A new claim, a claim for increase, and a decision review are different processes. TDIU and SMC also use their own requirements. The right path depends on the facts, the decision notice, and the evidence already in the record.
This guide explains five issues to discuss with a VA-accredited representative. It does not predict a rating, recommend filing several matters at once, or replace the instructions in the veteran’s actual notice.
What 2026 ratings actually pay
A single veteran at $1,808.45/mo (70%) goes to $3,938.58/mo at 100% — a $2,130.13/mo difference at the current veteran-alone rates. Add a spouse or qualifying dependents and the amounts differ. These figures illustrate the rate table; they are not an estimated outcome.
The 5 paths at a glance
Before going deep on each, the elevator pitch on all five:
- New direct service-connected claim — claim a condition you have but never filed for. If granted, VA adds the evaluation under its combined-rating rules.
- Secondary claim — ask VA to consider a condition caused or aggravated by an already service-connected disability.
- Claim for increase — existing condition has gotten worse, ask for a higher rating on it.
- TDIU — VA may pay at the 100% rate when service-connected disabilities prevent substantially gainful employment and the requirements are met.
- SMC — additional or higher compensation may apply for specified losses, loss of use, care needs, or combinations of service-connected disabilities.
Path 1
File a NEW direct service-connected claim
A current condition that may have a direct, presumptive, or other evidence-supported relationship to service.
A diagnosis or diagnostic code does not by itself establish service connection. For a direct theory under 38 CFR § 3.303, the record generally must support a current disability, an in-service event, injury, or disease, and a link between them.
Conditions veterans miss most often
- Tinnitus — DC 6260 uses a single 10% evaluation for recurrent tinnitus. Military noise exposure may be relevant evidence, but occupation alone does not establish service connection. See the tinnitus guide.
- Hearing loss — DC 6100. Requires audiometric testing per § 4.85. Often paired with tinnitus.
- Sleep apnea — DC 6847. A diagnosis and prescribed treatment do not by themselves establish service connection. The record must support the claimed direct or secondary theory. See the sleep apnea guide.
- Migraines — DC 8100. Prostrating attacks 1× per month = 30%; very frequent, completely prostrating, productive of severe economic inadaptability = 50%.
- GERD — current DC 7206. The current 0/10/30/50/80 schedule is based on documented esophageal stricture, dysphagia, required treatment, and listed complications. Older decisions may use prior criteria; verify the applicable schedule and effective date.
What evidence you need
- Current diagnosis (private provider or VA)
- Service treatment records showing in-service event/symptoms (or competent lay evidence of exposure)
- A nexus opinion linking the two — can be a private DBQ or an inferred opinion from the C&P examiner
Timeline + outcome
Processing time and outcome vary. If VA grants service connection, it combines the new evaluation with existing evaluations under the 38 CFR § 4.25 combined rating table. Do not add percentages arithmetically or assume that a new 10% evaluation will move the rounded combined rating to the next tier.
Best tool for this path
Path 2
File a SECONDARY claim
A condition claimed as caused or aggravated by an already service-connected disability.
A secondary claim under 38 CFR § 3.310(a) service-connects a condition that is “proximately due to or the result of a service-connected disease or injury,” or aggravated by it. The record still needs competent evidence supporting the secondary condition and the claimed causal or aggravation relationship.
Secondary theories to research with the record
- PTSD → sleep apnea. Established by a long line of medical literature in some populations, but a diagnosis and CPAP do not prove causation in an individual veteran.
- PTSD → hypertension. This is a possible secondary theory that requires an individual medical rationale; it is not a blanket PACT Act presumption.
- Medication → GERD symptoms. Medication effects may be relevant, but a clinician must address the individual history and claimed relationship.
- Back pain → radiculopathy. If your back pain shoots down a leg, ask a clinician whether a separately diagnosed neurologic condition is present. The bilateral factor applies only when its regulatory requirements are met.
- Knee → opposite knee or hip. An altered-gait theory requires evidence specific to the veteran; it is not presumed from a knee rating.
- Chronic pain → depression / anxiety. The depression-pain relationship may be considered when supported by a diagnosis and an individual medical rationale.
- Diabetes → peripheral neuropathy / ED / retinopathy / nephropathy. These are recognized possible complications, but each claimed condition still requires competent evidence and an adjudication.
What evidence you need
- Diagnosis of the secondary condition
- Evidence the primary condition is service-connected (already in your file)
- A supported medical opinion when the relationship is a medical question. A conclusion without an explanation or review of the relevant history may carry little weight.
Timeline + outcome
Processing time and outcome vary. Secondary service connection is not an easier lane; VA evaluates the diagnosis, the service-connected primary disability, and the evidence supporting causation or aggravation.
