PTSD & Secondary Conditions
Substance Use Secondary to PTSD: What Veterans Need to Know
Substance use disorders are not separately compensable by VA. That surprises most veterans — and it leads many to conclude the issue does not matter to their claim. It does. It simply matters in places most people are not looking.
Written by Jessica R. Allen, M.D., adult and addiction psychiatrist, licensed psychiatrist and former VA Compensation and Pension examiner | Brightview Psychiatry Solutions PLLC
Summary
Can a veteran get VA disability for substance use secondary to PTSD? Not as a separate rating. VA does not pay compensation for alcohol or drug abuse on its own, and there is no diagnostic code for substance use disorders. But under Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001), a substance use disorder caused by a service-connected condition can be service connected — as part of that condition rather than alongside it.
The practical value lies in three places: substance use is evidence of severity supporting a higher rating for the underlying mental health condition; getting it named in the wording of the service-connected disability protects future claims; and it opens a documented pathway to later physical conditions such as liver disease, and to dependency and indemnity compensation for a surviving spouse.
Why Substance Use Disorders Are Not Separately Rated
Two things are going on, and veterans usually only hear about one of them.
First, the willful misconduct bar. Federal law excludes compensation for disability resulting from a veteran's own abuse of alcohol or drugs. VA's General Counsel has confirmed that direct service connection for disability resulting from a claimant's own substance abuse is precluded for all VA benefits for claims filed after October 31, 1990. This is why a veteran cannot simply claim "alcohol use disorder" and receive a rating for it.
Second, and separately, there is no diagnostic code. Even setting the misconduct bar aside, the rating schedule at 38 C.F.R. § 4.130 contains no diagnostic code for alcohol use disorder, opioid use disorder, or any other substance use disorder. And under 38 C.F.R. § 4.14, VA does not rate the same disability picture twice under different diagnoses. All service-connected psychiatric symptomatology is evaluated under a single rating.
Put together: even when a veteran successfully establishes that alcohol use disorder is secondary to service-connected PTSD, the result is not a second check. It is a recognition that folds into the existing psychiatric evaluation.
What this means in practice
If someone offers to write you a nexus letter promising a separate rating for alcohol or drug use disorder secondary to PTSD, they are describing something the rating schedule does not provide. Ask them which diagnostic code they expect it to be rated under.
What Allen v. Principi Actually Held
This 2001 Federal Circuit decision is the reason substance use is worth raising at all. It is also narrower than it is usually described.
The Federal Circuit held that 38 U.S.C. § 1110 does not preclude a veteran from receiving compensation for an alcohol or drug abuse disability arising secondarily from a service-connected disability — or from using an alcohol or drug abuse disability as evidence of the increased severity of a service-connected disability.
The court was explicit that the holding is limited. Compensation results only where there is clear medical evidence establishing that the substance use disability is caused by the primary service-connected condition, and not the result of willful wrongdoing. VA remains free to find that drinking or drug use was voluntary conduct even where a veteran also has PTSD.
Allen identified two situations where compensation is precluded: primary alcohol abuse disabilities, meaning abuse arising from voluntary and willful drinking to excess; and secondary disabilities such as cirrhosis of the liver that result from that primary abuse.
The distinction that decides these cases
The bar attaches to PRIMARY abuse. Where the substance use disorder is itself secondary to a service-connected condition, the organ damage flowing from it is not automatically excluded — because the drinking was not primary abuse in the first place.
That single word is what separates a viable liver claim from a denied one, and it is why the medical opinion has to establish the psychiatric causation of the drinking before it ever discusses the liver.
Three Places Substance Use Genuinely Matters
None of these produces a separate check for the substance use itself. All three can change what a veteran or a surviving spouse actually receives.
1. A higher mental health rating
The most immediate and most overlooked use. Allen expressly permits substance use to be offered as evidence of the increased severity of a service-connected disability. This applies to essentially every veteran with a psychiatric rating, not just those with a downstream physical condition.
2. The wording of the disability
Whether the rating decision reads "PTSD" or "PTSD with alcohol use disorder" determines whether a later claim has to relitigate the drinking. Veterans almost never read this line, and it can matter enormously years afterward.
3. A later physical condition
Secondary service connection can operate in a chain. Where each link is documented and medically explained, a liver or lung condition several steps removed from service can still be service connected — and can support DIC.
