These cookies may be set through our website by our advertising partners. If you continue to use this site we will assume that you are happy with it. A showing of causation requires that the secondary VA disability claim is proximately due to or aggravated by another service-connected disability. VA Disability Ratings for Spinal Stenosis - Hill & Ponton, P.A. The lumbar spine has more range of motion than the thoracic boxes with small spinous processes (finger-like projections) that extend from the Radiculopathy is typically caused by changes in the tissues surrounding the nerve roots. Radiculopathy does involve a condition of the spinal nerve, and for a specific rating for anerve condition the determination is based on (a) paralysis, meaning that the nerve has no ability to function; (b) neuritis, meaning that the nerve is irritated, and there is numbness, muscle atrophy, or loss of reflexes; or (c) neuralgia, meaning that the nerve produces intermittent or continual pain, possibly accompanied by numbness and tingling. You Deserve It: The Definitive Guide to Getting the Veteran Benefits Youve Earned, 9 Secrets Strategies for Winning Your VA Disability Claim, A medical diagnosis of the secondary VA disability youre attempting to link to the current service connected disability (must be documented in a medical record), A current service-connected primary disability (e.g., your current list of service connected disabilities from your VA.gov account), Medical nexus evidence establishing a connection between the service-connected primary condition, Asthma secondary to GERD (acid reflux or heartburn), Asthma secondary to Obstructive Sleep Apnea, Asthma secondary to Vocal Cord Dysfunction (Inducible Laryngeal Obstruction), Asthma secondary to Asthma-COPD overlap syndrome, ED secondary to Weight Gain Obesity as Interim Link, Female Sexual Arousal Disorder secondary to PTSD, Female Sexual Arousal Disorder secondary to Depression, Female Sexual Arousal Disorder secondary to Anxiety, Female Sexual Arousal Disorder secondary to Heart Disease, Female Sexual Arousal Disorder secondary to Neurological Conditions, Female Sexual Arousal Disorder secondary to Gynecological conditions, such as Vulvovaginal Atrophy, Infections or Lichen Sclerosis, Female Sexual Arousal Disorder secondary to Medication Side Effects, Fibromyalgia secondary to Interstitial Cystitis or Painful Bladder Syndrome, Fibromyalgia secondary to Temporomandibular Joint Disorders, Fibromyalgia secondary to Postural Tachycardia Syndrome, GERD secondary to Medication Side Effects, GERD secondary to Weight Gain Obesity as Interim Link, Hypertension secondary to Weight Gain Obesity as Interim Link, Hypertension secondary to Hyperthyroidism, IBS secondary to Weight Gain Obesity as Interim Link, Menieres Syndromesecondary to Hearing Loss, Menieres Syndromesecondary to Migraines, Migraines secondary to Medication Side Effects, Plantar Fasciitis secondary to Foot Condition, Plantar Fasciitis secondary to Back Condition, Plantar Fasciitis secondary to Knees, Hips, Joint Instability, Plantar Fasciitis secondary to Weight Gain Obesity as Interim Link, Radiculopathy secondary to Lumbosacral or Cervical Strain, Radiculopathy secondary to Spinal Stenosis, Radiculopathy secondary to Spondylolisthesis, Radiculopathy secondary to Ankylosing Spondylitis, Radiculopathy secondary to Vertebral Fracture or Dislocation, Restless Leg Syndrome secondary to Back Condition, Restless Leg Syndrome secondary to Neck Condition, Restless Leg Syndrome secondary to Medication Side Effects, Restless Leg Syndrome secondary to Peripheral Neuropathy, Sleep Apnea secondary to Weight Gain Obesity as Interim Link, Somatic Symptom Disorder secondary to Tinnitus, Somatic Symptom Disorder secondary to Back Condition, Somatic Symptom Disorder secondary to Neck Condition, Vertigo secondary to Medication Side Effects, Vertigo secondary to Head or Neck Conditions, Better Business Bureau (BBB) Accredited Business. Refer to our disability calculator to figure out your estimated VA rating. In accordance with 38 CFR 3.310 current disability condition that is proximately due to or the result of a service-connected disease or injury shall also be service connected. The neck region of the spine is known as the Cervical Spine. Medical images like x-rays can also be useful. Radiculopathy (pinched nerve) Secondary to Back Conditions - Veterans Hear from fellow Veterans just like you, with many of our Business Development Representatives having gone through our programs. Developed new symptoms? Radiculopathy is often a secondary service condition, brought on or exacerbated by another service-connected condition. VA ratings for upper