Your rating made sense when you got it. Now your knee is worse, or a new problem has shown up that seems tied to an old one.
You can ask the Department of Veterans Affairs (VA) to look again. A VA rating increase and a secondary condition are both new claims, following the same steps and timeline as your first claim.
Both requests start as new claims
You use the same form for either one: VA Form 21-526EZ, the Application for Disability Compensation. You'll find it on VA.gov, along with VA Form 21-0966, the Intent to File.
An intent to file is a short notice that you plan to claim. It gives you a window to send the full claim and can protect your effective date, the date your new pay would count from. Check the Code of Federal Regulations (CFR) for how long the window lasts. Our guide to how VA disability back pay works explains why that date matters.
After you file, the VA gathers your records, usually schedules a compensation and pension (C&P) exam, then sends a decision letter.
How a VA rating increase works
The VA rates how much a condition affects you today, not when you were first approved. So the evidence that matters most in a claim for increase is current medical evidence showing your condition has gotten worse.
The VA compares that evidence to its Schedule for Rating Disabilities, published in the CFR. Each condition has its own criteria. For a knee, that might be how far it bends. For a mental health condition, it's how symptoms affect work and daily life.
Picture a veteran rated for a knee injury who now uses a cane and can't climb stairs at work. His last VA exam was years ago. Recent clinic notes and a new range-of-motion test show the VA his condition has changed.
Your own words count too. A written statement about what you can't do anymore adds detail exam notes often miss. You'll find a sample in our VA increase request letter examples.
How secondary service connection works
Secondary service connection covers a new condition caused or made worse by one that's already service connected. The rule is in the CFR.
Here are two of the most widely recognized VA secondary conditions:
- Knee to hip or back. A service-connected knee injury can change how you walk, and that limp can strain your hip or lower back. Our guide to VA back pain ratings covers how back conditions are rated.
- Diabetes to nerve damage. Service-connected diabetes can damage nerves in the feet and hands. The American Diabetes Association describes this nerve damage, called neuropathy, as a common complication.
"Made worse" matters. If you had back trouble before your knee injury and the knee has worsened it, that worsening can still count.
If granted, the secondary condition gets its own rating, combined with your others, not simply added. Our page on VA disability rates shows how ratings connect to monthly pay.
What a nexus opinion does for your claim
Nexus means a link between two things. A VA nexus opinion is a doctor's written opinion connecting your secondary condition to your service-connected one.
For a secondary claim, it's often the most important piece. Your records may show both conditions, but the VA still needs a medical reason to believe one led to the other.
A strong opinion explains that reason, names the records reviewed, and often uses wording the VA recognizes, such as "at least as likely as not." An opinion with no explanation carries less weight. Our key facts about medical nexus letters go deeper.
Can asking for an increase lower your rating?
A claim for increase usually means a new exam of your condition as it is now. If it shows improvement, the VA could propose a lower rating. If your condition has truly worsened, your records should show that.
Reductions also have rules, and long-standing ratings get more protection:
- You get notice first. The VA must tell you about a proposed reduction and give you time to send evidence.
- Older ratings are harder to lower. The longer you've held a rating, the more the VA generally needs to show lasting improvement, not one good day at an exam.
- The longest-held ratings and service connection get the strongest protection. After many years, VA rules limit reductions and removals to rare cases like fraud.
The exact time periods are in the CFR, or ask an advocate how they apply to you. Our article on whether the VA can reduce a PTSD rating walks through how reductions play out.
Keep seeing your doctors
Stay in care, at the VA or with a community provider. Regular visits support your health and build a clear medical record.
Tell your doctor about flare-ups, falls, missed shifts, and sleepless nights. Many veterans play down symptoms. If it isn't in the notes, the VA may never see it.
Review your medical evidence with an advocate before you file
These steps help make your evidence clear before it goes in:
- Gather your visit notes, test results, and new diagnoses from the past year or two.
- Compare them to the rating criteria for your condition.
- For a secondary condition, check whether a doctor has written down the link between the two.
- Write down how your daily life has changed since your last rating.
A Turnout veterans advocate can review your evidence with you. We help you understand the VA process and gather the evidence your claim needs, then stay with you through resolution, so you never face it alone. Read more about how a Turnout advocate takes the burden off you.
Today, pull your most recent medical records into one place, and run Radar, Turnout's free benefits scan, to see what else you may qualify for. Then bring your records to a conversation with a Turnout veterans advocate.
It's your turn. Get started.