Three most common claims left on the side: secondary service connection for side effects of medications
Many veterans are taking medications to treat their service connected PTSD or manage the pain for their back, ankle, and knee conditions. VA doctors will prescribe medications and discuss with veterans their side effects, but most veterans are unaware that they may be entitled to compensation for these side effects. 38 CFR 3.310(b) provides that veterans can receive compensation for non-service connected illnesses and injuries that are “proximately the result of service connected disease or injury”. These are called secondary service connection claims, claims that did not develop in service but are related to a service connected condition. Secondary service connection claims include the side effects of medications, either over the counter or prescription that veterans take for their service connected disabilities. Jones v. Shinseki, 26 Vet.App. 56 (2012).
Veterans who take medications often just “live with” the side effects without taking advantage of the benefits they are entitled to. Embarrassment about the side effects involved with many of the medications used to treat PTSD and joint pain keep veterans from seeking benefits for common conditions. Erectile dysfunction, gastrointestinal conditions, and headaches are the most common of these side effects that can be secondarily service connected.
Erectile Dysfunction (ED): This condition is a very common side effect to psychotropic medications (those used to treat mental health issues such as PTSD, depression, and anxiety). Medications for these conditions tend to decrease sex drive which, in turn, leads to ED. It is also prevalent in veterans who take opioids or pain medications for lower back pain. Service connection for ED is usually evaluated at 0%. However, special monthly compensation for loss of use of a creative organ is usually awarded which adds up to around $1,200 a year. Veterans can miss out on this if they fail to discuss this frequent side effect with their doctor and file an ED claim with the VA.
Gastrointestinal Conditions (GERD, IBS, and Acid Reflux): It is common for veterans taking pain medications to experience gastrointestinal issues such as constipation, diarrhea, and heart burn. It doesn’t matter whether the pain medications are prescription opioids such as hydrocodone or acetaminophen (Tylenol) given over the counter. These medications are usually taken daily to cope with back, knee, shoulder, ankle, and other joint pain. Veterans should speak with their doctors to determine whether the stomach condition is going to be a permanent issue and, if so, then they should consider filing a claim with the VA.
Headaches/Dizziness: These conditions often occur both in opioid usage as well as a side effect with some medications used to treat PTSD. The VA can be hesitant to connect headaches and dizziness, particularly if there is a different medication that can prevent this side effect. It is important to consult with your doctor (prior to filing) to explore options, but if none are present it might be time to consider filing with the VA.
Nobody wants to be a “sick call ranger”, but when veterans experience side effects from the medications they are taking to treat their service connected conditions, they are missing out on benefits they are entitled. For all of these claims, it is important to speak with a doctor regarding other options of treatment and to get medical evidence on record of a diagnosis of the secondary condition. Lay statements from veterans documenting the daily severity and duration of symptoms, can be useful in showing a pattern and severity of the condition. So, the next time a pharmacist offers to discuss the side effects of medication, it might worth a veteran’s time to listen and see what benefits they might be missing out on.