Can Substance Use Support a Higher PTSD, Depression, or Anxiety Rating?
Yes — and this is where substance use does the most work for the most veterans. It applies whether the service-connected diagnosis is PTSD, major depressive disorder, generalized anxiety disorder, or any other psychiatric condition rated under 38 C.F.R. § 4.130.
Allen v. Principi held that § 1110 does not preclude a veteran from using an alcohol or drug abuse disability as evidence of the increased severity of a service-connected disability. That sentence is doing something separate from the secondary service connection holding. It means substance use can be offered as proof of how bad the psychiatric condition is, without any claim that the substance use disorder should be rated on its own.
Why substance use is not on the symptom list, and why that does not matter
The General Rating Formula for Mental Disorders lists symptoms at each evaluation level. Substance use is not among them. Veterans and even some representatives read that omission as meaning drinking is irrelevant to the rating.
It is not. Under Mauerhan v. Principi, 16 Vet. App. 436 (2002), the symptoms listed in the formula are examples rather than an exhaustive checklist. What the formula actually requires is a level of occupational and social impairment. Any evidence probative of that level counts, listed or not.
The corresponding limit comes from Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013): symptoms alone do not establish a rating. The evidence must show that the symptoms produce the level of occupational and social impairment the criteria describe. So the argument is never "he drinks, therefore 70 percent." It is that the drinking demonstrates deficiencies in work, family relations, judgment, or mood.
How substance use maps to the criteria
The formula's own language is set out below alongside the kinds of substance-related facts that tend to evidence it. This is illustrative rather than a formula — VA weighs the whole disability picture, and only VA assigns evaluations.
| Criteria language | Substance-related evidence that may speak to it |
|---|---|
| Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks | Drinking that costs occasional days of work, hangovers affecting performance, use starting to interfere with routine tasks. |
| Reduced reliability and productivity; disturbances of motivation and mood; difficulty establishing and maintaining effective work and social relationships | Regular absenteeism, disciplinary write-ups, drinking alone rather than socially, withdrawal from family activities, declining work quality. |
| Deficiencies in most areas — work, school, family relations, judgment, thinking, or mood; impaired impulse control; difficulty adapting to stressful circumstances | Job loss or separation attributed to drinking, DUI or legal consequences, drinking triggered by workplace stress, detoxification admissions, residential treatment, relapse following psychiatric exacerbation. |
| Total occupational and social impairment | Inability to maintain any employment, complete social withdrawal, repeated hospitalization, inability to manage activities of daily living. |
Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks
Drinking that costs occasional days of work, hangovers affecting performance, use starting to interfere with routine tasks.
Reduced reliability and productivity; disturbances of motivation and mood; difficulty establishing and maintaining effective work and social relationships
Regular absenteeism, disciplinary write-ups, drinking alone rather than socially, withdrawal from family activities, declining work quality.
Deficiencies in most areas — work, school, family relations, judgment, thinking, or mood; impaired impulse control; difficulty adapting to stressful circumstances
Job loss or separation attributed to drinking, DUI or legal consequences, drinking triggered by workplace stress, detoxification admissions, residential treatment, relapse following psychiatric exacerbation.
Total occupational and social impairment
Inability to maintain any employment, complete social withdrawal, repeated hospitalization, inability to manage activities of daily living.
The mechanism has to be stated, not assumed
An examiner or adjudicator reading "veteran drinks heavily" may reasonably conclude the drinking is independent behavior. What converts it into evidence of psychiatric severity is the explanation: that the veteran drinks to fall asleep because nightmares make unmedicated sleep intolerable, or drinks before leaving the house because hypervigilance makes public spaces unmanageable. The behavior is the same. Only one version tells VA what it means.
Development or worsening: the argument specific to an increase claim
An increased rating claim asks a narrower question than an original claim. It is not simply whether the veteran is impaired. It is whether the disability has worsened since the evaluation currently assigned.
Substance use is unusually well suited to answering that question, because changes in use are datable in a way that mood rarely is. Each of the following marks a point in time that a record can establish:
- New onset. A veteran who did not drink problematically at the time of the last rating decision and does now.
- Escalation. Documented increases in quantity or frequency, or a shift from evening drinking to daytime or morning use.
- A first detoxification or treatment admission. A dated, objective event that did not exist at the prior evaluation.