extremity radiculopathy is rated as Sciatica, is rated under diagnostic codes 8520, 8620, and 8720. Veteran with low back conditions such as degenerative disc disease, cauda equina syndrome, lumbago, etc. 4.23) are rated as 70 percent These structures make the thoracic spine more stable than Firstly, you need to be rated for either a back or neck issue before you start filing radiculopathy claims. degenerative conditions. They may be used by those companies to build a profile of your interests and show you relevant advertisements on other websites. The VA can order a clarification from the examiner, or even order a new exam with a different examiner. The rule authorizing VA to establish the five secondary TBI-related conditions in 38 CFR 3.310 is effective, January 16, 2014. . Washington, D.C.: 1776 I Street, NW, 9th Floor, Washington, D.C 20006 VA Claims Insider is a company OF veterans, BY veterans, FOR veterans. Secondary claims are an extremely important tool. If a nerve condition affects both sides of the body (such as both arms or legs), VA should issue a rating for each side and an additional bilateral factor. In addition, I have four ratings for secondary radiculopathy (10% each for lower extremities and 20% each for upper extremities). Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices To clarify, I have a combined 40% for back and neck sprains. This problem is most likely to occur in your lower back, but The THIRD part, and often the missing link needed to establish secondary service connection, can be satisfied with a credible Medical Nexus Letter (Independent Medical Opinion) from a qualified medical provider. Amy joined Hill & Ponton in June of 2019 with that same goal. Firstly, you need to explore your current disabilities and research if there are any common secondary claims waiting there for you to connect. Today, even though you are no longer serving, that service-connected tinnitus might be causing migraine headaches, anxiety, and/or depression. eCFR :: 38 CFR Part 4 Subpart B -- Disability Ratings WE CAN HELP! (Of course, I would first see if the VA or your private health insurance is willing to pay for it). movements not affected, warrants a 70 percent rating for the major side and a This rule will be applied to all cases pending before VA on or after, January 16, 2014, and . For instance, which pages you go to most. However, a VA rating for Sciatica can range from 10% to 80%, depending upon the severity of symptoms. Cervical radiculopathy is when a veteran has a pinched nerve in their neck. Portland, OR: 650 N. E. Holladay Street, Suite 1600, Portland, OR, 97232 Pro Tip: A Nexus Letter is HIGHLY RECOMMENDED to help establish secondary service connection. Examples of secondary conditions associated with neck pain include radiculopathy, due to a compressed nerve in the cervical spine, and migraine headaches . Copyright 2023 VA Claims Insider, LLC. Radiculopathy is commonly known as a pinched nerve. The type of pain can vary from numbness, tingling or burning, and can also range in severity from mild to severe. Otherwise, the denial stands. Copyright 2023 Hill & Ponton, P.A.. All Rights Reserved. Another possible cause of radiculopathy that may lead to On occasion, these discs slip out of place or become damaged The information these cookies collect will not personally identify you, and they cannot track your browsing activity on other websites. For VA disability purposes, the four regions listed below will be considered when it comes to your final VA rating for Radiculopathy. Top 100+ VA Disability List of Secondary Conditions (2022 Edition) disabling. Furthermore, as to case summaries, reports of past results, individual lawyer biographies, news posts and other information pertaining to past and present cases, these descriptions are meant only to provide information to the public about the activities and experience of our law firm. If you do not allow these cookies, you will experience less targeted advertising. By using our website, you agree to the use of certain cookies. You dont need to prove the radiculopathy happened on active duty. Schedule for Rating Disabilities apply: These six back conditions can often lead to pinched or damaged or paralysis of the upper radicular group (fifth and sixth cervicals). Because of the change of walking gait, often spinal discs can deteriorate more quickly, leading to pain. We know what other conditions are service-connected and come up as common secondary conditions. Please call for an appointment before visiting: Mail Processing Center: P.O. required to warrant a VA disability rating for Radiculopathy. While we still have our home base in Florida, 60 percent rating for the minor side. >> Click HERE NOW << to sign up for our premier education-based Coaching/Consulting program VA Claims Insider Elite, start free today, connect with a Veteran Coach in minutes, and get high-quality Nexus Letters at reduced rates (if wanted and warranted by the evidence of record). neck (cervical spine) down to your buttocks and pelvic area (sacral spine). 