In order for any VA disability claim to be successful, 3 main elements of service connection must be present. Service connection means that a veteran’s disability happened or was worsened by his or her military service. In order to establish service connection, veterans must show 3 main elements of service connection:
- A current, diagnosed disability
- An in-service event, injury, or illness
- A medical nexus between the current disability and the in-service event
Element 1: Current, Diagnosed Disability
For VA purposes, a disability is any disease or injury incurred in service that causes a decrease in earning capacity. There are some conditions that VA does not consider eligible for service connection. For example, hereditary diseases or condition that results from a veteran’s own willful misconduct cannot be service connected.
Diagnoses must be current in order to qualify for VA disability compensation. Disabilities incurred in service that have since healed and no longer impair earning capacity are not eligible for VA compensation. For example, a veteran who developed cancer that can be linked to active duty is eligible for disability compensation while the cancer is active; however, if the cancer goes into remission and the veteran is left with no residual symptoms, he is no longer eligible for disability benefits for the cancer.
The easiest way to show proof of a disability is through a current diagnosis reported in medical records.
Element 2: In-Service Event, Injury, or Illness
The second element of service connection is an in-service event, injury, or illness that occurred while on active duty. Disabilities do not have to have been incurred in a combat situation; any illness, injury, or event that happened during active duty military service can be eligible for a disability rating.
Conditions caused because of a veteran’s own willful misconduct do not qualify for VA benefits. According to VA, willful misconduct is “an act involving conscious wrongdoing or known prohibited action.” For example, if an active-duty service member was involved in a car accident in which s/he was driving under the influence of alcohol and became injured, residuals of that injury would not be eligible for compensation.
How do veterans prove to the VA that the event, injury, or illness occurred?
The best forms of evidence to prove the second element of service connection are service treatment records and service records. Service treatment records will have documented any injury or illness for which you were treated while on active duty; these are the best form of evidence to prove a condition arose during service. Service records are also quite useful, as they may hold documentation of the event or injury that occurred, such as a bad fall or a specific training exercise.
Unfortunately, not all veterans have this type of evidence available to them. In this circumstance, lay statements from the veteran can be particularly effective when coupled with buddy statements from those who served with them and witnessed the event. These statements can help corroborate when and how the event occurred.
What about presumptive conditions or other conditions?
One exemption to the second element of service connection is presumptions. The most well-known example of a presumption are benefits for veterans with “boots on the ground” service in Vietnam. To prove service connection, these veterans only have to show a current diagnosis of an Agent Orange-related condition and that they were “boots on the ground” in Vietnam during the time period VA has defined.
Another situation for which veterans do not have to provide documentation that an event occurred are for Military Sexual Trauma claims. These events often go unreported for a number of reasons, which VA acknowledges. These claims can be supported by lay evidence, buddy statements, and a review of the veteran’s behavior through time-before and after the event.
Element 3: Medical Nexus
A medical nexus is the link between your current disability and the event, injury, or illness during service. Medical evidence is the best way to prove service connection. A statement from your treating doctor affirming that they believe your condition was “at least as likely as not” caused by military service can prove to be a powerful piece of evidence.
When a claim is submitted, the VA will schedule a Compensation and Pension (C&P) Examination. This exam assesses the severity and origin of the veteran’s condition. It is part of VA’s duty to assist veterans in obtaining evidence to support their claims. The findings help to establish a medical nexus. If the results of this examination are not favorable, veterans may bring the report to another medical professional for a second opinion.
What makes a doctor’s medical opinion stronger?
Not all medical evidence is weighed the same by VA. There are some ways to ensure medical opinions hold as much probative value as possible, such as:
- The opinion should be tailored to the veteran and based on his or her service and medical records, as well as personal medical history before and after service
- The opinion notes that the veteran’s condition was “at least as likely as not” incurred in or caused by military service
- The opinion provides supporting rationale for the claim. In other words, the medical professional “shows their work” by elaborating on how they reached their conclusion