Service-Connecting Mental Health Conditions: Depression, Anxiety, and Secondary Psychiatric Claims

by Dr. Deborah Miller, PhD, HSPP - owner and lead psychologist at vetnexusletter.com

Veterans often associate mental health claims with PTSD, but many other psychiatric conditions are eligible for VA disability compensation. I work every day with veterans who experience depression, anxiety, insomnia, and other mental health disorders because of their military service, but are not sure how to go about getting them service-connected.

This post explains how to establish service connection for non-PTSD mental health conditions, including both direct and secondary pathways.

What Mental Health Conditions Can Be Service-Connected?

The VA recognizes a wide range of psychiatric conditions for compensation, including:

·         Major Depressive Disorder (MDD)

·         Generalized Anxiety Disorder (GAD)

·         Panic Disorder

·         Bipolar Disorder

·         Adjustment Disorder

·         Obsessive-Compulsive Disorder (OCD)

·         Mood Disorders

·         Schizoaffective and Psychotic Disorders

These conditions can be service-connected directly or secondarily, depending on their relationship to your military service or other service-connected disabilities.

Direct vs. Secondary Service Connection

Direct Service Connection

Direct service connection applies when your mental health condition was caused by or first manifested during your military service. To establish direct service connection, you must show:

1.      A current, diagnosed mental health condition

2.      An in-service event, injury, illness, or psychological stressor

3.      A nexus (a medical opinion) linking your condition to that in-service event

Examples: - Developing depression following a demotion or harassment while in service - Onset of panic attacks during training or deployment

Even if your symptoms weren’t formally diagnosed in service, later diagnosis supported by credible evidence (such as lay statements or performance records) can help establish your claim.

For a direct claim, the VA needs to see evidence that your mental health symptoms started during service and have been chronic since that time until present day. The best way to do this is by having service treatment records and post-service records that show mental health treatment, but most veterans don’t have this because they tend to avoid mental healthcare.

Other forms of evidence would have to document the connection – strong personal statements, buddy statements from friends/family, current mental health records showing discussions with providers about symptom history starting in service, etc.

Secondary Service Connection

Secondary service connection applies when your mental health condition is the result of a service-connected physical or mental disability.

Examples: - Depression due to chronic pain from a service-connected back or knee injury – Anxiety/depression caused by sleep disturbances due to tinnitus, sleep apnea, or another service-connected condition

To win a secondary claim, you still need evidence and a nexus opinion—this time linking your psychiatric diagnosis to the primary, already service-connected condition. This evidence can come in the form of strong personal statements from the veteran, buddy statements from friends and family who directly observe the negative impact of the service-connected disability, medical records documenting the negative impact of the disability, etc.

Building a Strong Non-PTSD Mental Health Claim

1. Get a Clear Diagnosis

You must have a diagnosis from a qualified mental health professional. This can be through VA healthcare or private providers.

2. Document In-Service Events (for Direct Claims)

While you don’t need a formal diagnosis during service, you should identify any in-service incidents that may have triggered symptoms. Use: - Personnel records - Performance evaluations - Letters or emails from that time - Lay statements from peers or supervisors

3. Link to Existing Conditions (for Secondary Claims)

Describe how your service-connected physical condition has impacted your mental health. VA will want to see: - Continuity of symptoms and treatment - Statements from providers - Nexus letters from mental health professionals

4. Provide a Strong Nexus Opinion

The key to both direct and secondary claims is a medical opinion that says it is “at least as likely as not” that your mental health condition is related to your service (or another service-connected condition).

C&P Exams and DBQs

After you file, the VA may schedule a Compensation & Pension (C&P) exam. Be honest and detailed with your symptoms—avoid minimizing. The examiner will assess the severity and potential service connection.

Private DBQs and nexus letters can strengthen your claim, especially if the VA examiner does not provide adequate support.

Common Mistakes to Avoid

·         Filing without a current diagnosis

·         Failing to link condition to a specific in-service event/stressor or service-connected disability

·         Underreporting symptoms during exams

·         Not submitting a clear nexus opinion

Final Thoughts

Mental health claims are not limited to PTSD. If your depression, anxiety, or other condition is connected to your military service—or to an existing service-connected issue—you may qualify for compensation. By understanding the types of service connection and presenting a thorough, evidence-based claim, you increase your chances of success.

Need help establishing an official mental health diagnosis or obtaining a mental health nexus letter? Contact our team for expert assistance.