- Relapse after sustained sobriety. Particularly where it followed a documented psychiatric exacerbation, a trauma anniversary, or a stressor.
- A new substance. Adding benzodiazepines, opioids, or cannabis to alcohol, or moving to a substance with higher risk.
- New consequences. A first DUI, a job loss, a separation, or a medical complication such as abnormal liver enzymes.
- Failed treatment. Completing a program and returning to use, which speaks to the severity of what is being self-medicated.
- Medication changes. Starting naltrexone, acamprosate, or buprenorphine — dated prescribing events tied to a clinical judgment about severity.
Why this argument is stronger than it looks
Most mental health increase claims turn on symptom descriptions that are difficult to date and easy for an adjudicator to characterize as unchanged. "My depression is worse" is a statement about an internal state with no timestamp.
"I had never been to detox before 2023, and I have been twice since" is a documented change with a date attached. On the question an increase claim actually asks — has this gotten worse — that is a different quality of evidence.
Talking about it at a C&P examination
Many veterans minimize or omit substance use at a C&P exam, fearing it will be read as misconduct. The result is an examination report that documents less impairment than actually exists, which becomes the basis for the rating.
Describing the pattern rather than the quantity is usually more useful. An examiner assessing occupational and social impairment is listening for function:
- What the substance is doing for you — sleep, crowds, irritability, intrusive memories, being able to leave the house.
- What changed and when, relative to your last rating decision.
- What it has cost at work — missed days, warnings, terminations, jobs not applied for.
- What it has cost at home — separations, children's reactions, isolation from family.
- Treatment history, including detox, residential or intensive outpatient programs, and relapses.
- Whether it tracks your psychiatric symptoms — heavier during bad stretches, lighter during better ones.
The same reasoning applies to other behaviors that reflect impaired coping without appearing on the symptom list, including changes in eating. In both cases the argument is that the behavior is evidence of impairment, not that it is a separate ratable diagnosis.
Why the Wording on Your Rating Decision Matters
This is the point veterans almost never hear, and it can matter enormously years later — including to a spouse who will file long after the veteran is gone.
When VA grants service connection, the rating decision names the disability. There is a meaningful difference between a decision that reads "PTSD" and one that reads "PTSD with alcohol use disorder." The second version establishes, in VA's own adjudicated language, that the drinking is part of the service-connected picture rather than separate misconduct.
Once that phrasing exists in the file, a later claim for a physical condition caused by the drinking does not have to relitigate whether the alcohol use was service connected. That question has already been answered. The same is true for a surviving spouse filing for dependency and indemnity compensation after the veteran's death — the hardest element of her case may already be established in a decision issued decades earlier.
Veterans routinely accept a favorable decision without reading how the disability is described. If your psychiatric records document substance use tied to your service-connected condition and the rating decision does not reflect it, that is worth raising with your representative while the claim or appeal is still open.
Example One: Liver Disease Following Alcohol Use Secondary to PTSD
This is the classic chain, and the one where the primary versus secondary distinction does all the work.
| Link | What must be established |
|---|---|
| 1. Service-connected PTSD | Established by rating decision, with documented hyperarousal, nightmares, and sleep disruption. |
| 2. Alcohol use disorder secondary to PTSD | The medical opinion must establish this first, with clear medical evidence that the drinking arose from the psychiatric condition — commonly as self-medication — rather than from independent voluntary excess. |
| 3. Alcohol-related liver disease | Fatty liver, alcoholic hepatitis, or cirrhosis, documented by laboratory studies, imaging, or biopsy, and attributed by the treating hepatologist or gastroenterologist to alcohol. |
| 4. Secondary service connection | The liver condition is service connected and rated under the digestive system schedule on its own terms. |
1. Service-connected PTSD
Established by rating decision, with documented hyperarousal, nightmares, and sleep disruption.
2. Alcohol use disorder secondary to PTSD
The medical opinion must establish this first, with clear medical evidence that the drinking arose from the psychiatric condition — commonly as self-medication — rather than from independent voluntary excess.
3. Alcohol-related liver disease
Fatty liver, alcoholic hepatitis, or cirrhosis, documented by laboratory studies, imaging, or biopsy, and attributed by the treating hepatologist or gastroenterologist to alcohol.
4. Secondary service connection
The liver condition is service connected and rated under the digestive system schedule on its own terms.
