What Conditions Can Be Secondary to Service-Connected Anxiety or Depression?

Your anxiety or depression ratings may not cover everything that the condition has cost you. The VA also compensates for physical conditions caused or exacerbated by a service-connected mental health condition, including side effects from medication prescribed to treat it. Many veterans never file secondary claims. No one told them they could.

How Secondary Service Connection Works

Under 38 CFR § 3.310, a disability that is directly caused by a service-related condition is itself considered service-related. There are two possible scenarios:

• Causation: Your anxiety or depression, or the treatment for these conditions, caused the new medical condition.
• Aggravation: The condition already existed, but your mental health condition made it worse. The VA requires medical documentation of how severe the condition was before it worsened, and this baseline requirement can be a challenge for many claims.

In either case, you need current medical records and a professional opinion connecting the two conditions. The secondary condition will then receive its own rating based on its own specific diagnostic code.

Physical Conditions Commonly Linked to Anxiety and Depression

These issues often arise in secondary claims:

• Hypertension and heart disease: Chronic stress keeps the body in a heightened state, and medical research has linked depression to cardiovascular problems.
• GERD and irritable bowel syndrome: Stress affects digestion, as do some psychiatric medications.
• Migraines and tension headaches: These can be caused by stress and certain medications.
• Bruxism and TMJ disorder: Grinding your teeth during anxious periods can damage the jaw joint over time. 
• Erectile dysfunction: SSRIs and SNRIs often cause sexual side effects, and the ED rating itself can be 0%, but service connection may open the door to special monthly compensation for loss of function under 38 CFR § 3.350(a). 
• Sleep apnea: This can be caused by weight gain.

Medication Side Effects and Weight Gain Count

A condition caused by a drug prescribed for service-connected anxiety or depression may also be service-connected. Weight gain is a classic example. Antidepressants and antipsychotics are known to cause it, and reduced activity during a depressive episode contributes to it.

VA doesn’t treat obesity as a disability in itself. But in Walsh v. Wilkie, 32 Vet. App. 300 (2020), the Court of Appeals for Veterans’ Claims confirmed that obesity can be an intermediate step. If your mental health condition or medication caused or exacerbated your weight gain, and this weight gain led to sleep apnea, hypertension, or joint problems, these conditions can be connected with service. The medical opinion must address every link in this chain.

The medication drew attention in 2026 for another reason. In February, the VA issued an interim rule that would rate conditions based on how well you function while taking medication. After strong opposition from veterans and advocates, the VA rescinded this rule on February 27, 2026 and restored the previous text.

Substance Use Disorders Secondary to Mental Health

Federal law bars compensation for primary alcohol or drug abuse. The rule changes when substance use grows out of a service-connected condition. In Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001), the Federal Circuit held that alcohol or drug use disability secondary to a service connected disability can be compensated if there is clear medical evidence of the link.

One Thing That Won’t Get a Separate Rating

A second mental health diagnosis: VA rates PTSD, depression, anxiety and other psychiatric conditions under the General Rating Formula (38 C.F.R., § 4.130), producing a single rating based on overall occupational and social impairment. New symptoms may still push this combined rating higher, and the VA’s proposal to replace this formula remains unfinished as of November 2026. Therefore, the current formula continues to control.

Claim Everything Your Condition Has Caused

Secondary claims are won or lost based on medical opinions. Vague claims that say a link is “possible” will not carry the burden of proof. At Veterans Benefits Law Group, we help veterans identify secondary conditions they may have missed, gather medical evidence to connect them, and challenge denials throughout the appeals process.

If your mental health condition has taken a physical toll, schedule a free consultation to talk through which secondary claims may apply to you.