Depression can lead to weight gain and sleep disturbances, which increase the risk of sleep apnea. Each condition can worsen the other, creating a challenging cycle.
To establish a service connection for sleep apnea secondary to depression, you need a current diagnosis of both conditions, along with medical evidence showing the link between them.
The VA rates sleep apnea secondary to depression based on severity and treatment requirements, with ratings ranging from 0% to 100%, depending on the use of breathing assistance devices and other factors.
Nexus Letter for Sleep Apnea Secondary to Depression
A nexus letter for sleep apnea secondary to depression is essential evidence when applying for VA benefits.
For example, weight gain from overeating as a coping mechanism for mental distress can lead to sleep apnea. This secondary mechanism is significant because weight gain is the number one risk factor for developing the condition.
Having this information in your nexus letter can prove vital in receiving the VA disability benefits you rightfully deserve.
Obtaining a nexus letter is strongly recommended to strengthen your claim because it links your service-connected depression to the development or worsening of sleep apnea.
Nexus letters provide a healthcare provider’s professional opinion and medical rationale, clearly stating that your sleep apnea is the result of your service-connected depression.
The connection between sleep apnea and depression is complex and bidirectional, meaning each condition can influence and exacerbate the other.
A 2003 study at the Stanford University School of Medicine found that people with depression are five times more likely to have a breathing-related sleep disorder than non-depressed people.
In addition, research shows that a 10% weight gain is associated with a sixfold increase in risk of obstructive sleep apnea (OSA). It’s also proven that there is a link between depression and weight gain, which can further increase your risk for sleep apnea.
Depression can disrupt normal sleep patterns, contributing to conditions like insomnia or hypersomnia. These sleep disturbances can worsen sleep apnea by influencing how the body regulates breathing during rest.
The combination of sleep apnea and depression can create a vicious cycle. Poor sleep from sleep apnea exacerbates depressive symptoms, while depression can make it harder to seek or adhere to treatment for sleep apnea, like CPAP therapy.
However, effective treatment of one condition can often alleviate the other. For example, managing sleep apnea with CPAP or other interventions can improve mood and reduce depressive symptoms.
Similarly, treating depression with therapy or medication may lead to better sleep hygiene and fewer apnea episodes.
Proving Service-Connection for Sleep Apnea Secondary to Depression
You must prove service connection when filing a VA disability claim for sleep apnea secondary to depression.
Service connection requires:
A current medical diagnosis of sleep apnea from a sleep study AND
A current service-connected primary disability (Depression) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (Depression) AND the current disability you’re trying to connect secondary (Sleep Apnea)
You’ll be required to attend a sleep study to receive an accurate sleep apnea diagnosis. A sleep study helps identify evidence of irregular breathing, gasping, and other obvious signs of sleep apnea.
How the VA Rates Sleep Apnea Secondary to Depression
The VA rates sleep apnea secondary to depression at 0%, 30%, 50%, and 100%, depending on the severity, frequency, duration of symptoms, and whether the use of a breathing assistance device is required.
The highest VA rating for sleep apnea secondary to depression is 100%, with most veterans receiving a 50% rating for obstructive sleep apnea.
How Telemedica Can Support You in Obtaining Your Nexus Letter
Understanding the need for a nexus letter for sleep apnea secondary to depression may strengthen your claim. The licensed, trusted professionals at Telemedica can provide you with anexus letter, paving the way to the benefits you rightfully deserve.
Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?
Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims.
Schedule your FREE 20-minute consultationand learn how to get the supporting medical evidence you need to strengthen your claim.
Post-traumatic stress disorder (PTSD) affects many veterans, frequently because of traumatic experiences encountered during their service.
However, talking about PTSD isn’t always easy, especially due to the stigma around mental health conditions.
The post is to help guide veterans with PTSD through essential conversations in a way that is respectful and supportive.
Understanding PTSD
Before you discuss PTSD with others, it’s important to understand it yourself. PTSD is a mental health problem that develops after you go through or see a life-threatening event.
It’s normal to have stress reactions to these events; however, most people start to feel better after a few weeks. If your symptoms last longer than a month and are causing problems in your life, it could be PTSD.
Explaining your PTSD to family members can be a daunting task and you might worry about their reaction.
However, sharing your PTSD with your loved ones can lead to a greater understanding and support of your situation.
Ten tips for talking to your family about PTSD
Prepare yourself emotionally and reflect on what you want to share.
Anticipate potential questions they might ask to help mentally prepare yourself.
Select a time and place where you can talk without interruptions.
Start by explaining what PTSD is. You can start with a simple definition: “PTSD is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it.”
Remind your loved ones that it’s not something you chose, and you can’t “just get over it.”
Share your personal experience and current symptoms. (Remember to share to the level you feel comfortable with.)
Discuss your triggers and coping mechanisms to help your family know how to support you better.
Don’t be afraid to set boundaries, while letting them know what support you need.
Consider seeking professional help together, as a therapist can provide valuable insights and help facilitate the discussion.
Remember, your journey with PTSD is unique, but sharing it with your family can help lighten the load and foster a sense of understanding and connection.
How to Talk About PTSD With Your Doctor
Discussing PTSD with your doctor can be intimidating, but it’s an essential step to getting the help and support you need (and deserve!).
Taking some time to prepare beforehand and being honest and open, can help your doctor develop an effective treatment plan tailored to your needs.
Remember, seeking help is a sign of strength and can lead to meaningful and positive changes in your mental health.
Things to consider when speaking to speaking with your doctor are:
Prepare before your appointment (i.e.: make a list of your symptoms and their severity, write down about any specific traumatic events, and what coping mechanisms you’ve tried)
If possible, choose a doctor with experience with mental health issues.
Be honest and open, while using direct and clear language to describe your feelings and behavior.
Describe your symptoms in detail to help your doctor better understand the extent of your condition.
Don’t hesitate to ask questions about PTSD, including potential treatment methods.
Schedule regular follow-up appointments to monitor your progress and make necessary adjustments to your treatment plan.
Consider a referral to a specialist, who may be better suited to help with PTSD.
Talking to fellow veterans with similar experiences can be incredibly supportive and impactful. For example, you can join support groups that provide a safe space to share experiences and coping strategies.
A few tips for these conversations include:
Be respectful and supportive while remembering that every veteran’s experience with PTSD is unique.
Be mindful of triggers or certain topics that are sensitive to your fellow veteran.
Share resources that have helped you with PTSD, including books, websites, or mental health professionals specializing in treating veterans
Connect with the Veterans Crisis Line
You can confidentially connect with someone anytime day or night through the Veterans Crisis Lineby:
Dialing 988 and Selecting 1
Starting a confidential chat online
Texting 838255
The Veterans Crisis Line serves Veterans, service members, National Guard and Reserve members, and those who support them.
Note: You do not have to be enrolled in VA benefits or healthcare to connect.
It’s vital to remember that asking for help or admitting you are suffering, doesn’t mean you’re weak. The virtues of strength and bravery are highly valued in the military—and rightly so.
However, cultural prejudices and stereotypes have skewed those virtues into something they were never intended to be; a tough guy (or gal) who masks what’s happening inside.
The stigma surrounding mental health conditions is illogical and unproductive and could keep you from recognizing the extent of your condition and getting the help you need.
Post-traumatic stress disorder (PTSD) is primarily known for its psychological, emotional, and mood symptoms, but it can have a significant impact on your life in other ways.
PTSD can lead to physical symptoms that affect daily life, from trouble sleeping and muscle tension to chronic pain and digestive issues.
Recognizing when physical signs of PTSD manifest will help ensure you receive the proper care and treatment.
This guide will cover seven physical symptoms of PTSD in veterans, treatment options, and why it’s essential to reach out to your doctor.
