# Secondary Condition Evidence Map

Organizes the evidence you already have that connects a primary service-connected condition to a secondary condition you believe is related. Use it before your VSO appointment to see what you have and what is still missing.

## Prompt

## Context
You are helping [YOUR NAME], a veteran, map the evidence connecting a primary service-connected condition to a secondary condition they believe is related. Primary condition: [PRIMARY CONDITION, e.g. service-connected right knee injury]. Secondary condition claimed: [SECONDARY CONDITION, e.g. lower back pain]. Evidence the veteran currently has: [CURRENT EVIDENCE, describe medical records, treatment notes, and any statements in your possession that mention either condition]. How the veteran describes the connection: [VETERAN'S ACCOUNT, in your own words explain how you believe the primary condition caused or contributed to the secondary one, based on your own experience].

## Task
Produce a structured evidence map with four sections:
1. Evidence in hand: list each piece of evidence the veteran described, what it covers, and whether it mentions both conditions or only one.
2. Evidence gaps: identify what is missing that a VSO or provider would likely ask about.
3. Questions to ask your medical provider: plain-language questions the veteran can bring to a licensed clinician who can evaluate whether a nexus opinion is appropriate. A nexus opinion is a clinical determination; it is the provider's job, not the AI's.
4. Next steps to take before your VSO appointment: specific, practical actions.

## Standards
- Do not write a nexus opinion, and do not imply the AI has made a medical determination about whether the conditions are related. A nexus opinion must come from a licensed clinician.
- Do not invent symptoms, dates, diagnoses, treatment records, or medical connections the veteran did not describe.
- Do not predict or imply a disability rating or the likelihood of claim approval.
- Do not advise the veteran to exaggerate or add symptoms they did not experience.
- Route filing and representation to an accredited VSO. VA claim preparation is regulated under 38 CFR. Accredited VSO help for initial claims is free.
- Warn that unaccredited claim preparers who charge fees for initial claims may be operating illegally.
- Tell the veteran to verify current presumptive conditions and rating schedule rules on VA.gov or with their VSO, because these lists change.
- If [PRIMARY CONDITION] or [SECONDARY CONDITION] is missing, ask before drafting.

## Variables

- YOUR NAME
- PRIMARY CONDITION
- SECONDARY CONDITION
- CURRENT EVIDENCE
- VETERAN'S ACCOUNT

## Input checklist

- [ ] Name both the primary service-connected condition and the secondary condition you are mapping before running this prompt
- [ ] List every piece of evidence you currently have: treatment records, referral notes, imaging reports, and any prior VA decision letters
- [ ] Write your account of how the conditions connect in your own words. Be factual. Describe what you experienced, not what you want the outcome to be.
- [ ] Keep your Social Security number and VA file number out of this prompt. Share only the facts you are comfortable putting into an AI tool.
- [ ] Plan to review the evidence map and the questions list with an accredited VSO before your C&P exam or before filing. VSO help for initial claims is free.
- [ ] Confirm any presumptive conditions or rating schedule details on VA.gov or with your VSO. Lists and rules change.

## Verification checklist

- [ ] Check every piece of evidence listed: did you provide that document, or did the AI invent a record you do not have?
- [ ] Confirm the AI did not write a nexus opinion or state that the conditions are medically related. That determination belongs to a licensed clinician.
- [ ] Verify that no disability rating, approval likelihood, or benefit amount appears anywhere in the map.
- [ ] Check that the veteran's account section reflects only what you actually described, with no added symptoms or severity.
- [ ] Confirm the provider questions are plain-language questions, not clinical conclusions drafted for the doctor to sign.
- [ ] Verify that the next steps include routing to an accredited VSO, not to an unaccredited claim preparer.
- [ ] Do not treat this evidence map as a substitute for a VSO consultation or a medical evaluation.

## Sample output

Sample output. Generated by AI from sample inputs:

Veteran: Marcus Hale. Primary condition: service-connected right knee injury (rated). Secondary condition: lower back pain. Evidence in hand: VA rating decision letter confirming right knee at 10%, two physical therapy notes from 2023 mentioning altered gait, one primary care note from January 2026 documenting lower back pain. Veteran's account: Since my knee injury I walk differently. My physical therapist told me I was compensating on my left side and putting stress on my lower back. My back started hurting regularly about a year after my knee got rated.

Evidence in hand:
- VA rating decision letter (right knee, 10%): confirms service connection for primary condition. Does not mention lower back.
- Physical therapy notes, 2023 (two records): mention altered gait and compensation pattern. Do not explicitly connect altered gait to lower back.
- Primary care note, January 2026: documents lower back pain. Does not connect it to knee or gait.

Evidence gaps:
- No record that directly states the altered gait from the knee condition is causing or contributing to the lower back pain. This is the gap a nexus opinion from a licensed clinician would address.
- No imaging of the lower back is in hand. If imaging exists, obtain it.
- Physical therapy notes mention compensation but do not link it to the back. A note from the same provider stating that opinion in writing would be more useful, if the provider is willing to provide it.

Questions to bring to your medical provider (a nexus opinion is theirs to give, not the AI's):
- I have a service-connected right knee condition and documentation of an altered gait. Do you believe, based on your clinical evaluation, that my lower back pain is related to the knee and gait changes?
- If you do believe they are related, would you be willing to write a letter stating your clinical opinion about that connection?
- What type of evaluation would you want to do before forming that opinion?
- Are there any imaging studies or referrals you would recommend to evaluate the lower back independently?

Next steps before your VSO appointment:
- Request any additional treatment records from your VA or civilian providers that mention either condition.
- Bring the physical therapy notes and the primary care note to your VSO and ask whether the current records are sufficient or whether a nexus letter from your provider would strengthen the claim.
- Contact an accredited VSO to discuss filing a secondary condition claim. VA claim preparation is regulated under 38 CFR. Accredited VSO help for initial claims is free. Do not pay an unaccredited preparer to file your claim.
- Verify current rules on secondary service connection on VA.gov or with your VSO. Rules and presumptive lists can change.

## Customization notes

Run this prompt once per secondary condition you are mapping. Mixing multiple conditions in one map makes it harder to see what is missing for each one. If your secondary condition involves mental health or a stress-related diagnosis, describe functional impacts in plain language and bring those records to a licensed mental health provider before involving your VSO. For PACT Act presumptive conditions, confirm the current list on VA.gov before building your map, because the list has expanded and continues to be updated.

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From The VA & Benefits Navigator Library at vetslearn.com/libraries/va