Best tool for this path
Path 3
Request an INCREASE on an existing condition
The service-connected condition has worsened since VA last evaluated it.
A claim for increase under 38 CFR § 3.155 asks VA to re-rate a service-connected condition that has worsened. This is a separate path from an appeal — you’re not arguing the old rating was wrong, you’re telling VA the condition is worse now. 38 CFR § 4.7 requires VA to assign the higher of two ratings when the disability picture “more nearly approximates” it.
When to file
- You crossed a CFR tier threshold — e.g., back flexion dropped from 65° to 55° (10% → 20%)
- Medical or lay evidence shows increased severity or functional impact
- You have new diagnostic findings (MRI, EMG, sleep study) showing progression
- Mental health: occupational/social impairment has deepened (lost a job, lost a marriage, can’t work)
What evidence you need
- Medical records showing the current severity and functional impact
- A private DBQ if available, or rely on the C&P exam VA orders
- Buddy/spouse lay statements describing day-to-day worsening
Watch out — the reduction risk
Filing a claim for increase opens the rating to re-evaluation under 38 CFR § 3.344. If a stabilized rating of 5+ years is re-examined and found improved, VA can reduce the rating. Don’t file for increase unless you have strong evidence the condition is genuinely worse.
Timeline + outcome
Processing time and outcome vary. VA compares the current evidence with the applicable rating criteria and then applies combined-rating rules to any changed evaluation.
Best tool for this path
Path 4
TDIU — paid at 100% without a 100% schedular rating
If service-connected disabilities prevent substantially gainful employment, VA may consider TDIU and payment at the 100% rate.
Total Disability based on Individual Unemployability — TDIU — may apply when service-connected disabilities prevent substantially gainful employment. Under 38 CFR § 4.16, VA may pay compensation at the 100% rate ($3,938.58/month for a single veteran) while the underlying schedular rating remains lower.
Schedular eligibility (§ 4.16(a))
You meet the percentage threshold for consideration if ONE of these is true:
- One service-connected condition rated 60% or higher, OR
- Two or more service-connected conditions with at least one rated 40%+ AND a combined rating of 70%+
Extra-schedular eligibility (§ 4.16(b))
If you don’t meet the numerical thresholds but still can’t maintain substantially gainful employment due to service-connected conditions, the VA Director of claim may be referred for extraschedular consideration under § 4.16(b). The percentage thresholds are not the only issue; VA still reviews whether service-connected disabilities prevent substantially gainful employment.
What evidence you need
- Form 21-8940 (Veteran’s Application for Increased Compensation Based on Unemployability)
- Form 21-4192 from your last employer (employment information)
- Medical evidence linking inability to work to service-connected conditions
- Vocational expert opinion (helpful, not strictly required)
Timeline + outcome
Processing time varies. If VA grants TDIU to a veteran currently rated 70%, the monthly payment changes from $1,808.45/mo to $3,938.58/mo — $2,130.13/mo more at the current veteran-alone rates while the award remains in effect.
Best tool for this path
Path 5
SMC — Special Monthly Compensation for severe disabilities
Additional money beyond the schedule for loss of use, anatomical loss, Aid & Attendance, and Housebound status.
Special Monthly Compensation under 38 CFR § 3.350 covers specific service-connected losses, loss of use, care needs, and combinations of disabilities. SMC-K is $139.87/month — about $1,678.44/year tax-free — on top of your base rate, and it’s available at any rating level for specific anatomical losses.
SMC tiers and what triggers each
- SMC-K — flat $139.87/mo add-on for anatomical loss or loss of use. Most commonly missed for erectile dysfunction (DC 7522) — if you have service-connected ED, ask whether the record establishes loss of use of a creative organ for SMC-K. Other possible K bases include loss or loss of use involving a hand, foot, eye, breast; loss of use of a creative organ.
- SMC-L — $4,900.83/mo. Replaces the 100% rate. Triggered by Aid & Attendance need, anatomical loss of both feet/legs/hands, blindness with very limited acuity.
- SMC-M — $5,408.55/mo. More extensive losses than L.
- SMC-R.1 — $9,826.88/mo. This level has additional prerequisites and involves a need for regular Aid and Attendance.
- SMC-S — $4,408.53/mo. Housebound status — substantially confined to the home as a result of service-connected disabilities, with a rating-based path and a factual housebound path with specific requirements.
Reviewing DC 7522 and possible SMC-K
Erectile dysfunction under DC 7522 is usually rated 0% by itself unless there’s also penile deformity — so veterans assume there’s no money in it. A confirmed service-connected loss of use of a creative organ may support SMC-K ($139.87/mo). VA must still establish the service-connected basis and the SMC criteria; a diagnosis or medication list does not create an automatic award.