PTSD in Veterans
If you’ve witnessed or experienced a traumatic event, you’re at risk of developing PTSD. People with PTSD may experience angry outbursts, negative thoughts, avoidance symptoms, and are easily startled.
Research shows that at some point in their life, 7 out of 10 veteranswill have PTSD. The number of veterans with PTSD varies by service era, with a significant number from Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF).
Risk factors for PTSD include, but are not limited to:
Deployment
Traumatic brain injuries (TBI)
Reintegration stress
Lack of support system
Physical and sexual abuse (i.e., Military sexual trauma)
Childhood abuse
Substance abuse
Experiencing a natural disaster
While combat veterans may be more prone to experiencing PTSD, you don’t have to serve on the front lines to develop a mental illness.
How a Traumatic Event is Linked to Physical Health Problems
PTSD is often much more than a mental health condition. Traumatic events have a lasting impact on more than just the mind; they can also profoundly affect physical health.
When you experience trauma, your body’s stress response kicks into overdrive, leading to physical symptoms that persist long after the initial event.
For veterans with PTSD, these symptoms are often amplified, affecting everything from heart health to immune function.
Research has shown that trauma can lead to conditions such as chronic pain, cardiovascular issues, digestive problems, and even compromised immunity.
Chronic Pain
Many veterans with PTSD experience chronic pain, which can affect various parts of the body. Chronic painoccurs when you have pain in one or more areas of your body for at least three to six months.
When you are constantly in “fight or flight” mode, your muscles tense up, and you’re more prone to strain and injury, creating persistent pain over time.
Veterans with PTSD are more likely to report chronic pain, which can exacerbate other physical and mental health symptoms.
If you have chronic pain, it’s a great idea to keep a “pain diary,” where you can record patterns of pain, effective management techniques, and the effect it has on your daily life.
Examples of chronic pain include:
Headaches
Muscle Tension
Joint Pain
Back Pain
Neck Pain
Pelvic Pain
Fibromyalgia
Chronic pain istreated in various ways, depending on your type of pain, the cause of your pain (if known), and your age and overall health. However, most chronic pain is treated with medication, lifestyle changes, or therapies.
Gastrointestinal Problems
Gastrointestinal (GI) problems are common among veterans with PTSD because the digestive system is sensitive to stress and anxiety. Emotions cause chemical and physical responsesin the body, frequently resulting in pain and discomfort.
For example,researchshows that patients with irritable bowel syndrome (IBS) were found to have high rates of trauma history and PTSD.
Common GI problems include:
Nausea
Irritable Bowel Syndrome
Acid Reflux
Constipation
Most GI problems can be resolved with diet modifications, therapy, or medication. However, if you’re concerned about digestive system issues, following up with your doctor is vital.
Respiratory Symptoms
A 2011 study shows that trauma exposure and PTSD are associated with self-reported asthma and chronic obstructive pulmonary disease.
The same study found that subjects with PTSD had significantly higher odds ratios for most asthma-related symptoms than subjects without PTSD. (If you have PTSD, you’re more than just a study, but statistics show you aren’t alone.)
Additional respiratory symptoms include:
Shortness of Breath
Rapid or Shallow Breath
Hyperventilation
Tightness in the Chest
Coughing
If you have breathing problems, you must seek help immediately. Never wait to see what develops.
When your body is under prolonged stress, it produces increased levels of adrenaline and cortisol, which raise blood pressure and strain the heart.
Veterans who have undergone stressful and traumatic situations often carry this physical stress into daily life, making cardiovascular health a significant concern.
PTSD can significantly impact your cardiovascular system, leading to symptoms like:
Increased Heart Rate
Hypertension (High Blood Pressure)
Chest Pain
Obesity
You must address cardiovascular issues because stress cansignificantly impact your heart.
Sleep Disturbances
Many people have sleep troubles, but you’re more likely to develop sleep disturbances if you’ve been through a traumatic event.
The National Vietnam Veterans Readjustment Study found that 52% of combat veteranswith PTSDexperienced significant nightmares.
Your partner/spouse complains about you snoring or notices you have pauses in breath during your sleep
You wake up gasping or choking during the night
You wake up tired even after a whole night’s sleep
You struggle to stay awake during the day
Immune System Suppression
Chronic stress can weaken the immune system, increasing your risk of autoimmune disease. You may also experience frequent colds, flu, or other infections due to a compromised immune system.
In addition, PTSD may increase inflammatory markers and reduce anti-inflammatory ones.
Regular check-ups and a balanced lifestyle are essential for reducing illness frequency and supporting long-term health.
Fatigue or Low Energy
It’s common for veterans with PTSD to experience fatigue and low energy, affecting their quality of life. Symptoms may range from difficulty concentrating to feeling emotionally numb.
Chronic stress and poor sleep frequently lead to low energy levels and persistent fatigue, making daily life challenging.
Research shows that stress can lead to mental fatigue, affecting your ability to think, process and regulate emotions, and solve problems.
It’s important to note that fatigue isn’t just tiredness but a significant lack of energy that impacts all aspects of life.
Seeking Help for Physical PTSD Symptoms
You should never ignore unexplained pain in your body. Most physical symptoms of PTSD are easily managed with a variety of effective treatments, including medication and therapy.
For example, the U.S. Food and Drug Administration(FDA) approved two selective serotonin reuptake inhibitors (SSRIs) to help treat PTSD symptoms.
By speaking with your doctor or a mental health professional, you can ensure effective management and treatment, leading to a better quality of life.
If you use VA medical services, you should ask your primary care provider to help make an appointment with a VA mental health provider. Contact the closest VA medical center or Vet Center if you’re not already using VA medical services.
If you’re unsure about the resources you need, don’t hesitate to call 877-222-8387for assistance. They’re available Monday through Friday, 8:00 am – 8:00 pm EST.
Veterans Crisis Line
If you need immediate assistance day or night, you can contact the Veterans Crisis Line by:
Call 911 or go to the nearest emergency room for a medical emergency. You can also go to the nearest VA medical center, regardless of your discharge status or enrollment in VA healthcare.
Managing Physical Symptoms of PTSD
Since everyone’s journey with PTSD is unique, the way you manage it also will be. Common ways to manage physical symptoms of PTSD include:
Medical Treatment
Mind-body Practices (i.e., yoga, tai chi, and meditation)
A 2023 study found that individuals with higher levels of physical activity have better mental health status after a traumatic event than those who don’t regularly engage in physical activity.
Remember to always consult your doctor about the best way to manage your PTSD.
VA PTSD Resources
It’s never too late to receive help for PTSD, and getting help may prove vital to managing your symptoms.
The VA has over 200 PTSD treatment programs across the country that offer:
1-to-1 mental health assessment and testing to figure out if you have PTSD
Medicine proven to work for treating PTSD
1-to-1 psychotherapy (also called talk therapy). This includes proven methods like Cognitive Processing Therapy (CPT).
1-to-1 family therapy
Group therapy for special needs, like anger or stress management, or combat support
Group therapy for Veterans who served in certain combat zones or who’ve been through similar traumas
The VA healthcare program covers VA PTSD resources. If you don’t have VA healthcare, you can apply here.
Note: You still have options if you don’t have VA healthcare. It’s best to contact a Vet Center near you who can help guide you in the right direction.
Conclusion
Understanding that PTSD affects the mind and body is vital. You should never ignore physical symptoms, especially if they interfere with daily life.
Recognizing these symptoms is crucial for providing comprehensive care that addresses mental and physical health.
It’s not always easy admitting something is wrong. Butremember, being vulnerable is being strong.
Post-traumatic stress disorder (PTSD) is a condition that affects both combat and non-combat veterans.