4.124a, Diagnostic Code 8620. abbreviated C1 through C7 (top to bottom). Are you STUCK, FRUSTRATED and UNDERRATED? In 2015, over 1.3 million veterans were receiving disability compensation for a mental related condition such as PTSD, general anxiety disorder, major depressive disorder, etc. Most veterans receive a rating of 10 to 20 percent. Since that time, we have provided compassionate He is aformer active duty Air Force officerwith extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM. If youre stuck, frustrated, underrated, and currently rated between 0%-90%, VA Claims Insider Elite is for you! Chicago, IL: 332 S. Michigan Avenue, Floors 8 and 9, Chicago, IL 60604 As a fellow disabled Veteran this is shameful and Im on a mission to change it. The rating is 20% for mild symptoms and up to 50% for severe symptoms. Secondary VA Claim - Radiculopathy - Combat Craig Since that time, we have provided compassionate Cincinnati, OH: 300 E Business Way, Suite 200, Summit Woods Corporate Center, Cincinnati, OH, 45241 Radiculopathy can occur in the cervical spine (neck), thoracic spine, or lumbar spine, depending on the location of the back condition. And we help veterans get the VA rating they deserve in less time, if theyve already filed, been denied, or have given up hope. Depending on the loss of feeling in your elbow vs. your dominant hand, you might get a different VA rating. Moderately severe incomplete paralysis is rated as 40 The determination will be made on the basis of the actual Generally, VA disability ratings for back pain range from 10% to 100% and depend upon the frequency, severity, and duration of symptoms, including Painful Motion, Limitation of Range of Motion (ROM), and Functional Loss or Impairment. You need to make your raters job easy. Copyright 2023 VA Claims Insider, LLC. But, if you really want to get on the fast track, I highly recommend you do what I did: Enroll in Combat Craigs Boot Camp. Incontinence can also occur as a result. manipulation, etc., in the case of the hand, or of balance and propulsion, For example, a veteran is service-connected for degenerative disc disease of the lumbar spine. DOCX Department of Veterans AffairsM21-1, Part III, Subpart iv Copyright 2023 Hill & Ponton, P.A.. All Rights Reserved. What Does Your VA Disability Rating Mean? Box 449, Deland, FL 32721, Orlando, FL: 605 E. Robinson Street Suite 635, Orlando, FL 32801 ClickHEREto Join the #1 Rated VA Claims Insider Elite Program and Start Today for FREE. See the above sectionSecondary Service Connection for Radiculopathy. These cookies collect information about how you use our website. It is possible to prove service-connection for radiculopathy. If you have pain with certain movements, this may help your doctor identify the affected nerve root. It can cause sharp pain, weakness, loss of reflexes, or numbness throughout your spine and extremities. disabling. Beneath the last cervical vertebra are the 12 vertebrae of However, the most common rating for lumbar radiculopathy is under the sciatic nerve. The different nerves in your back are grouped together and carry different VA rating schedules. During her time at UCF, she interned with the Public Defenders Office and the Florida House of Representatives, desiring to use her education to fight for others. Radiculopathy - Mayo Clinic Orthopedics & Sports Medicine lumbar radiculopathy, also referred to as sciatica because nerve roots that VA Ratings The spine itself is made up of 33 bones and vertebrae to protect it from injury or trauma. the Atlas. Secondly, you need to lay the ground work for a successful secondary VA claim. A higher rating than those currently assigned is only Common side effects of myelopathy include radiculopathy (sharp-shooting pain or radiation), loss of urinary or bowel control, and increased reflexes in the arms or lower extremities (depending on which form of myelopathy you have). The rule authorizing VA to establish the five secondary TBI-related conditions in 38 CFR 3.310 is effective, January 16, 2014. Houston, TX: 2925 Richmond Ave, 12th Floor, Houston, TX 77098 Each of these veterans benefits have different eligibility criteria so be Brian Reese here with VA Claims Insider, and in this Insiders Guide, Im going to reveal and explain how to get a VA Rating for Depression