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Establishing the Service Connection

To qualify for VA disability compensation, the VA must determine that your medical condition was caused or aggravated by your military service. Service connection for a disability or death can be established through many ways. The four most common are:

The disability or condition was incurred in military service. These determinations are usually cut and dry because the evidence should be in your military medical records. An example would be if you were shot or were wounded by an explosion during combat.

The aggravation of a before-service disability during service. This can be harder to determine because it precludes prior-service conditions that get worse due to the natural progression of the disease or condition.

When making a determination, the VA considers the places, types, and circumstances of your military service as documented in your service records. The VA gives particular weight to combat duty and other hardships of service.

Because of a service-connected disability, a secondary condition has occurred. It has been scientifically proven that some medical conditions can cause other medical conditions. For example, it is medically known that individuals who have had an amputation of the leg at or above the ankle are prone to develop heart disease. In such cases, the condition (heart disease) caused by the service-connected disability (amputation) can be rated as a service-connected disability by the VA.

Presumption that the disease or disability was incurred in military service. In certain cases, the VA can make a presumption that a medical condition or disability is service connected. In all cases, there must be evidence of a current disability.

Making a Presumptive Service Connection

The VA presumes that specific disabilities diagnosed in certain veterans were caused by their military service, so it issues a presumptive service-connection determination. The VA does this because of the unique circumstances of the veteran’s military service. If you fit into one of the following groups and are diagnosed with one of the listed conditions, the VA presumes that the circumstances of your service caused the condition, and it awards disability compensation.

Veterans within one year of release from active duty: If you are diagnosed with a chronic disease (such as arthritis, diabetes, or hypertension), the VA can presume the condition is service connected, even in the absence of any evidence of service connection.

Veterans with ALS: If you served in the Persian Gulf (Iraq, Kuwait, Saudi Arabia, or other nearby locations) from August 2, 1990, to July 31, 1991, and are diagnosed with amyotrophic lateral sclerosis, otherwise known as ALS or Lou Gehrig’s disease, the VA considers that condition to be service connected. Additionally, the VA presumes a service connection if you served on active duty (anywhere) for 90 or more days and are diagnosed with ALS.

Former prisoners of war for any length of time: If you were a POW for any length of time and are diagnosed with a disability that’s at least 10 percent disabling for any of the following conditions, your condition is considered service connected:

  • Dysthymic disorder (clinical depression)
  • Heart disease or hypertensive vascular disease and its complications
  • Mental health conditions
  • The aftereffects of frostbite
  • Post-traumatic osteoarthritis (degenerative joint disease)
  • Stroke and its aftereffects

Former prisoners of war for at least 30 days: If you were a POW for at least 30 days and are diagnosed with a disability that’s at least 10 percent disabling for any of the following conditions, your condition is considered service connected:

  • Avitaminosis (any disease caused by chronic or long-term vitamin deficiency)
  • Beriberi (a nervous system ailment caused by thiamine deficiency)
  • Pellagra (disease caused by lack of niacin)
  • Any other nutritional deficiency
  • Chronic dysentery (severe, bloody diarrhea)
  • Cirrhosis of the liver
  • Helminthiasis (infested with worms)
  • Irritable bowel syndrome
  • Malnutrition
  • Peptic ulcer disease
  • Peripheral neuropathy (numbness of the fingers, toes, hands, or feet)

Vietnam veterans: If you served in Vietnam between January 9, 1962, and May 7, 1975, and were exposed to the herbicide known as Agent Orange, the VA assumes service connection for the following medical conditions:

  • Peripheral neuropathy (numbness of the fingers, toes, hands, or feet) if it manifests within one year of exposure to Agent Orange
  • Chloracne (acne-like eruption of blackheads and cysts caused by over-exposure to chemicals) or other diseases similar to chloracne if it manifests within one year of exposure to Agent Orange
  • Chronic lymphocytic leukemia
  • Hodgkin’s disease (type of lymphoma cancer)
  • Multiple myeloma (cancer of plasma cells)
  • Non-Hodgkin’s lymphoma
  • Porphyria cutanea tarda (blistering of the skin) if it manifests within one year of exposure to Agent Orange
  • Primary amyloidosis (protein fibers imbedded in tissues and organs, causing them harm)
  • Prostate cancer
  • Respiratory cancers (lung, bronchus, larynx, trachea)
  • Soft-tissue sarcomas (cancer of the soft tissues of the body)
  • Type 2 diabetes

Gulf War veterans: If you served in the Persian Gulf and have developed any of the following conditions (it must be diagnosed before December 31, 2011), the VA will assume you have Gulf War Syndrome, which is considered to be service connected:

  • Chronic fatigue syndrome
  • Fibromyalgia (widespread pain)
  • Irritable bowel syndrome
  • Any diagnosed or undiagnosed illness that the secretary of Veterans Affairs determines warrants a presumption of service connection

At the present time, signs or symptoms of an undiagnosed illness include fatigue, skin symptoms, headaches, muscle pain, joint pain, neurological symptoms, respiratory symptoms, sleep disturbance, GI symptoms, cardiovascular symptoms, weight loss, and menstrual disorders.

Other presumptive conditions: The VA may presume a condition is service connected in many other situations, based on the date and place of military service. The complete list is contained in Title 38 of the Code of Federal Regulations (CFR), in sections 3.307, 3.308, and 3.309:


  1. I am a disabled veteran with service connected status.
    How do I get a copy of the paperwork which shows my most recent cost of living increase

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