PTSD often comes with symptoms that cause occupational and social impairment. But PTSD can also cause other health problems called PTSD secondary conditions.
If you are a veteran with PTSD, it is possible to develop PTSD secondary conditions like sleep apnea, migraines, GERD (acid reflux), hypertension (high blood pressure), or erectile dysfunction because of your PTSD.
If you can prove your service-connected PTSD caused your secondary medical condition, you may qualify for additional VA disability benefits for your secondary condition(s).
This guide will explore some of the most common medical conditions secondary to PTSD, emphasizing VA ratings, how to file secondary claims to PTSD, and requirements for secondary service connections.
PTSD can cause a range of secondary conditions which may qualify you for additional VA disability benefits.
When filing a secondary claim to PTSD, veterans must prove three things: a current diagnosis of your secondary condition, a service-connected PTSD condition, and a medical nexus linking the two.
A credible Nexus Letter from a qualified healthcare provider can significantly strengthen your VA disability claim for secondary conditions.
Understanding the VA rating criteria for these secondary conditions is crucial to maximizing your benefits.
Understanding VA Secondary Conditions to PTSD
PTSD secondary conditions are disabilities that are proximately due to or aggravated by service-connected post-traumatic stress disorder.
Under38 CFR § 3.310, a veteran with a current disability condition that is caused or worsened by a service-connected condition can receive secondary service connection.
Proving Service Connection for PTSD Secondary Conditions
To establish service connection when filing secondary claims to PTSD, three key elements must be demonstrated:
A current medical diagnosis of the secondary condition
A current service-connected primary disability (e.g., service-connected PTSD)
A medical nexus linking the secondary condition to the service-connected PTSD (can be a Nexus Letter)
50% VA Rating: Very frequent prostrating and prolonged attacks productive of severe economic inadaptability.
30% VA Rating: Characteristic prostrating attacks occurring on average once a month over the last several months.
10% VA Rating: Characteristic prostrating attacks averaging one in 2 months over the last several months.
0% VA Rating: Less frequent attacks.
VA Rating Criteria for Migraine Headaches (DC 8100)
VA Disability Rating
Migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability
50%
Migraines with characteristic prostrating attacks occurring on an average once a month over last several months
30%
Migraines with characteristic prostrating attacks averaging one in 2 months over last several months
10%
Migraines with less frequent attacks
0%
Migraines VA Ratings chart
VA Claim for Migraines Secondary To PTSD
To support your VA claim for migraines secondary to your PTSD, you will want to include relevant medical evidence. This can include:
Documentation: Documentation of your migraine diagnosis and any relevant treatment records.
Nexus Letter: An independent medical opinion linking your migraines to PTSD.
Medication Side Effects: Note that some PTSD medications, like SSRIs, may also contribute to headaches. Documenting your side effects, including keeping a record of your migraines, can help to strengthen your claim.
Related: See our post on migraines secondary to service-connected PTSD here.
Sleep Apnea Secondary to PTSD
Sleep apnea is notably prevalent among veterans with PTSD.
While PTSD may not directly cause sleep apnea, research from 2015 shows that veterans with severe PTSD symptoms are at a higher risk of developing obstructive sleep apnea (OSA). The connection may be linked to factors like obesity, which can be exacerbated by PTSD.
Sleep Apnea VA Rating Criteria
Sleep apnea secondary to PTSD can be 0%, 30%, 50%, or 100%, and is rated under Diagnostic Code 6847:
100% VA Rating: Chronic respiratory failure with carbon dioxide retention or cor pulmonale or requires tracheostomy.
50% VA Rating: Requires use of a breathing assistance device such as a CPAP (Continuous Positive Airway Pressure) machine.
30% VA Rating: Persistent daytime hypersomnolence.
0%: VA Rating: Asymptomatic but with documented sleep disorder breathing.
VA Rating Scale: Sleep Apnea
VA Disability Rating
Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy
100%
Requires use of breathing assistance device such as a CPAP machine
50%
Persistent daytime hypersomnolence
30%
Asymptomatic but with documented sleep disorder breathing
0%
Sleep Apnea VA Ratings chart
VA Claim for Sleep Apnea Secondary to PTSD
Valid VA disability claims for sleep apnea secondary to PTSD typically include:
Nexus Letter: A medical opinion connecting your obstructive sleep apnea to PTSD, possibly through an intermediary condition like obesity.
CPAP Use: If you use a CPAP machine, this can help support your claim.
Gastroesophageal Reflux Disease (GERD) Secondary to PTSD
Gastroesophageal Reflux Disease (GERD) is often seen in veterans with PTSD, especially those on continuous medication for PTSD symptoms. The stress and side effects of PTSD treatment can contribute to digestive issues.
GERD VA Rating Criteria
The new VA rating criteria for GERD became effective May 19, 2024. GERD is now rated under Diagnostic Code 7206 for Esophageal Stricture, with VA ratings of 0%, 10%, 30%, 50%, or 80%.
New VA Rating Criteria for GERD
GERD VA Rating Criteria Under DC 7206, Esophagus, Stricture of:
VA Disability Rating
Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) Aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube)
80%
Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilation 3 or more times per year, (2) dilation using steroids at least one time per year, or (3) esophageal stent placement
50%
Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year
30%
Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic
10%
Documented history without daily symptoms or requirement for daily medications
0%
Note (#1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy
Note (#2): Non-gastrointestinal complications of procedures should be rated under the appropriate system
Note (#3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy
Note (#4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved
Note (#5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving at least 5 dilation sessions performed at 2-week intervals
New GERD VA Ratings chart
VA Claim for GERD Secondary to PTSD
Valid VA disability claims for GERD secondary to PTSD typically include:
Medical Evidence: Provide records showing GERD diagnosis and its symptoms (can be from a primary care physician).
Nexus Letter: Obtain a GERD nexus letter linking your GERD to PTSD or its treatment.
Medication Side Effects (if any): Highlight how medications for PTSD might contribute to GERD.
IBS Secondary to PTSD
Irritable Bowel Syndrome (IBS) is another condition commonly linked to PTSD. Research indicates a high prevalence of IBS among individuals with PTSD. Stress from PTSD can exacerbate gastrointestinal symptoms.
NEW IBS VA Rating Criteria
On May 19, 2024, the 0% non-compensable rating for IBS was removed; the new minimum compensable VA rating for IBS is now 10%.
IBS secondary to PTSD is rated at 10%, 20%, or 30%, under Diagnostic Code 7319.
New IBS VA Rating Criteria (Diagnostic Code 7319)
VA Disability Rating
– Abdominal pain related to defecation at least one day per week during the previous three months; and – Two or more of the following: 1. Change in stool frequency 2. Change in stool form 3. Altered stool passage (straining and/or urgency) 4. Mucorrhea 5. Abdominal bloating 6. Subjective distension
30%
– Abdominal pain related to defecation for at least three days per month during the previous three months; and – Two or more of the following: 1. Change in stool frequency 2. Change in stool form 3. Altered stool passage (straining and/or urgency) 4. Mucorrhea 5. Abdominal bloating 6. Subjective distension
20%
– Abdominal pain related to defecation at least once during the previous three months; and – Two or more of the following: 1. Change in stool frequency 2. Change in stool form 3. Altered stool passage (straining and/or urgency) 4. Mucorrhea 5. Abdominal bloating 6. Subjective distension
10%
IBS VA Ratings chart
VA Claim for IBS Secondary to PTSD
VA disability claims for IBS secondary to PTSD typically include:
Medical Evidence: Show documentation of IBS diagnosis.
Nexus Letter: Establish a connection between PTSD and IBS through a qualified medical professional.
Service-Connected Disability: Demonstrate how your PTSD or its treatment has led to or aggravated your IBS.