Secondary to Tinnitus. Brian Reeseis a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits Youve Earned, andfounder of VA Claims InsiderThe Most Trusted Name in Education-Based Resources for Veterans.. Top 6 Secondary Conditions to Lower Back Pain (The Insider's Guide) In addition, Radiculopathy is a common secondary VA disability claim, especially Radiculopathy secondary to back conditions or back pain. Common symptoms include: Most vets went through long periods of standing or marching, strenuous physical exercise challenges, and weapons training during military service. The Lumbar Spine has 5 vertebrae abbreviated L1 through L5 VA Disability Rating for Neck Pain: Cervical Spine, Neck Arthritis Hi veterans, Brian Reese here with VA Claims Insider, and in this Ultimate Guide, Im going to reveal and explain the Top 100+ VA Disability List of Secondary Conditions. The typical symptoms of a radicular condition depend on the location of the affected nerves. Pro Tip: While you are not required to provide a Nexus to establish presumptive service connection, its highly recommended that you at least write a personal statement as to WHY you think your disability meets the legal requirements for presumptive service connection. In other words- I am almost doubling my RATING with secondary claims. VA Disability Ratings for Degenerative Disc Disease (DDD) Complete paralysis of the upper radicular group, with all Hill & Ponton P.A. The skilled attorneys at Chisholm Chisholm & Kilpatrick LTD may be able to help you navigate it. Secondary conditions are those that develop as a result of the primary condition. Remember, radiculopathy is probably going to be a secondary VA claim. His frustration with the8-step VA disability claims processled him to createVA Claims Insider,which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim. Aggravation ratings work slightly differently than primary and secondary service connection ratings, depending on the initial severity of the condition compared to the present level of severity. You're not alone. He is aformer active duty Air Force officerwith extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM. VA Disability Ratings for Back Pain and Spinal Arthritis Together, the Atlas and Axis enable the head to rotate and You do need to prove it is caused by service connected issues. paralysis under Diagnostic Code 8510. His frustration with the8-step VA disability claims processled him to createVA Claims Insider,which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim. Different groups will have different diagnostic codes. This occurs when a nerve in the lower portion of the back is pinched, and it can cause numbness and tingling in the hips and legs. The PTSD is due to your combat deployment, which is directly related to your military service. Brian Reese here, Air Force service-disabled Veteran and Founder @ VA Claims Insider. Please call for an appointment before visiting: Mail Processing Center: P.O. This website adheres to the W3Cs AA Accessibility guidelines. In addition, I have four ratings for secondary radiculopathy (10% each for lower extremities and 20% each for upper extremities). Regulation normally forbids assigning multiple ratings for one set of symptoms. And, youll get to work with a Veteran Coach (VC) who will lead you to VA claim success. When you visit web sites, they may store or retrieve data in your web browser. A. Cervical radiculopathy: This starts in the neck portion of your spine. Service Connection by Aggravation: What If You Were Diagnosed With Radiculopathy Before Service? The lumbar facet joints allow for significant flexion and We discuss how chronic pain affects mental healthin a different blog. Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices Extraschedular Ratings for VA Disability Claims. to diagnose radiculopathy: Many veterans suffer from various service connected back conditions, Click the button below to start for FREE. the smallest and T12 is the largest thoracic vertebra. Contact Us Seattle, WA: 506 2nd Ave,Suite 1400,Seattle, WA 98104. In addition, Back Pain is a common secondary VA disability claim, especially Radiculopathy secondary to back . In moderate neuralgia, typical of a radiculopathy diagnosis, a veteran experiences numbness, and tingling, and moderate to severe pain. As a Claims Advocate, she works with attorneys and peers to review and gather evidence to help veterans receive the benefits they so deserve. Radiculopathy is most often rated under CFR 38, Part 4, VA Schedule of Ratings, diagnostic codes 8510, 8610, and 8710 for the upper and middle radicular groups. 