Establishing Service Connection for VA Disability Benefits

Veterans who have a medical condition that was caused by or became worse as a result of their service may be eligible for disability compensation from the VA. Once you establish service connection by showing a causal link between your current health problems and an incident that happened during active duty, the VA can assign you a disability rating and provide you a monthly monetary benefit.

Any type of disease, illness, or injury, whether physical or mental, can be a service-connected disability. Service connection may be direct, aggravated, presumptive, secondary, or result from treatment at a VA medical center. The type of service connection doesn't have an impact on the amount of disability compensation you can receive—only your rating percentage.

Direct Service Connection

As the name implies, direct service connection means that there's a straight cause-and-effect between an incident that happened on duty and a current medical condition. Examples of direct service connection include ongoing muscle weakness from combat wounds, post-traumatic stress disorder (PTSD) from witnessing a disturbing event, or chronic back pain from heavy lifting while repairing a vehicle.

In order to establish direct service connection, you'll need proof that the incident occurred (meaning it's mentioned in your records or in statements from fellow servicemembers), medical records showing treatment for your current condition, and evidence linking the condition to the on-duty incident. For example, if you went to a VA doctor for a cough right after you were exposed to toxic chemicals, that should be sufficient to establish direct service connection if you're then diagnosed with a heart problem.

If you weren't diagnosed with your current condition while you were enlisted, you can still establish direct service connection if you have a medical opinion from a doctor that makes a correlation between your time in service and your current health issues. This is commonly referred to as a "nexus letter."

Aggravated Service Connection

Aggravated service connection exists when a veteran has a medical condition before entering service, the entrance medical exam records the existence of this condition, and the condition gets worse as a result of an in-service event. One example might be a veteran with mild tinnitus whose ear ringing gets worse as a result of proximity to an explosion.

If your condition isn't mentioned in your entrance medical exam, you'll have to provide the VA with medical evidence of a pre-service diagnosis and treatment. You'll also need proof of an incident that happened to make the condition worse. The VA will assume that worsening symptoms are a natural progression of your impairment unless you can demonstrate that your military service accelerated the decline. A nexus letter can help establish this link.

Presumptive Service Connection

Some medical conditions are assumed to be the result of military service due to the fact that veterans in unique circumstances are at a higher risk of contracting certain diseases. For example, presumptive service connection is available for various types of cancers and conditions caused by exposure to infectious diseases or chemicals, such as Agent Orange. Gulf War veterans can get presumptive service connection for chronic symptoms of an undiagnosed illness. (You can find the complete list of service-connected disabilities on this VA pamphlet.)

Not all veterans can qualify for presumptive service connection. You'll need to have served for at least 90 days, and you must have served at the specific place and time for which your condition is connected. For example, POWs confined more than 30 days will have presumed service connection for illnesses related to malnutrition, while veterans who served in Afghanistan after September 19, 2001 have presumed service connection for tuberculosis.

You'll also need to submit medical evidence that your medical condition has been diagnosed and that symptoms appeared within a presumptive time period (typically one year after your discharge, but can vary depending on your disabling condition).

Secondary Service Connection

If you already have one service-connected condition and you've been diagnosed with another disorder that was caused by the original condition, you may be eligible for additional disability compensation based on secondary service connection. Examples of secondary service connection may include depression caused by chronic pain or retinopathy caused by diabetes.

The documentation you'll need to prove secondary service connection is similar to that for other types of service connection. You'll have to show medical evidence (such as tests used to make your diagnosis) of the related condition, as well as a doctor's opinion establishing the relationship between the secondary condition and your initial service-connected disability.

Service-Connection For Disability Caused by the VA

If you're injured—or your existing condition worsened—while receiving care at a VA health facility, the resulting limitations will be considered a service-connected disability for the purposes of receiving benefits. This type of service connection is also known as a "Section 1151" claim. You also have the option to sue the VA under the Tort Claims Act, but filing for Section 1151 compensation is generally a less complicated process (and easier to win).

How to Apply for VA Compensation for a Service Connected Disability

You can apply for VA disability benefits by completing Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. Once you've finished filling out the form, you can submit it to the VA in any of the following ways:

• file online using the electronic version of Form 21-526EZ
• fax the form to 844-531-7818 (from inside the United States) or 248-524-4260 (from outside the U.S.)
• bring your application to your local VA office, or
• download the form, print it out, and mail it to the Department of Veterans Affairs Claims Intake Center, PO Box 4444, Janesville, WI, 53547-4444.

If you'd like help with your application—or you've already received a denial from the VA saying that you didn't establish service-connection—consider contacting an experienced veterans' lawyer. Most disability attorneys work on contingency, meaning they don't get paid unless you're approved for benefits, and many offer free consultations so you can get a sense of whether your claim will be successful. Some may be able to point you in the direction of free or low-cost legal services for veterans if you're in need of more financial help.