DC 9411 — Posttraumatic stress disorder
Also known as: combat stress, mental health, post traumatic stress, Posttraumatic stress disorder, ptsd, nightmares, flashbacks, hypervigilance, startle response, mst, military sexual trauma, sexual assault
These are commonly claimed secondary connections linked to this primary disability. Use them as a screening tool for conversations with your doctor, VSO, or VA-accredited attorney.
Posttraumatic stress disorder → Generalized anxiety disorder
How the connection is commonly explained
Generalized anxiety commonly develops alongside or as a result of PTSD.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened generalized anxiety disorder.
Posttraumatic stress disorder → Hiatal hernia and paraesophageal hernia
How the connection is commonly explained
PTSD disrupts the autonomic nervous system, increasing stomach acid production. Stress is a well-documented trigger for GERD.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened hiatal hernia and paraesophageal hernia.
Posttraumatic stress disorder → Hypertensive vascular disease
How the connection is commonly explained
Chronic fight-or-flight activation from PTSD elevates blood pressure over time. Multiple studies support this link.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened hypertensive vascular disease.
Posttraumatic stress disorder → Major depressive disorder
How the connection is commonly explained
PTSD frequently causes or worsens major depressive disorder through chronic stress and trauma responses.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened major depressive disorder.
Posttraumatic stress disorder → Migraine
How the connection is commonly explained
Research shows significantly higher rates of migraines among veterans with PTSD. Chronic stress and hyperarousal are migraine triggers.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened migraine.
Posttraumatic stress disorder → Sleep Apnea Syndromes
How the connection is commonly explained
PTSD causes hypervigilance, nightmares, and disrupted sleep patterns that contribute to obstructive sleep apnea. Medications for PTSD can cause weight gain and muscle relaxation.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened sleep apnea syndromes.
Posttraumatic stress disorder → Erectile dysfunction, with or without penile deformity
How the connection is commonly explained
PTSD medications such as SSRIs commonly cause erectile dysfunction. Chronic stress and anxiety also directly affect sexual function.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened erectile dysfunction, with or without penile deformity.
Posttraumatic stress disorder → Irritable bowel syndrome (IBS)
How the connection is commonly explained
PTSD affects the gut-brain axis, disrupting normal bowel function. The stress response commonly manifests as GI symptoms.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened irritable bowel syndrome (ibs).
Posttraumatic stress disorder → Temporomandibular disorder (TMD)
How the connection is commonly explained
PTSD-related stress and anxiety cause jaw clenching and teeth grinding, leading to TMJ disorder.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened temporomandibular disorder (tmd).
Posttraumatic stress disorder → Tinnitus, recurrent
How the connection is commonly explained
PTSD hypervigilance can worsen perception of tinnitus. Often co-occurs from shared combat noise exposure.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened tinnitus, recurrent.
Posttraumatic stress disorder → Chronic Fatigue
How the connection is commonly explained
PTSD disrupts sleep architecture, leading to persistent fatigue even with adequate sleep time.
Filing tip
Because this connection can be more case-specific, detailed medical rationale and symptom history are especially important. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened chronic fatigue.
Posttraumatic stress disorder → Substance Abuse
How the connection is commonly explained
Self-medication with alcohol or drugs is common with PTSD.
Filing tip
Because this connection can be more case-specific, detailed medical rationale and symptom history are especially important. For this pairing, ask the provider to explain how posttraumatic stress disorder led to or worsened substance abuse.
This condition may also be secondary to
TBI-related neurocognitive disorder frequently co-occurs with PTSD, with TBI increasing vulnerability to PTSD development.
The traumatic event causing TBI frequently also causes PTSD.
How to File a Secondary Claim
Disclaimer: Secondary connections shown are based on commonly established medical links. Individual claims require medical evidence. Consult a VSO or VA-accredited attorney.