ED Secondary to PTSD
Veterans with PTSD are at an increased risk of sexual dysfunction, including erectile dysfunction (ED). This sexual dysfunction can be due to the psychological impact of PTSD or the side effects of PTSD medications.
ED Secondary to PTSD VA Ratings
ED VA ratings are 0%, and eligible veterans can receive Special Monthly Compensation (SMC) for loss of use of a creative organ. SMC-K is paid out each month in addition to other VA disability compensation.
0% VA Rating: Non-compensable VA rating.
VA Special Monthly Compensation (SMC): SMC-K is available for loss of use of a creative organ.
The 2024 pay rate for SMC-K for Erectile Dysfunction is $132.74 monthly.
VA Claim for ED Secondary to PTSD
VA disability claims for ED secondary to PTSD typically include:
Medical Evidence: Document your ED diagnosis and symptoms.
Nexus Letter: Get an independent medical opinion linking ED to PTSD.
SMC: If applicable, veterans can apply for Special Monthly Compensation (SMC) due to loss of use.
Hypertension Secondary to PTSD
Hypertension, or high blood pressure, is a significant health issue that can be linked to PTSD. Chronic stress from PTSD may elevate blood pressure, increasing the risk of serious health complications.
Hypertension is defined by consistent readings of 140/90 mmHg or higher. Physical symptoms can include headaches, dizziness, and blurred vision, though some people may not experience noticeable symptoms that cause significant concern.
Hypertension Secondary to PTSD VA Ratings
Hypertension is rated under 38 CFR § 4.104, DC 7101. VA disability ratings for hypertension can be 0%, 10%, 20%, 40%, or 60%, based on the severity of your symptoms and the need for continuous medication.
60% VA Rating: Diastolic pressure 130 or more.
40% VA Rating: Diastolic pressure 120 or more.
20% VA Rating: Diastolic pressure 110 or more, or systolic pressure predominantly 200 or more.
10% VA Rating: Diastolic pressure 100 or more.
0% VA Rating: Diastolic pressure below 100 and systolic pressure below 160.
Diastolic pressure predominantly 100 or more, systolic pressure predominantly 160 or more, or requiring continuous medication.
20%
Diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more.
40%
Diastolic pressure predominantly 120 or more.
60%
Diastolic pressure predominantly 130 or more.
Hypertension VA ratings chart
PTSD’s Impact on Hypertension
PTSD can exacerbate hypertension through stress, anxiety, and unhealthy behaviors. Medications for PTSD may also contribute to high blood pressure.
VA Claim for Hypertension Secondary to PTSD
To support your VA claim for hypertension secondary to PTSD and help you to prove service connection:
Medical Evidence: Show diagnosis and severity of hypertension
Supporting Documentation: Provide proof of service-connected PTSD and its impact on your hypertension
Nexus Letter: Obtain an opinion linking hypertension to PTSD
Frequently Asked Questions (FAQs)
What causes PTSD?
Post-Traumatic Stress Disorder (PTSD) is a serious mental health condition triggered by experiencing or witnessing a traumatic event (or multiple traumatic events). It is characterized by symptoms such as flashbacks, nightmares, severe anxiety, and emotional numbness.
What is the average PTSD VA rating?
The average PTSD VA rating is 70%, highlighting its significant impact and severe impairment on veterans’ lives.
What are medical conditions secondary to PTSD?
Medical conditions secondary to PTSD are conditions caused by your service-connected PTSD in some way. For example, if your PTSD causes you to have insomnia or migraines, or if the medication you take for PTSD causes erectile dysfunction (ED), you may have a secondary condition. Veterans suffering from these PTSD secondary conditions may qualify for additional VA disability benefits.
Many veterans don’t realize that there are additional high-value VA disability claims that can be claimed secondary to their service-connected PTSD.
Does a nexus letter for conditions secondary to PTSD help your claim?
Nexus letters are critical for proving secondary service connection, in most cases. A nexus letter is a key document that can improve your VA disability claim and help you increase your VA disability rating. It explains how your secondary condition is caused or worsened by your primary service-connected disability.
Why are nexus letters valuable?
A credible medical nexus letter from a qualified mental health professional helps the VA understand the connection between your conditions and your military service. Independent medical opinions can also help to provide credibility and support to your VA disability claims. This has the potential to help you increase your disability benefits.
Do I need a nexus letter for medical conditions secondary to PTSD?
While a nexus letter is not mandatory, it is highly recommended. It provides a professional medical opinion linking your secondary condition to your primary service-connected disability. This can make a big difference in proving that your secondary condition is related to your existing service-connected condition.
Understanding and claiming medical conditions secondary to PTSD can significantly increase your VA disability rating and benefits.
Six common secondary conditions to PTSD include: Migraine headaches, sleep apnea, GERD, IBS, erectile dysfunction, and hypertension.
Additionally, it is almost always recommended to get a credible nexus letter when trying to service connect a secondary condition.
Medical Evidence Wins VA Claims
Whether you need a nexus letter for secondary conditions or something else, we make it easy for veterans to connect with a licensed provider through our HIPAA-compliant telemedicine platform—anytime, anywhere!
From DBQs and Nexus Letters to Psych Evals and Telemedicine Evaluations, the Telemedica team is standing by to serve you. Get the evidence you need to win your VA claim today.
If you suffer from migraines secondary to PTSD, you may be entitled to additional VA compensation and benefits.
A secondary service connection occurs when a current service-connected condition causes or aggravates another disability, expanding your ability to claim VA benefits.
This post will explain the following:
The connection between migraines and PTSD
How the VA rates migraines secondary to PTSD
The importance of a nexus letter
How to prove service connection, and more
Keep reading to learn more about how to claim migraines secondary to PTSD to help you on your journey to the benefits you rightfully deserve.
Main Takeaways
The VA ratings for migraines secondary to PTSD are 0%, 10%, 30%, and 50%, depending on the severity, duration, and frequency of your migraines.
A nexus letter for migraines secondary to PTSD may help strengthen your VA claim, while adding credibility.
You must service-connect your secondary condition of migraines to your primary service-connection of PTSD to be eligible for VA benefits.
Migraines and PTSD: What’s the Connection?
Migraines are headaches on one side of your head, causing throbbing and pulsing. On the other hand, post-traumatic-stress disorder (PTSD) is a mental health condition that’s caused by an extremely stressful or terrifying event. But what’s the connection?
According to the Association of Migraine Disorders, 69% of people with both episodic migraine and PTSD had PTSD-related symptoms prior to the onset of headaches.
While researchers are still working on the exact link between PTSD and migraines, they have found the following connections between the two conditions:
Shared genes and biological pathways – Both conditions involve changes in brain chemistry and function.
Stress and hyperarousal – Veterans with PTSD frequently experience heightened stress, which can trigger migraines.
Sleep disturbances – Sleep disturbances can exacerbate PTSD symptoms, which can trigger migraine headaches.
Emotional and physical strain – PTSD’s emotional burden may trigger migraine headaches.
Environmental factors – Living in high-risk environments may exacerbate symptoms of PTSD and migraines.
A 2011 study found that PTSD may greatly increase the impact of migraines, but that behavioral PTSD treatment alone can positively influence chronic pain conditions and disability.
Note: Migraines are only one of the secondary conditions to PTSD, so it’s important to speak with your healthcare provider about any concerns.
Migraines Secondary to PTSD VA Ratings
The VA rates migraines under 38 CFR § 4.124a, Schedule of Ratings – Neurological Conditions and Convulsive Disorders,Diagnostic Code (DC) 8100.
The VA ratings for migraine headaches secondary to PTSD are 0%, 10%, 30%, and 50%.
