A Higher Rating or a New Condition

Two different claims walk in this door

You already have a rating. Either the rated condition got worse, or you have a new problem and you suspect the rated condition caused it. The VA calls the first a claim for increase. It calls the second secondary service connection, under 38 CFR 3.310.

Path one: the rated condition got worse

The VA already agrees the condition came from service. The only question is how bad it is now, measured against the same ladder that produced your current rating. Each diagnostic code in 38 CFR Part 4 lists its levels, and each level names findings: degrees of motion, episodes per year, the words a mental health examiner uses. Know which rung you are claiming before you file.

Two rules help you. 38 CFR 4.7 says that when your condition sits between two levels, you get the higher one if your condition more nearly matches it. 38 CFR 4.10 says a rating rests on how well the body or mind functions in daily life, including work, and it makes the examiner describe those effects in full.

What proves worsening

• Treatment records that show the change over time. 38 CFR 4.1 requires each disability to be viewed in relation to its history.
• The specific findings the next rung names: a number of degrees, a number of episodes a year. The record has to show them.
• Your own statement, and statements from the people who see you every day, on what you could do at the last exam and cannot do now.
• Timing. Under 38 CFR 3.400(o)(2), an increase can reach back to the date the worsening could first be shown, as long as the VA receives your complete claim or intent to file within a year of that date.

You do not have to wait for the VA's examiner to measure you. A private doctor can complete the Disability Benefits Questionnaire (DBQ) for the condition before you file, if VA publishes one for it, so the measurements that decide the rung are in the file first. VA keeps some DBQs off the public list, including hearing loss and tinnitus, initial PTSD, TBI, cold injury, and the Gulf War general medical exam. For those your doctor writes a report and the VA exam supplies the form. The DBQ has to be done the way a VA exam is done. For a joint or the spine, that means a goniometer, the tool that measures how far a joint bends. 38 CFR 4.46 calls a goniometer indispensable in VA's own exams. An adequate private report can be accepted for rating without a VA exam (38 CFR 3.326(c)), and if it falls short the VA orders its own exam (38 CFR 3.326(a)), so ask for the same tool. 38 CFR 4.59 says the joint should be tested for pain on active and passive motion, weight-bearing and not, and compared with the other joint if possible. The exam also has to measure again after repeated movement, note where pain starts, and record what a flare-up takes away (38 CFR 4.40, 4.45, and 4.59, as the Court of Appeals for Veterans Claims reads them in DeLuca v. Brown and Sharp v. Shulkin, and as the DBQ form asks). A DBQ that estimates motion by eye carries little weight.

The risk: a re-exam cuts both ways

When you file for an increase, the VA often orders a new exam. 38 CFR 3.327(a) lets it request a reexamination whenever it needs to verify the current severity of a disability. If the exam shows improvement, the VA can propose a reduction. At any age, a reduction has to rest on an actual change in the condition, not on a more thorough exam or different words from the examiner (38 CFR 4.13), it has to be judged against the whole history (38 CFR 4.1, 4.2), and the exam itself has to be adequate, including pain and repeated-use testing for a joint (38 CFR 4.40, 4.45, 4.59, and the repeated-use testing the Court of Appeals for Veterans Claims requires under DeLuca v. Brown). The knee decision on the home page restored two ratings that were under five years old on exactly that ground. Know how much more protection your rating has before you file.

• Under five years. 38 CFR 3.344(c) says the extra protections in 3.344(a), such as no reduction on a single exam for a condition that comes and goes, do not yet apply, so a reexamination that shows real improvement can reduce the rating.
• Five years or more at the same level. 38 CFR 3.344(a) applies. The VA cannot use an exam less thorough than the one that set your rating. For a condition that comes and goes, it cannot reduce based on a single exam unless the whole record clearly shows lasting improvement. And it must be reasonably certain the improvement will hold up in ordinary life.
• Ten years, and this rung protects the service connection itself, not the percentage. Under 38 CFR 3.957, service connection cannot be severed after ten years unless the original grant was based on fraud, or the service records clearly show you lacked qualifying service or character of discharge. Severed means taken away altogether. Your rating can still be reduced on an adequate exam that shows real improvement. Only the twenty-year rule below protects the percentage.
• Twenty years. Under 38 CFR 3.951(b), a rating continuously in effect at or above a level for twenty years cannot be reduced below that level except on a showing of fraud.

A proposed reduction has to follow 38 CFR 3.105(e): written reasons and 60 days to submit evidence. Under 38 CFR 3.105(i), if you request a hearing within 30 days of the notice, payments continue at the current level until the decision.

Path two: a new condition caused by a rated one

38 CFR 3.310(a) says a disability that is proximately due to or the result of a service-connected condition shall be service connected. 38 CFR 3.310(b) covers a condition that did not come from service but was made worse by a rated one. Only the added harm counts, not the normal course of the disease. And it counts only if medical records show how bad the condition was before the rated one started making it worse, or in the earliest records after that.

This is step six of the nine steps: mental health caused by your rated conditions. Depression or anxiety caused by chronic pain, tinnitus, sleep apnea, a brain injury, or any other rated condition is service connected on its own footing and rated under 38 CFR 4.130 on occupational and social impairment. 38 CFR 4.126(a) makes the rater weigh all the evidence, not only what the examiner saw that day.

What a secondary needs

1. A current diagnosis, or competent evidence of persistent or recurrent symptoms.
2. The rated condition, which you already have.
3. A doctor's written opinion that the new condition is at least as likely as not caused or aggravated by the rated one, with the reasoning spelled out. Under 38 CFR 3.159(c)(4), if the record is not enough to decide the claim, a sign that the new condition may be tied to another service-connected condition is part of what requires the VA to get an exam or opinion. Under 38 CFR 3.102, an approximate balance of the evidence goes to you.

File the opinion with the claim, not after. Do not claim a rung the record cannot support. The same exam that rates the new condition looks at the old one. This site is education, not representation. You file on VA.gov or with a free accredited representative.

Where the Claim Map fits

Open the Claim Map and choose your rated condition. It shows that condition's diagnostic code, the rating percentages the code carries, and the secondary conditions most often claimed alongside it in the Board decisions we have indexed, with the count and the share granted for each pair. It then asks where you are in the process and what evidence you already hold, and saves that to your account. Reading the criteria rung by rung is what the written playbook adds. To read the decisions behind a pair today, open the decision pages.

The two paths on this page start the Claim Map in two different places, so pick the button that matches yours.

Know your combined rating first

The VA does not add ratings, it combines them. The combined rating calculator shows the math, then starts your Claim Map with those ratings.