The reason this can work is that the liver damage did not result from primary alcohol abuse. It resulted from drinking that was itself a manifestation of a service-connected psychiatric disability. Allen's exclusion is written for the primary case.
The order matters. A shortcut opinion — noting that the veteran has PTSD and also has cirrhosis — invites VA to treat the drinking as willful misconduct and deny on that basis. The psychiatric causation of the drinking has to be established on its own before the liver enters the discussion.
A note on what strengthens this
Treatment records help rather than hurt. Documented detoxification admissions, residential or intensive outpatient treatment, relapse histories tied to psychiatric exacerbations, and clinician notes describing self-medication are the evidence that distinguishes a secondary substance use disorder from voluntary excess. Seeking treatment does not weaken a claim. It is frequently what makes one provable.
Example Two: Lung Cancer Following Tobacco Use, and the DIC Claim That Follows
The tobacco pathway has an additional statutory hurdle, and getting the timing right is the difference between a viable claim and one barred by law before it is read. A claim resting on smoking having begun during service is barred by 38 U.S.C. § 1103 for claims filed after June 9, 1998.
But VA General Counsel Precedent Opinion 6-2003 addressed a different question and reached a different answer. It held that neither § 1103(a) nor its implementing regulation bars secondary service connection for a disability related to the veteran's use of tobacco products after service, where that disability is proximately due to a service-connected disability that is not itself service connected on the basis of in-service tobacco use.
In other words: the claim is not that service caused the smoking. The claim is that the service-connected PTSD caused or drove the smoking after service, and the smoking caused the cancer.
| Question | What the evidence must show |
|---|---|
| One | Whether the service-connected disability caused the veteran to use tobacco products after service. |
| Two | Whether that tobacco use, resulting from the service-connected disability, was a substantial factor in causing the secondary disability. |
| Three | Whether the secondary disability would not have occurred but for the tobacco use caused by the service-connected disability. |
One
Whether the service-connected disability caused the veteran to use tobacco products after service.
Two
Whether that tobacco use, resulting from the service-connected disability, was a substantial factor in causing the secondary disability.
Three
Whether the secondary disability would not have occurred but for the tobacco use caused by the service-connected disability.
Worth knowing
The facts underlying VAOPGCPREC 6-2003 are close to the situation many families face. The opinion arose from the case of a former prisoner of war who had been service connected for PTSD since 1990, whose death certificate listed metastatic lung cancer with tobacco use noted as contributing, and whose surviving spouse filed for dependency and indemnity compensation.
That is the scenario the General Counsel was addressing directly.
How this reaches DIC
Dependency and indemnity compensation is payable to eligible survivors when a service-connected disability was the principal or a contributory cause of death. Under 38 C.F.R. § 3.312, a contributory cause is one that contributed substantially or materially to death, or combined to cause it — a causal connection, not merely a casual one.
So the chain for a surviving spouse runs: service-connected PTSD, then post-service tobacco use driven by that PTSD, then lung cancer, then death. If each link holds, the death may be service connected even though lung cancer was never rated during the veteran's lifetime.
This is also where the second pathway above pays off. A rating decision that already names nicotine dependence or tobacco use as part of the service-connected psychiatric disability gives the survivor a substantially easier case than one that requires proving the whole chain after the veteran is no longer able to describe his own history.
On disclosure
Many veterans hesitate to raise substance use with a treating provider or a C&P examiner out of fear that it will be held against them. That fear is understandable and it is also, in claims terms, usually backwards. Undocumented substance use cannot support a rating increase, cannot establish a chain to a later condition, and cannot appear in the wording of a rating decision. It can only work in your favor if it is in the record.
Honest Limits: Why These Claims Are Harder Than They Look
These are among the more difficult secondary theories in VA law. A veteran deciding whether to pursue one deserves to know why.
"Clear medical evidence"
Allen contemplates compensation only where clear medical evidence establishes that the substance use disability was caused by the service-connected condition. That is stronger language than the ordinary at-least-as-likely-as-not framing, and adjudicators read it that way.
Coexistence is not causation
Courts have been direct that having both PTSD and a substance use disability does not prevent VA from concluding that the drinking or drug use was willful. The opinion has to explain the psychiatric mechanism, not simply note that both conditions are present.