DC 8100, Migraine Headaches
VA Disability Rating
Migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability
50%
Migraines with characteristic prostrating attacks occurring on an average once a month over last several months
30%
Migraines with characteristic prostrating attacks averaging one in 2 months over last several months
10%
Migraines with less frequent attacks
0%
(Migraine VA Ratings Chart)
Note: Your VA rating for migraine headaches secondary to PTSD will depend on the severity, duration, and frequency of your migraines.
Migraines Secondary to PTSD: Proving Service-Connection
The three essential elements that must be satisfied to service-connect migraines as a secondary condition to PTSD are:
A current medical diagnosis of migraines
Evidence of a service-connected primary disability (PTSD), AND
Medical nexus evidence establishing a connection (nexus) between the current disability (migraines) as proximately due to, the result of, or aggravated by PTSD. This can be a nexus letter.
Note: Aggravation refers to the worsening of a non-service-connected condition due to a service-connected condition.
The VA claims process for secondary conditions is anything but straightforward; however, there are considerations when applying for VA benefits, including:
Consider a DBQ (disability benefits questionnaire), which may benefit your claim.
Obtain lay statements from close family and friends.
Submit a personal statement in support of your claim.
Do I Need a Nexus Letter for Migraines Secondary to PTSD?
The VA doesn’t require nexus letters; however, we highly recommend obtaining a nexus letter for migraines secondary to PTSD.
A nexus letter is a medical opinion that links your secondary condition (migraines) to your primary service-connected condition (PTSD).
Nexus letters for secondary conditions help add credibility to your VA claim and may expedite your case. Although, it’s important to understand that nexus letters don’t guarantee service connection.
Our team at Telemedica can help provide you with a nexus letter with high probative value from one of our licensed providers.
When submitting a nexus letter, ensure it has the following four key elements:
The physician’s credentials, particularly ones that make them a trustworthy source for your current medical condition.
A reference indicating that the physician composing the letter has thoroughly reviewed the veteran’s medical and military records about the claim.
The physician’s opinion regarding the cause of the current diagnosed condition and its relation to the veteran’s military service.
Medical rationale that fully supports the physician’s opinion.
Generally, one nexus letter per VA claim is sufficient; however, you can submit multiple nexus letters from different physicians, particularly if you have a complex case.
Filing a VA Claim for Migraines Secondary to PTSD
When you have your official medical diagnosis of migraines, you can begin filing your VA claim. (If you don’t have a medical diagnosis for your secondary condition, you should schedule an appointment with your doctor.)
You can file your VA claim for migraines secondary to PTSD online or download VA Form 21-526EZ and submit your application in one of the following ways:
By mail to:
Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444
Via fax:
Inside the U.S. (844) 531-7818 | Outside the U.S. (248) 524-4260
Note: If you plan to file for disability compensation using a paper form, you may want to submit an intent to file formfirst. This gives you time to gather your evidence while avoiding a later potential start date
(FAQs) Frequently Asked Questions
Does PTSD cause migraines?
No, PTSD doesn’t directly cause migraines. However, the stress and anxiety associated with PTSD can trigger migraine symptoms. You can help manage migraines by drinking enough water, using cold or warm compresses, and drinking ginger tea.
Do I need a DBQ for migraines secondary to PTSD?
No, you don’t need to provide a Disability Benefits Questionnaire (DBQ) with your VA disability claim for migraines secondary to PTSD. However, a DBQ may help support your VA claim by providing medical evidence from your health care provider.
What is the cost of a nexus letter for secondary conditions?
The cost of a VA nexus letter for secondary conditions can vary based on several factors, including, but not limited to, the complexity of your case and the level of expertise of your medical professional.
You may be able to get a nexus letter from your treating physician at no additional cost, particularly if you have a strong rapport with them.
However, there might be associated fees if a specialized opinion is needed, such as from a medical specialist.
Is there a time limit for filing a secondary service connection claim?
While there is no specific time limit for filing a secondary service connection claim, it’s best to file it as soon as possible after your secondary condition develops to ensure that you receive the maximum VA disability benefits available.
Whether you need a nexus letter for migraines secondary to PTSD or something else, we make it EASY for veterans to connect with a licensed provider through our HIPAA-compliant telemedicine platform—anytime, anywhere!
From DBQs and Nexus Letters to Psych Evals and Telemedicine Evaluations, the Telemedica team is standing by to serve you. Get the evidence you need to support your VA claim today.
You can contact us with any questions; we will gladly assist you.
Anxiety and depression are common mental health issues among veterans, and they can often lead to or exacerbate secondary conditions.
Understanding the various VA secondary conditions to anxiety and depression is crucial, as these conditions can significantly affect your quality of life.
This guide examines common VA secondary conditions to anxiety and depression. We’ll discuss VA ratings for secondary conditions, how to file your VA claim for a secondary condition, and steps to service-connect your condition.
We’ll also take a closer look at the value of a nexus letter for secondary conditions.
VA secondary conditions occur when a service-connected disability causes or aggravates a new or pre-existing condition, illness, or injury.
For example, suppose you’re service-connected for anxiety or depression, and your anxiety/depression causes another VA-ratable condition. In that case, you may qualify for a VA rating for your secondary condition (e.g., sleep apnea).
In addition, anxiety and depression can be secondary conditions if they are caused secondary to a different primary service-connected condition (e.g., GERD)
VA Secondary Conditions to Anxiety and Depression
There are many VA-ratable conditions that can manifest due to your service-related anxiety or depression. Below are some of the most-common VA secondary conditions to anxiety and depression.
Headaches/Migraines
Anxiety and depression can trigger or worsen migraine headaches, leading to severe pain and disability. It’s not uncommon for migrainesto be accompanied by vomiting, nausea, and sensitivity to light and sound.
These headaches can range from tension headaches to migraines and are often exacerbated by the stress and emotional turmoil associated with mental health conditions.
In addition, research shows that those who experiencemigraines with aura (a classic migraine) are more likely to develop depression than those without it.
While waiting for an official diagnosis, you can help manage your migraines by:
Finally, if you can keep a migraine diary, it may help you determine potential triggers, how long the migraines lasted, and what treatment methods helped.
VA Rating for Migraines Secondary to Anxiety and Depression
The VA rates migraines secondary to anxiety and depression at 0%, 10%, 30%, and 50% under diagnostic code (DC) 8100.
When filing your VA claim for migraines secondary to anxiety, it’s crucial to include medical evidence. This evidence can strengthen your claim and increase the likelihood of a successful outcome.
Sleep Apnea
Anxiety and depression can contribute to the development of obstructive sleep apnea, which is characterized by pauses in breathing during sleep. In addition, anxiety can exacerbate already diagnosed sleep apnea by making it harder to fall asleep.
Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea and occurs when the throat muscles relax and block airflow to the lungs.
Central Sleep Apnea (CSA) occurs when the brain fails to send the correct signals to the muscles that control breathing.
Complex Sleep Apnea or Treatment-emergent central sleep apnea occurs when obstructive sleep apnea turns into central sleep apnea after receiving treatment.
When you can identify specific triggers, you can determine the best treatment methods.
Common triggers for sleep apnea caused by mental health disorders include:
Physiological – If your anxiety or depression has also caused chronic stress, you may be prone to a reduced quality of sleep.
Psychological – If you’re prone to nightmares or worry about not being able to breathe while sleeping, you’re more likely to experience sleep disturbances.
Environmental – Specific lifestyle factors, including substance use, can worsen sleep apnea and make it challenging to get quality sleep.
VA Rating for Sleep Apnea Secondary to Anxiety and Depression
The VA rates sleep apnea secondary to anxiety and depression at 0%, 30%, 50%, or 100% underDC 6847-Sleep Apnea Syndromes(Obstructive, Central, Mixed).