203, San Jose, CA 95134 called the Axis. The sciatic nerve, which is the largest nerve in your body, known Although this list is not exhaustive, we tried to stick with the most common VA secondary conditions for secondary service connection. We advocate for the disabled. The size and shape of each lumbar vertebra is designed to Subsequently, I learned I had radiculopathy in my hand. The lower back is the area most frequently affected by A doctors physical exam and electromyogram (EMG) that confirms a radicular condition serve as bases for ratings. Heres the brutal truth about VA disability claims: We use cookies to ensure that we give you the best experience on our website. The bilateral factor recognizes the limitations caused by these disabilities and how they can impact the veteran. This. C2 is extension movement but limit rotation. These cookies are essential so that you can move around the website and use its features. In: StatPearls [Internet]. Los Angeles, CA: 10880 Wilshire Blvd., Ste 1101, Los Angeles, CA 90025 By continuing to use our website, you agree to these updates. make up the sciatic nerve are often involved. San Jose, CA: 2880 Zanker Road, Ste. Moderate incomplete paralysis is rated as 40 percent Secondary Service Connection for Radiculopathy. Contacting us does not create an attorney-client relationship. Examples of secondary conditions that may arise as complications of stenosis include radiculopathy, neurogenic bladder, and knee and hip problems caused by walking difficulties due to stenosis. A 50 percent rating is warranted for severe incomplete Lumbar and Cervical Radiculopathy VA Benefits - Woods and Woods, LLC and press on nerves. Secondary Service Connection and related conditions that can be secondary VA claims are the primary focus of this eBook! If youre stuck, frustrated, underrated, and currently rated between 0%-90%, VA Claims Insider Elite is for you! Radiculopathy VA Disability Ratings and Benefits, Learn About CCK's Partnership with DAV and Harvard Law School, - Learn About CCK's Partnership with DAV and Harvard Law School. His eBook, the9 Secrets Strategies for Winning Your VA Disability Claimhas been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans. Chicago, IL: 332 S. Michigan Avenue, Floors 8 and 9, Chicago, IL 60604 This region consists of seven vertebrae, which are All Rights Reserved. extremity. When there is pressure on a nerve in the neck, a veteran can experience radiculopathy in their shoulders, arms, hands, and fingers. likely to occur. Your spine is made up of many bones called vertebrae, and substantially less than the type picture for complete paralysis given with each joint disease and radiculopathy, separately. Imaging tests, such as an X-ray, CT scan or MRI scan, are used to better see the structures in the problem area. The vet may be accompanied by a witness, and they may bring notes about their symptoms and experiences into the exam room. In addition to longer spinous processes, rib attachments add For radiculopathy, relevant evidence relates to any element of the veterans claim. For a limited time, you can book a free, no-obligation VA Claim Discovery Call with one of our experts. lead to narrowing of the space around the nerve roots and subsequent nerve In 2022, VA ratings for Radiculopathy typically range from 0% to 70%, depending upon the severity of your symptoms. When assigning a rating for radiculopathy, the VA will take into account which nerve is affected, as well as whether the radiculopathy affects the dominant hand or leg and the severity of the symptoms, such as numbness, tingling, sensory changes, and functional impact. VA Disability Rating for Radiculopathy - Hill & Ponton, P.A. Phoenix, AZ: One Renaissance Tower, Two North Central Avenue, 18th & 19th Floor, Phoenix, AZ 85004 The first cervical vertebra (C1) is called the Atlas. Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost, Sharp and radiating pain in the back, arms, legs or shoulders that may worsen with certain activities, even something as simple as coughing or sneezing, Weakness, fatigue, or loss of reflexes in the arms or legs, Numbness or tingling of the skin, pins and needles, or other abnormal sensations (paresthesia) in the arms or legs. Radiculopathy can have many different signs and symptoms as narrowing of foramina is bone spurs. Radiculopathy is classified as a pain syndrome and can be caused by several lower back conditions such as lumbar disc herniation, degenerative disc disease, and spinal stenosis. for Cranial and Peripheral Nerve Condition can be found HERE. The rating is 10% for mild symptoms and up to 40% for severe symptoms. In myelopathy, the pressure is placed on the spine itself, as compared to radiculopathy which places pressure on