One of the best kept secrets at the VA seems to be the types of injuries you claim, more specifically, the verbiage used on your claim.

DIRECT: If you tear your right ACL and have surgery that’s an easy one. It’s documented, the injury, the surgery, the recovery etc. That’s called a DIRECT injury. You would simply claim this as “right ACL tear”.

SECONDARY: Continuing the ACL scenario…What most forget about is the left side of your body while your right ACL is healing. You’ll be limping, possibly on crutches and wearing a brace while doing PT which can mess up your hip, knee and/or back. The pain your left joints will feel is known as a SECONDARY injury, aka compassionate/overcompensation injury. Your left knee will begin to hurt due to your right ACL repair. This is a claim….it is compensable by the VA, if you claim it correctly. You’d need to claim, “left knee SECONDARY to right ACL repair”. If you just claim left knee, the VA will consider it a DIRECT injury and go looking for a specific traumatic event in your STRs.

AGGRAVATED: This is usually seen with an injury that happened before you joined the military. You’ll remember this because of all the medical hoops you had to jump through at MEPS to join. Let’s use the ACL tear as an example. You played football in high school and tore your ACL. After surgery you were given a clean bill of health and joined the military. No matter how good you feel, that ACL is forever compromised, it is weaker. So after a tour or two of carrying heavy combat loads over rocky terrain or a few years pushing boots as a DS your ACL tears again. Most likely it tore sooner than it would have if you had chosen a less physically demanding job. You would claim ” Left ACL tear AGGRAVATED beyond normal progression due to military service”. (This goes for anything that is documented on your entrance physical.)