In order for the Department of Veterans Affairs (VA) to award service-connection for a disability, the Veteran must establish these three elements:
A current chronic physical or mental condition;
An event or stressor that occurred during Active Duty service; and
A link (also known as a ‘nexus’) that connects the chronic condition to the in-service event.
Current Chronic Physical or Mental Condition
If a Veteran is suffering from a condition (or conditions) that continue to ail him/her post service, and is considered chronic (or ongoing in nature), these condition(s) may be related to his/her time in service. These condition(s) may include physical ailments, such as: Degenerative Disc Disease (DDD); hypertension (high blood pressure); and osteoarthritis; and diagnosed mental health conditions, such as: Traumatic Brain Injury (TBI); Post-Traumatic Stress Disorder (PTSD); and General Anxiety Disorder.
In-Service Event or Stressor During Active Duty
If a Veteran suffered an injury or illness while on Active Duty, this injury or illness may be compensated by the VA as a service-connected disability. Please note that service-connection refers to the injury or illness being experienced while on Active Duty. This means that for Reserve components, or National Guard, the only way to establish service-connection is during any time the Veteran was activated or ordered to Active Duty for a specific time period, be it for training or recall purposes. Some aspects of service-connection may require an eligible period of service, such as a specific length of time during a specific period of time (i.e. 90-days of total Active Duty service with at least one full day during a war-time period). This may vary from benefit to benefit sought by VA.
An in-service stressor may be considered as a single incident or event that resulted in an injury or illness that is either documented, acknowledged by VA by presumption, or may be verified and proven through submission of evidence.
Nexus
In order to find service-connection, the VA must find a connection between the current condition(s) and the in-service event. This is known as the ‘nexus’. There are many different ways a Veteran can provide a nexus between disabilities and in-service events:
Providing a continuity of treatment, which includes medical documentation that shows treatment of the injury or illness since the time of discharge (medical evidence);
Per the 38 CFR § 3.309, certain conditions, illnesses, and diseases are presumed as service-connected following Active Duty service in a period of war on or after January 1, 1947. This presumption does not require the Veteran to have to prove service-connection through continuity of treatment, nor does the Veteran need to provide evidence regarding onset of the condition; service-connection is deemed ‘automatic’ for these specific conditions.
A Medical Provider, specifically a Specialist in the field of the condition sought for disability benefits, may provide a letter to the VA that fills in the gaps between the in-service event and current chronic condition, giving an opinion as to if the condition is related to service, and the Specialist’s rationale as to how he/she came to that conclusion. It is important to note that the VA will often reject an opinion from a specialist if it does not comply with VA requirements. VA requires that the opinion be based upon competent medical evidence, unless the evidence is something a lay person can report. In addition, the VA will likely reject a medical opinion if it is speculative, conclusory, or does not address medical or other evidence that appears to be against the claim. The VA language in determining if a medical opinion from a Specialist is considered as favorable evidence consists of ‘At least as likely as not’ (or 50% chance), or ‘More likely than not’ (51% chance or greater). Submission of this opinion may not automatically grant the claim for service-connection; however, the VA is required to review and assign proper weight to the opinion when making their decision.
Lay Statements are that of a normal person who may have known the Veteran prior to, during, and even after service, and can state without speculation that the conditions suffered in-service and current are accurate with what the Veteran is claiming. These statements may be made by family members, friends, service-members, roommates, coworkers, etc. Such statements may not be enough alone to provide a nexus; however the VA is required to review and assign proper weight to the statements when making their decision.