Timeline problems are common
Substance use that clearly predates the psychiatric condition, or that continued unchanged through periods of psychiatric remission, weakens causation considerably. Aggravation may remain available, but it is a different argument requiring baseline evidence.
The records often do not exist
Many veterans never disclosed substance use to a VA provider, precisely because they feared exactly this — being labeled as misusing rather than suffering. Where nothing is documented, there may be little for an opinion to attach to.
If you are in crisis right now
Veterans Crisis Line — dial 988, then press 1. You can also text 838255 or chat online at VeteransCrisisLine.net. It is staffed 24 hours a day, and you do not need to be enrolled in VA health care to use it.
What Belongs in a Medical Opinion on This Theory
Under Nieves-Rodriguez v. Peake, the probative value of a medical opinion rests on the reasoning connecting the evidence to the conclusion. On this theory more than most, the reasoning is the whole case.
- The psychiatric mechanism first — how the specific symptoms drove the substance use, in physiological and behavioral terms.
- A direct answer on willful misconduct, rather than leaving VA to supply its own finding.
- The temporal sequence between psychiatric onset and the onset or escalation of substance use.
- Correlation with psychiatric course — whether use worsened during documented exacerbations.
- Consideration of independent causes, including family history and pre-service use, addressed rather than omitted.
- Each link of the chain separately where a downstream physical condition is claimed.
- Causation and aggravation as independent theories, since Allen v. Brown treats them separately.
- A candid limitations section stating what was not reviewed and what the evidence cannot establish.
Questions Veterans Ask
Will admitting to alcohol or drug use hurt my VA claim?
It is far more likely to help than hurt. Substance use cannot support a rating increase, cannot establish a chain to a later physical condition, and cannot appear in the wording of your rating decision unless it is documented. VA can find that use was willful misconduct, which is why the medical explanation matters — but concealment removes the evidence entirely rather than protecting you.
Can I get a separate rating for alcohol use disorder secondary to PTSD?
No. There is no diagnostic code for substance use disorders in the rating schedule, and VA evaluates all service-connected psychiatric symptomatology under a single rating. Service connection can be established under Allen v. Principi, but it merges into the existing psychiatric evaluation rather than adding a second one.
Can drinking support a higher PTSD or depression rating?
It can. Allen v. Principi permits substance use to be offered as evidence of the increased severity of a service-connected disability, separately from any secondary service connection question. Substance use is not on the symptom list in the rating formula, but under Mauerhan v. Principi that list is illustrative rather than exhaustive. What matters is whether the evidence shows the level of occupational and social impairment the criteria describe, which under Vazquez-Claudio v. Shinseki is the actual test.
My drinking got worse since my last rating decision. Does that support an increase?
It may, and it is often better evidence than symptom descriptions alone. An increased rating claim asks whether the condition worsened since the current evaluation was assigned. Changes in substance use are datable in a way that mood is not — a first detoxification admission, a relapse after sustained sobriety, a new substance, a DUI, or a job loss are all dated events a record can establish. Bring those dates and the records that document them.
Does getting sober hurt my claim?
No, and this is worth saying plainly. Recovery does not erase the years of documented use, the treatment records, or the physical consequences that already developed. Documented treatment often strengthens a claim by showing the severity of what was being treated. Please do not delay getting help because of a claim.
My rating decision just says "PTSD." Can the wording be changed?
It depends on the posture of your claim. Where a claim or appeal is still open, the disability description can be addressed as part of that adjudication. Where the decision is final, the options are narrower and generally involve a new claim or, in limited circumstances, a request for revision. This is a question for an accredited representative, agent, or attorney rather than a physician.
Does this work for opioid use that started with prescribed pain medication?
That pathway is often more straightforward, because it does not depend on the psychiatric argument at all. Where opioids were prescribed for a service-connected orthopedic or pain condition and dependence developed, the disability arises from treatment for a service-connected disability, which is compensable under 38 C.F.R. § 3.310. The documentation trail from the prescribing records is also usually much clearer.
Can substance use disorder support TDIU?
Indirectly. TDIU rests on whether service-connected disabilities prevent securing or following substantially gainful employment. Where substance use is part of the service-connected psychiatric picture, its occupational consequences — terminations, absenteeism, inability to sustain employment — are part of that analysis. It is not a separate basis, but it is relevant evidence.
My husband started smoking in Vietnam and died of lung cancer. Can I file for DIC?
