Republished from Hill and Ponton July 19, 2019 in VA Claim Tips, Veterans by Sarah Overcashier
In order to receive compensation from the VA, a veteran’s disability must be service-connected. There are five ways to establish service connection:
- Direct Service Connection
- Service Connection through Aggravation
- Presumptive Service Connection
- Secondary Service Connection
- Service Connection by Injury Caused by VA Health Care
Direct Service Connection
Direct service connection is for a disease or injury that first began in service or was caused by active military service. The burden of proof falls on the veteran to show that their current disability is directly related to their service. This is most easily proven by using military and service medical records as evidence that the condition was diagnosed in service or that symptoms of the condition began in service. However, in the absence of service records, other evidence can be used to make a case for direct service connection.
Service Connection through Aggravation
Service connection through aggravation is when a disability the veteran had before going into service gets worse because of their service. In other words, the veteran’s service caused the condition to progress faster than it should have naturally. All veterans undergo an entrance medical examination before entering active duty to establish the veteran’s health prior to service. If the veteran has any pre-existing conditions, the medical examiner should have noted them on the Report of Medical Examination. A claim for service connection through aggravation is best supported by a medical opinion written by a doctor showing that service aggravated the condition beyond the natural progression. If the pre-existing condition does not appear on the Report of Medical Examination, the veteran is assumed to be in good health and sound of mind when entering service: this is called Presumption of Soundness.
Presumptive Service Connection
By law, the VA has established that veterans diagnosed with certain diseases within a specific period of time after service don’t have to prove that their disease is service-connected; it is presumptively service-connected.
A full list of presumptively service-connected diseases and circumstances can be found here, but the most common circumstances include:
- Diagnosis of specific diseases within one year of being discharged from active duty
- Vietnam Veterans exposure to herbicides, such as Agent Orange
- Gulf War Veterans
- Former prisoner-of-war
- Exposure to contaminated water at Camp Lejeune between August 1, 1953, through December 31, 1987, for a minimum of 30 days (cumulative)
Secondary Service Connection
Often veterans find that one disability will lead to another. If that’s the case, the veteran may want to apply for a secondary service connection. The VA defines a secondary service-connected disability as “…proximately due to or the result of a service-connected disease or injury…” There is no time restriction from the date of discharge from active duty to when the secondary condition develops. Secondary service-connection can be somewhat more difficult to prove; a doctor written medical opinion showing how the veteran’s service-connected disability caused the secondary condition is generally the best evidence.
Service Connection by Injury Caused by VA Health Care
The final way to establish service connection is through an injury or aggravation of an injury which was caused by the VA; it is similar to medical malpractice against the VA. The burden of proof falls heavily on the veteran in Section 1151 claims to show that the injury or aggravation was caused by VA negligence.Tags: 1151 claim|establishing service connection|secondary service connection|service connected benefits|service connection aggravation