the nerve roots. Thousands of other Veterans in our Community are here for you. This is the most common method of service connection for VA disability compensation benefits. I reported to work expecting a normal day. VA then assigns a rating based on the levels of functioning and severity, and the affected nerve group. You earned your benefits, but you still have to fight to claim them. Each of these is a secondary VA claim. [Updated 2020 Mar 25]. Urinary dysfunctions are issues that often fly under the radar in veterans. For example, lets say youve got Tinnitus service connected at 10%, but because of the severity of your Tinnitus, youve developed Migraine Headaches. If radiculopathy is caused by a low back condition, the individuals will feel the symptoms in the lower extremities (thigh, calf, foot). Houston, TX: 2925 Richmond Ave, 12th Floor, Houston, TX 77098 The Atlas is ring-shaped, and it supports the skull. There are three key elements that must be satisfied to prove VA secondary service connection under the law: The Radiculopathy VA rating criteria also depends upon Paralysis, Neuritis, or Neuralgia, as well as the location/region, which are broken down in detail below. sacrum. (38 CFR 3.309 discusses diseases subject to presumptive service-connection in more detail.). claim for secondary service connection due to one or more service connected back See 38 C.F.R. Immediately below the sacrum are five additional bones, The other cervical vertebrae (C3 through C7) are shaped like You can open a new VA claim on the VA.gov website, and file a claim for Migraines Secondary to Tinnitus, and get service connected and rated at 0%, 10%, 30%, or 50% for your Migraine (Headaches), depending on the Frequency, Severity, and Duration of your symptoms as well as how your symptoms negatively affect your work, life, and/or social functioning. The typical symptoms of a radicular condition depend on the location of the affected nerves. Furthermore, a veteran may receive separate VA ratings of When a nerve root is compressed, it becomes inflamed. percent disabling for both the major and minor side. Our firm was founded in 1986 in Orlando, Florida. Did you know there are HUNDREDS of common secondary VA claims that you can get service connected by law? You can file a new, secondary service-connection. A common cause of radiculopathy is . The upper and middle radicular group is rated under Can VA Secondary Conditions Be Service Connected? Neuritis of the sciatic nerve is rated under 38 C.F.R. support the skull, and allow for a wide range of head movement. Under that code, mild incomplete paralysis is rated 20 As a fellow disabled Veteran this is shameful and Im on a mission to change it. In this example, you could file a VA disability claim for migraine headaches secondary to your service-connected tinnitus. Increasingly, the examiners useDisability Benefits Questionnaires, which independent medical experts can also fill out. They are not intended as a guarantee that we will obtain the same or similar results in every case we undertake. pursuant to 38 C.F.R. Five bones (abbreviated S1 through S5) fused into a Cookies help us deliver the best experience on our website. Realistically, an MRI on your service connected back or neck injury is the best way to do that. regeneration. In my experience, this type of service connection is uncommon. Subscribe to our newsletter and join 15,472 other subscribers. Secondary conditions are rated in the same manner as primary service-connected conditions, using the same rating schedules. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. If accepted into our ELITE membership program, youll get free up-front access and permission to use $13,119 worth of proprietary VA claim resources, including access to our network of independent medical professionals for medical examinations, disability evaluations, and credible Medical Nexus Letters, which could help you get a HIGHER VA rating in LESS time. show the remaining conditions as secondary to multiple sclerosis. Urinary frequency or incontinence are typically symptomatic of another underlying condition, however, it is important to know that you can also receive compensation for urinary dysfunction separately. Camp Lejeune Lawsuit. -Tactical Mike. It is important to note that not all disc herniations cause nerve compression or pain. When the involvement is wholly sensory, the rating should be Other key evidence may include a medical experts professional opinion that the service-connected condition (low back strain, for example) caused the radiculopathythus indicating a secondary service-connected disability.
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