WELCOME
Week 3
Principles of Service Connection
Service Connection requires a requisite
Duty Period: 38CFR 3.6
…includes active duty, any period of
active duty for training during
which…was disabled or died from a
disease or injury incurred or aggravated
in line of duty, or any period of inactive
duty for training during which…was
disabled or died from an injury…
Methods of Service Connection
Direct
Presumptive
Secondary / Adjunct
Aggravation
VA Medical Care (1151)
There are conditions / disabilities
which cannot be service connected:
38 CFR 3.303(c)
Congenital conditions
Hereditary conditions
Constitutional abnormalities
Presumption of Soundness
38 CFR 3.303 (c)
38 CFR 3.304 (b)
Service Connection requires three
components: 38 CFR 3.303, 3.304
1. Current disability
2. In service event
3. Causal link (nexus) between 1 & 2
Evidence for Consideration
Service medical records
Military personnel file
Unit records
Secondary military records
Personal records
Lay (buddy) statements
Post service medical records
Pre service medical records
Direct Service Connection
38 CFR 3.303(a) The facts establish that a
particular injury or disease resulting in disability
was incurred coincident with service in the Armed
Forces. Each disabling condition shown by a
veteran’s service records or for which he seeks
service connection must be considered on the basis
of the places, types and circumstances of his
service as shown by service records, official history
of each unit in which he served, his medical
records, and all pertinent medical and lay evidence.
Combat: 38CFR 3.304(d)
Satisfactory lay or other evidence that
an injury or disease was incurred or
aggravated in combat will be accepted
as sufficient proof of service
connection if the evidence is consistent
with the circumstances, conditions or
hardships of such service…
Line of Duty:
38CFR 3.301
38CFR 3.1(m)(n)
…service connection may be granted
only when a disability or cause of
death was incurred or aggravated in
line of duty, and not the result of the
veteran’s own willful misconduct…..
Direct Service Connection
Exclusions
Venereal disease (3.301(c1))
Alcohol use (3.301(c2)
Drug use (3.301(c3))
Direct Service Connection
EXAMPLES
Combat Wound
Injury
Disease
Chronicity & Continuity:
38CFR 3.303(b)
…chronic disease shown as such in
service (or presumptive period) so as
to permit a finding of service
connection, subsequent manifestations
of the same chronic disease at any
later date, however remote, are service
connected….
Direct Service Connection
Chronicity and Continuity
EXAMPLES
Bronchitis
Injury
Direct Service Connection
Post Traumatic Disorder (PTSD)
38CFR 3.304 (f) (three legs)
1.
Verification of in-service Stressor
2.
Diagnosis by Competent Medical Authority
3. Medical evidence of a link between
symptoms and verified stressor
Presumptive Service Connection
Theory of Presumption
Presumptive Service Connection
38CFR 3.307 (a), 3.309, 3.311, 3.317, 3.318
Chronic Disease
Tropical Disease
Former Prisoner of War
Herbicide Exposure
Radiation Exposure
Persian Gulf War – Undiagnosed illness
ALS
Presumptive Service Connection
Chronic Disease
38CFR 3.307 (a)(3), (c)
38CFR 3.309 (a)
EXAMPLE
Tumors, malignant
Hypertension
Organic diseases of nervous system
Psychoses
Presumptive Service Connection
Tropical Disease
38CFR 3.307 (a)(4)
38CFR 3.309 (b)
EXAMPLE
Malaria
Leishmaniasis
Former Prisoner of War
38CFR 3.304 (e)
Circumstances of the veteran’s
confinement together with medical
principles will be used in determining
whether disability manifest subsequent
to service is etiologically related to
POW experience.
Presumptive Service Connection
Former Prisoner of War
38CFR 3.307 (a)(5)
38CFR 3.309 (c)
EXAMPLE
Psychosis or Anxiety State
AHD, HHD, MI, CHF, CVA
Post-traumatic osteoarthritis
Presumptive Service Connection
Radiation Exposure
38CFR 3.309 (d), 3.311
Verified participation in an event or
verification of exposure (occupational)
Leukemia (other than CLL)
Lymphomas (other than Hodgkin’s)
Multiple Myeloma
List of Cancers
Presumptive Service Connection
Herbicide Exposure
38CFR 3.309 (e)
Service in Vietnam or other specific
locations or proof of exposure
Presumptive Service Connection
Persian Gulf War – Undiagnosed illness
38CFR 3.317
Signs or symptoms which may be
manifestations of undiagnosed illness or
medically unexplained chronic multisymptom illness during the Persian Gulf
War or to a degree of 10% or more not
later than December 31, 2011.
Presumptive Service Connection
ALS
38CFR 3.318
Service connection at any time after
service.
Secondary Service Connection
38CFR 3.310 (a), (c)
Disability which is proximately due to or
the result of a service connected disease or
injury shall be service connected.
Conditions, disabilities, deemed to be the
consequence of treatment for a service
connected disability.
Cardiovascular disease in a veteran with a
single AK amputation or with bilateral BK
amputations.
Service Connection by Aggravation
Pre-existing Condition
38CFR 3.306(a)
A preexisting injury or disease will be
considered to have been aggravated by active
service where there is an increase in disability
during such service unless there is a specific
finding that the increase in disability is due to
the natural progress of the disease.
Service Connection by Aggravation
Non SC condition
38CFR 3.306, 3.310 (b), 3.222
Any increase in severity of a non service
connected disease or injury that is proximately
due to or the result of a service connected
disease or injury and not due to natural
progress will be service connected.
Service Connection – Other Methods
Result of VA Medical Treatment
Result of VA Voc Rehab
Service Connection – Other Methods
VA Medical Treatment
38CFR 3.358, 3.800
Disability caused by hospital care or medical /
surgical treatment.
Disability caused by carelessness, negligence,
lack of proper skill, error in judgment.
Event not foreseeable.
Evaluations - Ratings
38CFR 4.1
The rating schedule is a guide in the
evaluation of disability resulting from
disease or injury as a result of military
service. The percentage ratings represent
the average impairment in earning capacity
in civil occupations.
Questions?
Quiz