Timeline + outcome
Processing time varies. VA’s current rate guidance says a veteran may receive one to three SMC-K awards in addition to eligible basic or SMC rates, subject to the governing combination rules.
Best tool for this path
Which path is right for you?
One or more issues may be relevant, but parallel filings are not automatically the right strategy. Review the record and any decision notice before choosing a lane:
| Your situation | Best path |
|---|---|
| You have a condition you never filed for | Path 1 — New direct claim |
| Your existing condition caused another one | Path 2 — Secondary |
| A condition has gotten significantly worse | Path 3 — Claim for increase |
| You can’t sustain work because of SC conditions | Path 4 — TDIU |
| You have ED, loss of use, A&A need, or Housebound | Path 5 — SMC |
| VA denied or under-rated a recent claim | Appeal (Supplemental / HLR / Board) |
Why path stacking matters — the combined-rating math
VA combined ratings use the 38 CFR § 4.25 combined rating table, not simple addition. A 60% + 30% does not equal 90% — it equals about 72%, which rounds to 70%. The implication: a single new condition rarely jumps you a full 10% tier on its own. But three new conditions at 10%–30% each often do.
The combined-rating result depends on the disabilities VA actually service connects and the evaluations it assigns. Use scenarios for education, not as a prediction of an award. See the What-If Simulator to model your specific combination.
Pick a path with the Coach
The Claim Coach asks five intake questions and helps organize the conditions, evidence, and questions you may want to discuss with a VA-accredited representative. It does not select a legal review lane, file a claim, or predict a decision.
Quick answers
What is the fastest way to increase a VA disability rating?
There is no single fastest path. The correct review option depends on the decision date, whether you have new and relevant evidence, and whether you believe VA made an error using the existing record. A new claim for increase is different from a decision review. Read the actual decision notice and ask a VA-accredited representative which lane fits the record.
Can I increase my VA rating without an appeal?
Yes — three of the five paths in this article (new direct claim, secondary claim, and claim for increase) are NOT appeals. They are new claims filed under 38 CFR § 3.155. You can file them at any time, and each is decided on its own merits. Appeals (Supplemental, HLR, Board) only come into play after a decision you want to challenge.
How much can a 70% rating actually increase your VA pay?
Going from 70% to 100% changes a single veteran's monthly base rate from $1,808.45 to $3,938.58. TDIU may pay at the 100% rate when VA determines that service-connected disabilities prevent substantially gainful employment. The percentage thresholds alone do not establish entitlement.
What is a VA secondary claim?
A secondary claim under 38 CFR § 3.310(a) is a service connection claim for a condition caused or aggravated by an already service-connected condition. The most common examples: sleep apnea secondary to PTSD, radiculopathy secondary to back pain, depression secondary to chronic pain, hypertension secondary to PTSD. The primary condition must already be service-connected — the secondary is its downstream effect.
What is TDIU and how does it pay at the 100% rate?
TDIU stands for Total Disability based on Individual Unemployability. Under 38 CFR § 4.16, VA may pay at the 100% rate ($3,938.58/month for a veteran alone) when service-connected disabilities prevent substantially gainful employment. The percentage thresholds create a schedular route for consideration; meeting them does not by itself establish entitlement. Claims below those thresholds may be referred for extraschedular consideration under § 4.16(b).
What is SMC and which veterans qualify?
Special Monthly Compensation (38 CFR § 3.350) provides additional or higher compensation for specific service-connected losses, loss of use, care needs, and combinations of disabilities. VA may add SMC-K to compensation at any disability rating when its requirements are met. The letter levels use detailed criteria and cannot be selected from a diagnosis alone.
How often can I file a claim for increase?
There is no hard cap — you can file a claim for increase under 38 CFR § 3.155 any time your service-connected condition has worsened. But filing repeated weak claims with no new evidence wastes time. Wait until you have a documented decline (new medical records, a worse C&P exam, new symptoms, a new diagnosis of a complication) before re-filing. For appeals, the 1-year deadline under § 3.2500 starts from the date on the decision letter.
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Sources validated August 19, 2026: VA Individual Unemployability guidance and VA Special Monthly Compensation guidance and current rates.
Educational content only. This is not legal, medical, or financial advice. Always consult an accredited VSO or VA-accredited attorney for claim-specific guidance. CFR citations: 38 CFR §§ 3.102, 3.155, 3.303, 3.310, 3.344, 3.350, 4.7, 4.16, 4.25, 4.26. Rate values from va.gov/disability/compensation-rates (FY2026, effective Dec 1, 2025). TDIU and SMC guidance validated against current VA.gov pages on August 19, 2026.