Possibly, but the theory has to be framed carefully. A claim resting on the smoking having started during service is barred by 38 U.S.C. § 1103 for claims filed after June 9, 1998. The viable theory under VAOPGCPREC 6-2003 is that a service-connected disability such as PTSD caused the tobacco use after service, that the use was a substantial factor in causing the cancer, and that the cancer would not have occurred but for it. Speak with an accredited representative about your specific circumstances.
Support and Recovery: Help Is Available, and None of It Affects Your Claim
Reaching out for help with substance use does not jeopardize a VA claim, does not affect your benefits, and does not go on any record that VA uses against you. Treatment records more often strengthen a claim than weaken it. More importantly, your health matters more than any claim outcome.
SAMHSA National Helpline
1-800-662-HELP (4357)
Free, confidential treatment referral and information, 24 hours a day, 365 days a year, in English and Spanish. TTY 1-800-487-4889. You can also text your ZIP code to 435748.
Alcoholics Anonymous
aa.org/find-aa
Free peer support meetings worldwide, in person and online. Many areas have meetings specifically for veterans.
Narcotics Anonymous
na.org/meetingsearch
Free peer support for any drug, in person and online. No dues, and no requirement other than a desire to stop using.
VA substance use treatment
va.gov
Detoxification, medication for opioid and alcohol use disorder, outpatient and residential programs, and treatment integrated with PTSD care. Ask your VA primary care team or use the facility locator.
Vet Centers
1-877-927-8387
Community-based counseling for combat veterans and survivors of military sexual trauma, staffed largely by veterans. Confidential and separate from VA medical center records.
SMART Recovery
smartrecovery.org
A secular, science-based alternative to twelve-step programs using cognitive and behavioral tools. Meetings are free, in person and online.
988 Suicide & Crisis Lifeline
Call or text 988
Available 24 hours a day in more than 150 languages, for anyone in emotional distress, including distress related to substance use. Veterans should press 1.
Al-Anon and Nar-Anon
al-anon.org
Support for family members and friends affected by someone else's drinking or drug use. Spouses and adult children of veterans often find these groups particularly useful.
About the author
Jessica R. Allen, M.D. is an adult and addiction psychiatrist, a licensed physician, and a former VA Compensation and Pension examiner. Substance use claims sit at the intersection of two areas most examiners handle separately. Having evaluated claims from the examiner's side of the file, she writes opinions that address the willful misconduct question directly rather than leaving VA to supply its own answer. Through Brightview Psychiatry Solutions PLLC, she prepares independent medical opinions and nexus letters for veterans pursuing VA disability claims nationwide.
Sources
- Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001), reh'g denied, 268 F.3d 1340 (Fed. Cir. 2001).
- Mauerhan v. Principi, 16 Vet. App. 436 (2002) — the symptoms listed in the General Rating Formula are examples, not an exhaustive checklist.
- Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013) — symptoms must produce the level of occupational and social impairment described in the criteria.
- VA General Counsel Precedent Opinion 6-2003 — secondary service connection for tobacco-related disability or death.
- VA General Counsel Precedent Opinion 7-99 — direct service connection for disability resulting from a claimant's own abuse of alcohol or drugs.
- 38 U.S.C. § 1103 — special provisions relating to claims based upon effects of tobacco products; 38 U.S.C. § 1110 — basic entitlement to compensation.
- 38 C.F.R. § 3.310 — disabilities proximately due to, or aggravated by, service-connected disease or injury; 38 C.F.R. § 3.312 — principal and contributory causes of death.
- 38 C.F.R. §§ 4.14 and 4.130 — avoidance of pyramiding; schedule of ratings, mental disorders.
- Allen v. Brown, 7 Vet. App. 439 (1995); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).
Related Pages
- PTSD Nexus Letters — Direct-service PTSD, MST-related PTSD, and delayed-onset claims.
- PTSD Rating Increase Nexus Letters — Medical evidence that your PTSD has worsened since your last rating decision.
- Depression Nexus Letters — Direct and secondary depression claims, including depression secondary to physical conditions.
- View All Nexus Letters — Every condition Brightview writes nexus letters for.
If you are in crisis, the Veterans Crisis Line is available 24/7: dial 988 and press 1, or text 838255. This article is general information about VA claims and nexus letters, not medical advice, and it does not create a treatment relationship.