Service-connected VA benefits requirements

Establishing entitlement to compensation from the Department of Veterans Affairs for service connected disabilities requires the claimant meet three criteria.

To receive a service-connected disability benefit a veteran must have suffered a disease, injury, or event that resulted in a disability while on active duty, or had a pre-existing condition that was aggravated by the veteran’s service. For this paper these 4 elements that caused the in-service disability will be referred to as disease, injury, or event.

The first criteria are an in-service disease, injury, or event that resulted in a disability. This disease, injury, or event must have occurred during a period of active duty. Since medical evidence is paramount it is usually helpful if medical treatment was provided and recorded in your service medical (treatment) records while on active duty, but not absolutely necessary. The lay statement blog discusses how a claimants applying for a service connected disability can overcome the lack of documented treatment for a disease, injury, or event while on active duty.

The second criterion is a present residual disability related to that injury or illness. You must have a current disability. This means a chronic disability which has been diagnosed by either a private physician or a VA physician. Again, having a confirmed diagnosis of current disability is helpful to the success of your claim, but not absolutely necessary. This issue will also be discussed in a later blog.

The third requirement is a nexus, or connection, between the in-service disease, injury, or event and the current disability. There must be a connection between the in-service disability and the veteran’s present disability. Federal statute, case law, and VA rules and regulations require the VA to look for two elements when determining if a nexus exists. These elements are called chronicity and continuity.

See the chronicity and continuity blog for more information on nexus.

Determining the first requirement that an in-service disease, injury, or event resulted in a disability in service is best accomplished through your service medical (treatment) records. If you were injured or became ill during active duty and sought treatment your service treatment records should establish this first element. The VA is responsible, by statute, for obtaining these records. The VA, however, is only required to do a reasonable effort to obtain the records. The VA may claim that they asked the veteran if any other records exist to prove his claim of disability. I will discuss how to overcome this element when VA determines service treatment records are not available in a later blog.

The second requirement of a current disability is best proven by treatment records for the disability since leaving service. This can be done by the use of your VA Medical Center treatment records or by providing the VA with copies of private treatment records. These records must relate to treatment for the disability you are claiming. Submitting treatment records for your heart condition when you’re claiming a back condition will not meet the requirement for establishing a nexus between the in-service illness/injury to your back and your current back disability.

Lastly, the VA should look at all the evidence, service personnel records and service and private medical records, to determine if the nexus has been established. If the nexus is proven to exist, entitlement to service connection for the claimed condition should be established. Remember the three requirements to establish entitlement to service connection disability benefits before filing your claim. Decide how you will best meet these requirements and be able to prove these requirements.

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