WingmanOpen the free toolsWingmanOpen the free toolsIf the VA already service-connected your alcohol use disorder (also called alcohol use disorder, alcoholism, alcoholic, alcohol abuse), it can cause or worsen other conditions that are ratable on their own. These "secondary" claims are where many veterans leave money on the table. Below is what a service-connected alcohol use disorder commonly leads to, why, and what evidence each one takes.
A secondary claim only works if the primary condition (alcohol use disorder) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. More on nexus letters →
Read this one first, because the direction matters more than anything else in the claim. The VA cannot grant direct service connection for a disability that results from abuse of alcohol (38 CFR 3.301(a), for claims filed after October 31, 1990). It CAN grant service connection for alcohol use disorder when it is proximately due to, or aggravated by, an already service-connected condition under 38 CFR 3.310(a). In practice that most often means PTSD, depression or chronic pain came first and the drinking followed. So the claim is not filed as alcoholism on its own, it is filed as alcohol use disorder secondary to the condition that is already service connected. This is a medical condition and a well-trodden claim path, not a character issue.
What you'd need: Documentation that the underlying condition is already service connected, a treatment history showing which came first, and a nexus opinion stating the alcohol use is at least as likely as not caused or aggravated by that condition. Substance use treatment records and mental health notes both help.
Long-term heavy drinking damages the liver, and unlike the drinking itself, the liver damage is rated on its own criteria in the digestive system schedule. If the alcohol use is service connected as a secondary condition, the liver disease follows the same chain.
What you'd need: Liver enzyme trends over years, imaging or elastography, biopsy if one was done, and hepatology notes. For cirrhosis, the labs behind a MELD score and any record of ascites, varices or encephalopathy.
Alcohol is the leading cause of chronic pancreatitis, and the VA rates it on its own criteria built around how often you get episodes of abdominal or mid-back pain and whether you have malabsorption or weight loss.
What you'd need: Imaging showing pancreatic changes, lipase and amylase results from episodes, hospital records for each flare, and notes on enzyme replacement, weight loss or diabetes that followed.
Sustained heavy drinking damages the small nerves in the feet and hands, both directly and through the vitamin deficiencies that come with it. The burning, numbness and weakness are rated on the affected nerves, separately from anything else.
What you'd need: An EMG or nerve conduction study, a neurology note describing the distribution, B vitamin levels, and a nexus opinion distinguishing this from diabetic or other causes.