DVA Secondary Conditions: Claiming Conditions Caused by Service Injuries

Most veterans stop at their first accepted condition. They get tinnitus accepted, or a knee injury, or PTSD, and they think the job is done. It isn’t.

DVA allows you to claim conditions that were caused by, or worsened by, your already-accepted service injuries. These are known as secondary conditions, and they represent one of the most consistently under-claimed areas in the entire DVA system.

The average DVA claim now includes 4.4 conditions, up from 2.6 in 2022. That shift reflects better advocacy, not a sudden increase in how many conditions veterans actually have. The conditions were always there. They just weren’t being claimed.

What is a secondary DVA claim?

A secondary condition is a medical condition that developed or worsened because of a condition DVA has already accepted as service-related. Under the MRCA, DVA can accept liability for a new condition if it arose from or was aggravated by an accepted condition. This works through the Statement of Principles (SoP) framework. Each SoP contains specific factors that define what can cause or worsen that condition. Many of those factors explicitly reference other medical conditions, which creates a direct legal pathway from your accepted injury to the new claim.

You don’t need new service-related events to establish a secondary claim. The accepted condition itself is the connection to service.

How secondary claims work under Australian law

Secondary claims in Australia operate differently from the US VA system. There are no nexus letters in the Australian framework. The mechanism is the SoP.

The three main secondary claim types

• Condition caused by condition. An accepted mental health condition causes a physical one (PTSD contributing to hypertension), or an accepted physical condition causes a mental health one (chronic pain from a knee injury contributing to depression). The new condition has its own SoP, and one of the factors in that SoP references the accepted condition.
• Condition caused by treatment. An accepted condition requires medication or treatment, and that treatment causes a new condition. The most common example is chronic NSAID use for musculoskeletal pain causing GERD. The SoP for GERD contains an NSAID use factor. Your accepted back injury doesn’t directly cause the GERD, but the medication used to treat it does.
• Condition caused by functional consequences. An accepted condition limits your mobility or activity, leading to weight gain, and that weight gain causes further conditions. This is the obesity cascade: a knee injury reduces your ability to exercise, your BMI rises above 30, and that sustained obesity meets the SoP factor for lumbar spondylosis, sleep apnoea, or hypertension.

Mental health secondary conditions

Mental health conditions are the most common secondary claims and the most significant in terms of impairment points.

Depression secondary to tinnitus

The most frequently missed secondary claim in the system. Tinnitus is DVA’s most accepted condition. SoP No. 11 of 2024 (RH) factor 9(15) requires severe and permanent tinnitus at the time of clinical onset of depression. The BoP version does not contain this factor — peacetime veterans need the chronic medical condition pathway instead.

Insomnia secondary to PTSD

Chronic insomnia is almost universal among veterans with PTSD, and almost universally unclaimed as a separate condition. SoP No. 37/38 of 2019 factor 8(1) requires only that PTSD was present within one year before the clinical onset of chronic insomnia. Insomnia is assessed under GARP M Chapter 6 (Sleep Disorders), separately from the PTSD rating in Chapter 5 — the two produce independent impairment scores that combine.

Physical secondary conditions

Cardiovascular and metabolic secondary conditions

What impairment points are at stake

Each accepted condition — primary or secondary — has its own permanent impairment assessment under GARP M. Those impairment points combine using the formula in GARP M Chapter 23. The combining formula is not additive. Twenty points from PTSD plus 15 points from insomnia does not equal 35 combined points. The formula accounts for overlap, and the combined impairment score (CIS) is typically lower than the sum of individual ratings. However, multiple accepted conditions consistently produce a higher CIS than any single condition alone.

What evidence you need

• Clinical evidence for the secondary condition itself. A diagnosis from an appropriate specialist: psychiatrist or clinical psychologist for mental health conditions, gastroenterologist for GERD, sleep physician for sleep apnoea, rheumatologist or orthopaedic surgeon for joint conditions.
• Evidence of the link between the accepted condition and the secondary condition. Your medical practitioner needs to confirm, in a report or letter, that the specific SoP factor is satisfied. A treating GP referral is a good starting point but is rarely sufficient on its own for the liability stage.

How to approach your secondary claims strategically

Work backwards from your accepted conditions. For each accepted condition, identify which SoP factors in other conditions’ SoPs reference it. That map tells you which secondary claims are legally available to you. Then review your medical history to identify which of those secondary conditions you actually have a diagnosis for.

Don’t assume that because you have an accepted condition, DVA will proactively identify your secondary claims. They won’t. Secondary claims must be lodged. The burden is on the veteran and their advocate to identify and pursue them.

Frequently asked questions

Can I claim a secondary condition if my primary condition was accepted years ago?

Yes. There is no time limit on lodging a secondary claim after the primary condition was accepted. The relevant dates are the clinical onset of the secondary condition and whether the primary condition was present at that time, not when the primary condition was accepted by DVA.

Do I need a new injury or service event to claim a secondary condition?

No. The connection to service runs through the already-accepted condition. You do not need a new service event, new deployment, or any additional service-related incident.

Can I claim multiple secondary conditions at the same time?

Yes, and you should. There is no limit to how many secondary claims can be lodged concurrently. Each is assessed separately on its own merits. Lodging them together is more efficient than lodging in sequence.

Does claiming a secondary condition affect my primary condition's rating?

No. Your primary condition’s accepted status and impairment rating are not affected by secondary claims. Each condition is assessed independently.

What if DVA rejects my secondary claim?

A rejected secondary claim can be appealed to the VRB, then to the ART. The grounds for rejection are usually that the SoP factor was not satisfied on the evidence. Both are addressable through additional medical evidence or a VRB appeal.