In addition, the VA requires you to attend a sleep study to receive an accurate sleep apnea diagnosis and eventual VA rating.
It comes as no surprise that anxiety and depression are likely to elevate your blood pressure. Chronic stress increases your body’s production of stress hormones like cortisol, which puts you at risk for long-term increases in blood pressure.
While anxiety doesn’t cause long-term high blood pressure, bouts of anxiety can cause temporary elevations in blood pressure. However, these temporary elevations can damage your blood vessels, kidneys, and heart.
To avoid unnecessary rises in blood pressure, it’s important to avoid smoking and alcohol, and maintain a healthy diet.
In good news, studies show patients with anxiety and/or depression had faster rates of hypertension control because they demonstrated more primary care and specialty visits.
If lifestyle changes don’t improve your hypertension, your healthcare provider may prescribe medication to help regulate your blood pressure.
VA Rating for Hypertension Secondary to Anxiety and Depression
The VA rates hypertension at 10%, 20%, 40%, and 60% under DC 7101 – hypertensive vascular disease. Your VA rating for hypertension secondary to anxiety and depression will depend on your diastolic and systolic pressure levels.
Gastroesophageal Reflux Disease (GERD)
GERD is a condition where there is a backflow of stomach acids into your esophagus. Stress and anxiety can increase the production of stomach acid, leading to GERD.
A 2023 study found that up to 1 in 3 subjects with GERD experience anxiety and depression. While genetics play a significant role in developing GERD, it’s also common in veterans.
Potential symptoms of GERD include:
Difficulty breathing
Nausea
Heartburn
Vomiting
In addition, if your anxiety and depression are affecting your sleep, you may be prone to GERD since lying down frequently worsens the condition.
Your doctor may prescribe medication to help your condition, with some cases requiring surgery. You can help manage GERD with lifestyle changes, including:
Dietary changes
Losing weight
Quitting smoking
VA Rating for GERD Secondary to Anxiety and Depression
The VA rates GERD from 0% to 80%, with breaks at 10%, 30%, and 50%. You can find the schedule of ratings for GERD underDC 7206.
Your GERD secondary to anxiety VA disability rating will depend on the severity of your esophageal strictureand its impact on your health.
Arthritis
Arthritis is a debilitating condition that can significantly impact your quality of life. When you’re stressed, your body releases chemicals to help you handle the situation, leading to an increased heart rate, faster breathing, or tense muscles.
Over time, the increased tension in your muscles can worsen your arthritis pain, causing a vicious cycle of constant pain and fatigue.
In addition, psychological factors play a role in developing arthritis secondary to anxiety and depression. For example, constantly managing chronic pain can lead to feelings of helplessness and hopelessness.
Know your limits and don’t overdo it with activity
Keep your joints moving throughout the day
Obtain good posture and avoid slouching
Manage a health body weight
Quit smoking
Avoid activities that involve high impact and repetitive motion (i.e., running and jumping)
It’s important to talk to your doctor about your arthritis pain because treatment can help relieve symptoms and improve joint function.
VA Rating for Arthritis Secondary to Anxiety and Depression
The VA generally rates arthritis secondary to anxiety and depression between 10% and 50%, with breaks at 20%, 30%, and 40%, depending on the type and severity of your symptoms.
For example, degenerative arthritis is rated under DC 5003with ratings of 10% or 20%. However, if you develop rheumatoid arthritis secondary to anxiety and depression, you may qualify for a 20%, 40%, 60%, or 100% under DC 5002, Multiple-Joint Arthritis.
Irritable Bowel Syndrome (IBS)
While the exact cause of IBS isn’t well understood, there seems to be a significant link between its development due to anxiety and depression.
For example, anxiety and depression can worsen IBS symptoms, leading to abdominal pain, bloating, and changes in bowel habits.
Symptoms of IBS include, but are not limited to:
Cramping or bloating
Abdominal pain or discomfort
Excessive gas
Indigestion
Mucus in your stool
Changes in your bowel movement patterns
It’s recommended you keep a journal of your symptoms to share with your doctor. While many cases of IBS can be treated with lifestyle changes, it’s vital you talk to your doctor if your anxiety and depression is severe enough to cause significant changes to your GI tract.
The following are not signs of IBS and are reasons to get medical attention:
Bloody stool
Chronic diarrhea
Severe abdominal pain
Bowel movements that completely stop
VA Rating for ISB Secondary to Anxiety and Depression
The VA rates IBS secondary to anxiety and depression using DC 7319with ratings at 10%, 20%, and 30%, depending on factors like abdominal bloating, change in stool frequency, and subjective distension.
TMJ with Bruxism
Temporomandibular joint (TMJ) disorder is a condition affecting the jaw joint and the muscles responsible for moving your jaw. TMJ with bruxism is a condition that causes you to clench, grind, or gnash your teeth while you’re awake or asleep.
While TMJ can vary from one person to the next, common symptoms include:
Difficulty opening and closing your mouth
Tooth pain or sensitivity
Clicking or popping sound when opening and closing your mouth
Pain or tenderness in your jaw
Neck pain, earaches, or headaches
Research shows a significant link between bruxism and mental health disorders, especially in emotional disorders and occupational exposures.
For example, if you are anxious, it’s common for the muscles in your jaw to become tense or tight. When you clench your jaw or grind your teeth, it can lead to inflammation and muscle tension in your jaw joint, which can cause TMJ.
VA Rating for TMJ with Bruxism Secondary to Anxiety and Depression
The VA rates temporomandibular joint disorder (TMD) under DC 9905, with ratings ranging from 10% to 50%, with breaks at 20%, 30%, and 40%.
Your TMJ with bruxism secondary to anxiety VA rating will depend on the severity of your symptoms and limitations, including the extent of jaw movement.
Nexus Letter for Secondary Condition to Anxiety and Depression
Claims for VA secondary conditions to anxiety and depression benefit significantly from a nexus letter with high-probative value.
A nexus letter with high-probative value should include:
The physician’s credentials, particularly ones that make them a trustworthy source for the following opinion
A reference indicating that the physician composing the letter has thoroughly reviewed the veteran’s medical records and military records that pertain to the claim.
The physician’s opinion regarding the cause of the current diagnosed condition and its relation to the veteran’s military service.
Medical rationale that fully supports the physician’s opinion.
To receive a VA rating for secondary conditions to anxiety and depression, you must service-connect your condition.
A VA service connection for secondary conditions requires the following:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link to the current service-connected disability (anxiety and depression) AND
A current service-connected primary disability (anxiety and depression) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (anxiety and depression) AND the current disability you’re trying to connect secondary
Filing a VA Claim for Secondary Conditions
You can file for VA secondary conditions to anxiety and depression by following the steps below:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ– Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444
A secondary service connection requires a primary service connection.
For example, in order to receive a secondary service connection for bruxism caused by your anxiety (e.g., a bruxism secondary to anxiety VA rating), you must first have a primary service connection (and VA rating) for your anxiety.
It’s important to understand that you can’t get separate ratings for anxiety and depression, as all mental health conditions are rated under the same VA criteria.
Conclusion
Recognizing VA secondary conditions to anxiety and depression is crucial for comprehensive care and management of your health.
If you need a nexus letter to provide that missing link between your disability and an in-service event, injury, or disease, Telemedicais here as your nexus letter expert.
We can connect you with a licensed provider who understands your unique needs through our secure, private, and convenient platform. Contact us today!
Tinnitus can significantly affect daily life, but the side effects are more pronounced when coupled with a secondary condition.
There are several secondary conditions to tinnitus, and understanding your eligibility may increase your monthly VA benefits.
This guide will cover the top four secondary conditions to tinnitus. We’ll explain more about VA secondary conditions, how the VA rates secondary conditions to tinnitus, how to service-connect your condition, and how to file a VA claim.
