VAMaX4U

Chapter 4: Strategies for Identifying Your Secondary Conditions

Chapter 4

Strategies for Identifying Your Secondary Conditions

Comprehensive Self-Assessment Techniques

Identifying potential secondary conditions begins with a thorough self-assessment. Many veterans are unaware of the full range of conditions that may be connected to their service-connected disabilities. A systematic approach to self-assessment can help you recognize these connections.

Self-Assessment Approach

A comprehensive self-assessment involves examining your health from multiple angles:

  • Physical symptoms and limitations
  • Psychological and cognitive effects
  • Medication side effects
  • Changes in daily functioning
  • Progression of symptoms over time

Body System Inventory

One effective approach is to conduct a systematic inventory of each body system, noting any symptoms or issues you experience. This helps ensure you don’t overlook potential secondary conditions.

Body System Questions to Consider Potential Secondary Conditions
Musculoskeletal
  • Do you have pain in joints other than your service-connected ones?
  • Have you noticed changes in your posture or walking pattern?
  • Do you have muscle weakness or spasms?
  • Arthritis in additional joints
  • Degenerative disc disease
  • Tendonitis
  • Fibromyalgia
Neurological
  • Do you experience numbness, tingling, or burning sensations?
  • Do you have headaches or dizziness?
  • Do you have trouble with balance or coordination?
  • Peripheral neuropathy
  • Radiculopathy
  • Migraines
  • Vertigo
Mental Health
  • Has chronic pain affected your mood or outlook?
  • Do you have trouble sleeping due to physical symptoms?
  • Have limitations from your conditions caused frustration or isolation?
  • Depression
  • Anxiety
  • Sleep disorders
  • Adjustment disorder
Cardiovascular
  • Has your activity level decreased due to service-connected conditions?
  • Do you experience shortness of breath or chest pain?
  • Have you been told you have high blood pressure?
  • Hypertension
  • Coronary artery disease
  • Heart failure
  • Peripheral vascular disease

This table represents just a starting point. A complete self-assessment would include all body systems, including respiratory, digestive, endocrine, genitourinary, skin, and special senses (vision, hearing, etc.).

Medication Analysis

Medications prescribed for your service-connected conditions can cause a wide range of side effects that may qualify as secondary conditions. A thorough medication analysis can help identify these potential connections.

Pain Medications

Common Examples: NSAIDs (ibuprofen, naproxen), opioids (hydrocodone, oxycodone), muscle relaxants

Potential Secondary Conditions: Gastritis, peptic ulcer disease, kidney damage, liver damage, cognitive impairment, sleep apnea, constipation

Psychiatric Medications

Common Examples: SSRIs, SNRIs, benzodiazepines, antipsychotics

Potential Secondary Conditions: Weight gain, metabolic syndrome, sexual dysfunction, movement disorders, dry mouth and dental issues

Corticosteroids

Common Examples: Prednisone, cortisone, dexamethasone

Potential Secondary Conditions: Osteoporosis, diabetes, cataracts, glaucoma, hypertension, weight gain, skin thinning

Blood Pressure Medications

Common Examples: Beta-blockers, ACE inhibitors, calcium channel blockers

Potential Secondary Conditions: Erectile dysfunction, fatigue, dizziness, electrolyte imbalances, gout

Action Steps for Medication Analysis

  1. Create a complete list of all medications you take for service-connected conditions.
  2. Research potential side effects using reliable sources (pharmacy information, medication guides).
  3. Document any symptoms you experience that match known side effects.
  4. Review this information with your healthcare provider.
  5. Request that side effects be documented in your medical records.

Strategic Medical Record Review

Your medical records contain valuable clues about potential secondary conditions that you might not have connected to your service-connected disabilities. A strategic review of these records can uncover important evidence.

Key Elements to Look For

  • Documented Symptoms: Look for patterns of symptoms reported over time that may relate to your service-connected conditions.
  • Provider Observations: Note any comments from healthcare providers that suggest connections between conditions.
  • Diagnostic Testing: Review results of blood work, imaging, or other tests that might indicate secondary conditions.
  • Treatment Patterns: Identify treatments prescribed that might be addressing secondary conditions.
  • Medication Changes: Note adjustments to medications that might have been made to address side effects.

Request complete copies of your medical records from all relevant providers, including VA medical centers, private physicians, and specialists. You can obtain VA medical records through the VA’s Blue Button feature on My HealtheVet or by submitting VA Form 10-5345.

Connecting the Dots: Relationship Mapping

After identifying potential secondary conditions, the next step is to clearly map their relationship to your service-connected disabilities. This helps build a compelling case for secondary service connection.

As the diagram illustrates, primary service-connected conditions often lead to secondary conditions in multiple body systems. Additionally, secondary conditions themselves can cause tertiary conditions, all of which may be eligible for VA compensation.

Creating Your Personal Connection Map

To create your own relationship map:

  1. List all your service-connected conditions in the center.
  2. Around each primary condition, add the secondary conditions you’ve identified.
  3. Draw arrows showing the relationships (causal or aggravating).
  4. Note the specific mechanisms of connection (e.g., altered gait, medication side effect).
  5. Include any tertiary conditions that stem from secondary conditions.

Symptom Tracking Systems

Systematic tracking of your symptoms over time can reveal patterns and connections that might otherwise go unnoticed. These tracking systems can provide valuable evidence for your claims.

Daily Symptom Journal

Keep a detailed journal of your symptoms, noting severity, duration, triggering factors, and relationship to service-connected conditions. Include impacts on daily activities and any treatments attempted.

Medication Effect Log

Document all medications taken, dosages, timing, and any side effects experienced. Note when medications are changed and how those changes affect your symptoms.

Functional Impact Assessment

Regularly assess and record how your conditions affect your ability to perform daily activities, work tasks, and social functions. Note changes over time and relationships between limitations.

Digital Health Apps

Use smartphone apps designed for tracking chronic conditions, pain levels, medication effects, sleep patterns, and other health metrics. Many apps can generate reports that may be useful for your healthcare providers.

Chapter Summary

  • A comprehensive self-assessment approach helps identify potential secondary conditions by examining your health from multiple angles.
  • Conducting a systematic body system inventory ensures you don’t overlook potential secondary conditions in any area of your health.
  • Medication analysis can reveal side effects that may qualify as secondary conditions.
  • Strategic review of your medical records can uncover important evidence of secondary conditions.
  • Relationship mapping helps clearly establish the connection between your service-connected conditions and potential secondary conditions.
  • Systematic symptom tracking provides valuable documentation of the development and progression of secondary conditions.

© 2025 Ronald A. Bolton. All rights reserved.