Home › Conditions › Secondary claims › IBS ← PTSD
A secondary claim is a condition caused or worsened by one the VA has already service-connected (38 CFR 3.310). The causation fight is already half-won — the VA agreed your ptsd came from service; the question is only whether it caused or aggravated the ibs. That's a medical question with a recognized answer.
The connection
The gut-brain axis is real medicine, not a metaphor — functional GI disorders like IBS track closely with chronic stress and PTSD in the research literature. For Gulf War-era veterans there may also be a direct presumptive path; for everyone else, secondary to a service-connected mental health condition is the recognized theory.
How the VA rates ibs
DC 7319 — Irritable bowel syndrome
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 30% | Abdominal pain related to defecation at least one day per week during the previous three months; and two or more of: change in stool frequency, change in stool form, altered stool passage (straining and/or urgency), mucorrhea, abdominal bloating, or subjective distension |
| 20% | Abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the same signs |
| 10% | Abdominal pain related to defecation at least once during the previous three months; and two or more of the same signs |
This code also covers functional digestive disorders such as dyspepsia, functional bloating and constipation, and diarrhea — including the Gulf War undiagnosed-illness presumptives of § 3.317.
Full criteria, exam and evidence guide: VA rating for IBS (Irritable Bowel Syndrome). And the anchor: VA rating for PTSD, Depression and Anxiety.
What the claim needs — the three legs
- The anchor: service connection for the ptsd (see how that condition is rated). Not connected yet? File both in the same claim — the VA decides the anchor first, then the secondary against it.
- A current diagnosis of ibs — the VA rates diagnosed conditions. If you only have the symptoms, file them anyway: the C&P exam supplies the diagnosis, and a "no diagnosis" denial is repaired with a supplemental claim that keeps your date.
- The medical link. An opinion stating it is "at least as likely as not" that the ptsd caused or aggravated the ibs. The VA's own C&P examiner supplies this free in most cases; your own doctor can too. A paid independent opinion is the answer to a denial, not the first move.
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See If You Qualify →Frequently asked questions
Can I claim ibs secondary to ptsd?
Yes, if three things hold: the ptsd (or its equivalent) is service-connected, you have a current diagnosis of ibs, and a medical opinion connects the two. The connection described on this page is a recognized pathway raters see regularly.
Do I need to pay for a nexus letter for ibs secondary to ptsd?
Usually not. The VA's own C&P examiner can supply the connecting opinion at your exam for free, and your own treating doctor can also provide it. A paid independent opinion is worth buying only after a denial for lack of nexus — a supplemental claim within one year keeps the original effective date.
What if the primary condition isn't service-connected yet?
File them together in the same claim. The VA decides the primary first and then the secondary against it in the same decision; a secondary filed alone against a condition the VA has not connected fails. Filing both at once under one Intent to File protects the effective date for both.
Last reviewed 2026-09-19.