Understanding VA Secondary Conditions
Tinnitus is considered a low-value claim because the highest VA rating is 10%. However, if your service-connected tinnitus leads to a secondary condition, you may be entitled to a higher VA rating.
For example, if you’re service-connected for tinnitus, and your tinnitus causes another VA-ratable condition, you may qualify for a VA rating for your secondary condition (e.g., insomnia).
(In addition, tinnitus can be a secondary condition if it is caused by another primary service-connected condition).
4 VA Secondary Conditions to Tinnitus
Insomnia
Migraines
Depression
Somatic Symptom Disorder
Insomnia Secondary to Tinnitus
Insomnia is a sleep disorder characterized by the inability to fall asleep, stay asleep, or both.
A 2021 study found that insomnia occurs in 10%-80% of tinnitus patients, with most reports noting over a 40% frequency.
For example, you may notice the ringing in your ears more at night and, therefore, have difficulty sleeping.
VA Ratings for Insomnia Secondary to Tinnitus
The VA rates insomnia at 10%, 30%, 50%, 70%, and 100%, under CFR Title 38, Part Schedule for Rating Disabilities, Diagnostic Codes (DC) for Mental Disorders.
Migraines Secondary to Tinnitus
Tinnitus is frequently linked to several types of headache disorders, including migraines.
VA ratings for migraines secondary to tinnitus range from 0% to 50%, with breaks at 10% and 30%.
Nexus Letter for Migraines Secondary to Tinnitus
A nexus letter for migraines secondary to tinnitus may help strengthen your VA claim by providing a clear link between your two conditions. A nexus letter is a document written by a medical professional that explains the relationship between your service-connected tinnitus and the secondary condition you’re claiming.
Researchshows a direct link between depression and veterans suffering from tinnitus, primarily due to the distress and impairment across cognitive, functional, and psychiatric spectra.
In addition, veterans with tinnitus are also at a greater risk for additional mental health disorders, including anxiety.
Depression secondary to tinnitus can be rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending upon the severity of your depression and how your mental health symptoms affect your work, life, and social functioning.
Note: You can contact the Veterans Crisis Line 24/7 for confidential support by dialing 988 and selecting 1. (You don’t have to be enrolled in VA benefits or health care to connect.)
Somatic Symptom Disorder Secondary to Tinnitus
Somatic Symptom Disorder (SSD) is defined by the Mayo Clinicas an “extreme focus on physical symptoms, such as pain, fatigue, or tinnitus, causing major emotional distress and functional problems.”
If you constantly focus on the ringing in your ears, you may experience significant occupational and social impairments.
Generally, a person’s reaction to their condition is excessive to the actual severity of their medical condition.
VA Ratings for SSD Secondary to Tinnitus
SSD secondary to tinnitus is rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending on the severity of the condition and its impact on work, life and social functioning.
Secondary Conditions to Tinnitus: Nexus Letters
If you can prove your service-connected tinnitus caused an additional condition or worsened a preexisting one, you may qualify for a higher VA rating.
Generally, a nexus letter for secondary conditions is needed unless the condition is straightforward, like a back nerve condition secondary to a service-connected back problem.
Establishing a Service Connection for a Secondary Condition
You must service-connect your condition to receive a VA rating for a secondary condition to tinnitus.
A VA service connection requires:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link to the current service-connected disability (tinnitus) AND
A current service-connected primary disability (tinnitus) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (tinnitus) AND the current disability you’re trying to connect secondary
Receiving VA Benefits for Multiple Health Conditions
You may be familiar with the complicated “VA Math” concept, where 1+1 doesn’t necessarily equal 2.
For example, if you have a 10% VA rating for tinnitus and receive a 50% VA rating for depression, you’re not awarded a 60% VA rating.
Instead, tinnitus secondary conditions are based on schedules, which calculate your impairment after the primary disability is considered. You can use a VA Disability Calculatorto check your combined VA rating.
Filing for Secondary Claims to Tinnitus
You can file for VA secondary conditions to tinnitus by using one of the three options below:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ– Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444
If you have been previously denied, you can file an appeal. Our team at Telemedica can prepare a Rebuttal Letterto help address incorrect or inaccurate statements in your VA denial letter.
Secondary conditions vary among veterans with tinnitus, and your treatment and support should be tailored to your specific needs.
It’s vital you seek professional help when addressing both the primary symptoms of tinnitus and any secondary conditions as a comprehensive approach for effective management and recovery.
The team at Telemedica is standing by to answer your questions. Contact us today!
This guide will cover VA MST screening questions, MST support and resources, and how the VA rates MST.
If you have experienced military sexual trauma (MST), it’s essential to understand you’re not alone and that help is available.
Since MST is an experience, not a diagnosis, it affects everyone differently.
The VA recognizes the significant impact MST can have on a veteran’s mental and physical health and has a screening process to help identify and support those affected.
What is Military Sexual Trauma (MST)?
According to the VA, MST refers to sexual assault or sexual harassment experienced during military service. Unfortunately, many cases of MST go unreported, so it’s challenging to know exactly how many veterans are affected.
However, researchshows that approximately 1 in 3 women veterans and 1 in 50 men veterans report experiencing Military Sexual Trauma (MST) during their Veteran Health Administration (VHA) screening. However, anonymous surveys have reported higher rates. It’s important to remember that anyone can experience MST, regardless of gender.
Examples of MST include, but are not limited to:
Being pressured or coerced into sexual activities, such as with threats of negative treatment for refusal to cooperate, or with promises of better treatment in exchange for sex
Sexual contact or activities without your consent, including when you were asleep or intoxicated
Being overpowered or physically forced to have sex
Being touched or grabbed in a sexual way that made you uncomfortable, including during “hazing” experiences
Comments about your body or sexual activities that you found threatening
Unwanted sexual advances that you found threatening
VA MST Screening Questions
You can expect the following MST screening questions as part of your confidential VA MST screening.
While you were in the military:
Did you receive uninvited and unwanted sexual attention, such as touching, cornering, pressure for sexual favors, or verbal remarks?
Did someone ever use force or threat of force to have sexual contact with you against your will?
Note on VA MST Screening Questions: An affirmative response for either is considered a positive screen for MST. However, a positive screen doesn’t indicate a veteran’s current subjective distress, diagnosis, interest in, or need for treatment.
Remember that VA healthcare providers should ask every veteran whether they experienced MST, especially since many don’t disclose this information unless asked directly.
MST VA Disability Ratings
While there is no specific VA rating for MST, you may qualify for VA disability for mental health conditions related to MST.
For example, many veterans experience MST and PTSD (Post-Traumatic Stress Disorder), so you may be eligible for a PTSD VA rating. The VA rates PTSD at 0% to 100%, with breaks at 10%, 30%, 50%, and 70% under the § 4.130 Schedule of ratings—Mental disorders.
Average Disability Rating for MST
The average disability rating for mental health conditions, including PTSD related to MST, is often cited as 70%, but it’s possible to receive a 100% MST PTSD VA rating if you have total occupational & social impairment due to:
Gross impairment in thought process or communication
Persistent delusions or hallucinations
Grossly inappropriate behavior
Persistent danger of hurting yourself or others
Intermittent inability to perform day-to-day activities
Disorientation of time and place
Memory loss of names of close relatives, your occupation, or your own name
It’s important to understand that you don’t need to meet all the subjective symptoms listed above to receive a 100% MST VA Rating .
Service-Connecting MST
To receive an MST VA disability rating, you must establish a direct link between your condition and military service.
To establish service connection, you must:
Provide a medical diagnosis of your current disability
Provide evidence of an injury, disease, or aggravation that occurred during your military service
Establish a nexus (connection or link) between your in-service injury, disease, or aggravation and your present diagnosed disability through competent medical evidence (e.g., a Nexus Letter).
