Service Connection

There are 5 ways to establish service connection:

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1. Direct Service Connection

2. Aggravation of a Pre-Existing Disability

3. Presumptive Service Connection

4. Secondary Service Connection

5. VA Negligence (Section 1151 Claims)

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Direct Service Connection

The most common way to establish direct service

connection is to submit to the VA:

1. Medical evidence of a current disability;

2. Lay or medical evidence of an in-service incurrence of a disease, injury, or event; and

3. Medical evidence that links the current disability to the precipitating disease, injury, or event in service.  

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There is an exception to element two and three above if the disease is considered a chronic disease. In that case, if the current disability or disease was diagnosed in-service or within a presumptive period after service, you may be able to provide evidence of "Chronicity" or "Continuity of Symptomatology," which is evidence that the condition recurred regularly, without an intercurrent (intervening cause) when you filed your claim. 

 

Aggravation of Pre-Existing Disability

Did you note to the VA during entrance to service a condition or were you not examined at all? If your previously-noted condition worsened, i.e., aggravated, during military service, then you might be able to obtain benefits under a concept called the "presumption of aggravation." Since the condition pre-existed service, the veteran only needs to show that the condition worsened during service - not necessarily that it was caused by service.

 

The VA must then attempt to rebut your claim by showing that your current disability was related to natural progress of the condition. You may want to consider submitting a medical evaluation and lay statements to show that the condition worsened faster or to a higher degree than its natural progression. 

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Presumptive Service Connection

You do not necessarily require medical evidence of a nexus if your current disability is service connected through a legal presumption.

 

Legal presumptions are available for certain chronic diseases, tropical diseases, diseases specific to former prisoners-of-war, diseases specific to radiation-exposed veterans, diseases associated with exposure to certain herbicide agents such as Agent Orange, diseases associated with exposure to mustard gas and Lewisite, certain diagnosed and undiagnosed illnesses in veterans of the Gulf War, and certain diseases associated with exposure to contaminants in the water supple at Camp Lejuene.

 

To establish the presumption, the veteran must show that the disease or disability manifested itself to a degree of at least ten percent disabling within the presumptive period (if any).​

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Secondary Service Connection

A veteran can seek secondary service connection when an already-service-connected disability contributes to the creation of a new disability and where a service-connected disability aggravates a non-service-connected condition. Some examples of secondary service connection are:

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• Depression caused by a service-connected physical impairment, 

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• Right knee, hip, and low back pain caused by overcompensation of a service-connected left knee.

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VA Negligence 

You or your family might be entitled to benefits if the VA caused an injury or death through VA health care or other VA activities, such as VA vocational rehabilitation, or participation in a VA Compensated Work Therapy Program (CWT). You or your estate must show that the injury or death was proximately (immediately or directly) caused by "carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault" or caused by "an event not reasonably foreseeable" in VA's furnishing of hospital care, medical treatment, surgical treatment, or examination. You may have rights under the Federal Torts Claims Act (FTCA) and the VA under 38 U.S.C. § 1151.