MST Support and Resources
If you’re an MST survivor, it’s crucial to remember that the VA is firmly committed to providing access to the required help you need. Services are designed to meet you where you’re in your recovery process.
VA MST-related services include, but are not limited to:
Every VA healthcare system has an MST coordinator to assist with MST-related issues.
There is no charge for the treatment of physical and mental health conditions related to MST. (You don’t have to be service-connected or have a VA disability rating to receive this care.)
MST-related counseling is available through community-based Vet centers.
There are nationwide programs that offer specialized sexual treatment in residential or inpatient settings.
To receive more information about available services:
Since MST can lead to various long-term health conditions, including PTSD, depression, anxiety, substance use disorders, and other physical health issues, it’s crucial to receive the appropriate care and support.
Early identification through screening can help connect you with valuable services and resources, guiding you toward recovery and enhanced quality of life.
Post-traumatic stress disorder (PTSD) is a significant condition on its own, but when you add a secondary condition, life can become even more crippling.
There are several secondary conditions to PTSD, and knowing whether you qualify can significantly impact your monthly VA benefits.
It’s common for veterans to file secondary VA claims if their PTSD caused or worsened another VA-ratable condition.
This post will cover seven secondary conditions of PTSD. We will explain how the VA rates secondary conditions to PTSD, how to establish secondary service connection, and how to file a VA claim for secondary conditions to PTSD.
How the VA Rates PTSD
The VA rates PTSD at 0%, 10%, 30%, 50%, 70%, or 100%, depending on the severity and frequency of your PTSD symptoms.
What are Secondary Conditions to PTSD?
Secondary conditions to PTSD are VA-ratable conditions that are caused by or made worse because of your service-connected PTSD.
For example, if the stress caused by your PTSD caused you to develop migraines that negatively affect your ability to function, you might qualify for a VA rating for migraines secondary to PTSD.
Secondary Conditions to PTSD: Nexus Letters
If you can prove your service-connected PTSD caused an additional condition or worsened a preexisting one, you may be eligible for further compensation. One way to help prove secondary service connection is through a Nexus Letter from a qualified medical professional.
The VA rates secondary conditions to PTSD up to 100%, depending on the condition and the severity and frequency of symptoms.
Common VA Disabilities Secondary to PTSD
This VA disability list of secondary conditions to PTSD can help lead you in the direction of the benefits and compensation you deserve.
Migraine Headaches Secondary to PTSD
Veterans with PTSD are likely to develop migraines, and it’s one of the most common secondary conditions to PTSD.
If you’ve served, you know the heightened stress and anxiety it can bring. These added emotions in connection with your PTSD commonly lead to migraine headaches, a frequently debilitating condition.
In addition, the stress from PTSD leads to tension in the head and neck, causing migraines. Migraines can significantly affect your quality of life, and PTSD can trigger these extreme headaches.
Hypertension Secondary to PTSD
Hypertension, or high blood pressure, is frequently associated with PTSD, especially for veterans stationed in higher-stress areas like Iraq and Afghanistan.
Unfortunately, veterans who were severely injured in war are at a greater risk for developing hypertension. Left untreated, high blood pressure can lead to severe conditions, including heart and kidney disease, stroke, and vision loss.
While the finding was for female and male veterans, it showed females have a slightly higher risk for early blood pressure elevation into the hypertension range.
GERD Secondary to PTSD
GERD frequently occurs in veterans due to the symptoms of PTSD, including stress, anxiety, and depression. These symptoms can lead to an overproduction of stomach acid, causing GERD.
Even if you were diagnosed with GERD before your time in the service, you may qualify for a secondary condition if you can prove your service-connected PTSD aggravated the condition.
The following are triggers for GERD and should be avoided:
Drinking alcoholic beverages
Drinking caffeinated beverages
Eating late in the evening
Eating large portions
Smoking
Irritable Bowel Syndrome (IBS) Secondary to PTSD
Veterans with an increased severity of PTSD are more likely to experience increased gastrointestinal symptoms, including irritable bowel syndrome (IBS).
A common link between IBS and PTSD is based on the signaling between the brain and the gut. If your PTSD causes you to be hypervigilant, the brain signals the gut to enter a hyperarousal state, resulting in side effects like diarrhea or constipation.
In addition, IBS can cause significant psychological impairment to veterans with an already-diagnosed case of PTSD.
Erectile Dysfunction (ED) Secondary to PTSD
PTSD is known to cause physical and psychological responses, like fear or anxiety, leading to an interference with the ability to become aroused.
Veterans who develop or have a worsened condition of erectile dysfunction because of their PTSD may be entitled to additional benefits and compensation.
Sleep Apnea Secondary to PTSD
While PTSD doesn’t cause sleep apnea directly, it’s not uncommon for PTSD to aggravate an already diagnosed case of sleep apnea. It’s essential to understand the two conditions aren’t medically connected.
Many veterans face difficulty when trying to service-connect sleep apnea and PTSD because there is a lack of medical evidence linking the two.
To help confirm your sleep apnea diagnosis, it’s highly recommended you provide a nexus letter to help establish a secondary service connection for sleep apnea secondary to PTSD.
You can receive a Nexus Letter from one of our independent professional providers at Telemedica, which can help lead you to a winning claim. Get in touch with us today to get started.
Substance Abuse Disorders Secondary to PTSD
Many veterans with PTSD develop a substance abuse disorder as a way to cope with their condition. It’s a serious condition, and you deserve the proper treatment, care, and compensation.
Unfortunately, substance abuse disorders frequently exacerbate PTSD symptoms, which can significantly impact daily life.
You are NOT alone.80% of veterans struggle with alcohol abuse, and 7% have had an issue with both alcohol and illegal drugs.
How to Establish Service Connection for Secondary Conditions to PTSD
To be service connected for secondary conditions to PTSD, you must provide the following:
A medical diagnosis of the secondary disability condition you’re attempting to link to PTSD
A current service-connected primary disability (In this case, PTSD)
A medical nexus or link establishing a connection between the service-connected PTSD and the current disability you’re trying to connect (i.e., sleep apnea, GERD, depression). A qualified Nexus Letter can go a long way in helping to prove service connection for a secondary condition
How to Receive Benefits for Multiple Health Conditions
Many veterans are familiar with “VA Math,” knowing it’s not as easy as 1+1=2. For example, if you have a 50% rating for PTSD and receive a 30% rating for sleep apnea as a secondary condition, you aren’t awarded an 80% VA rating.
Instead, secondary conditions of PTSD are based on schedules, which calculate your impairment after the primary disability is considered.
For quick and easy combined VA disability rating percentages, you can use a VA Disability Calculator to check your Combined VA Rating.
4 Steps for Filing Secondary Claims to PTSD
You can file for PTSD secondary conditions by following the below steps:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ – Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Ensure your non-service-connected secondary disability condition is medically diagnosed and that the primary disability condition is service-connected at 0% or higher
Obtain a Nexus Letter from a private healthcare provider to help show the link or connection between the non-service-connected secondary disability and the service-connected primary disability
File the non-service-connected secondary disability condition secondary to the primary service-connected disability in VA.gov
If you have been previously denied, you can file for an appeal. Our team at Telemedica can prepare a Rebuttal Letterto help address incorrect or inaccurate statements on your VA denial letter.
Telemedica Can Help
The presence of secondary conditions varies among individuals with PTSD, and your treatment and support should be tailored to your specific needs.
It’s crucial to seek professional help when addressing both the primary symptoms of PTSD and any secondary conditions as a comprehensive approach for effective management and recovery.
The team at Telemedica is standing by to answer your questions. Contact us today!
