Service-Connection
Topics:
Conditions Diagnosed While in the Military
Conditions Aggravated by Military Service
Conditions Caused by Service-Connected Conditions (“Secondary”)
Conditions Caused by Exposure
Conditions on the VA Presumptive List
Service-Connection After 8 Years of Active Duty Service (DoD ONLY)
Service-Connection for Reservists
Service-connection means that a veteran’s medical condition was directly caused by military service, whether it occurred on active duty, was aggravated by military service, was caused by conditions that are themselves service-connected, etc.
Both the VA and the DoD will only give Military Disability Ratings for conditions that are service-connected.
All exceptions to Service-Connection can be found on our Conditions That Are Not Ratable page, and can include genetic or hereditary conditions, or conditions that existed prior to service (EPTS).
For a condition to be considered service-connected, its connection to service MUST be clearly documented in an official record, like a medical record, while the service member is still in the military (except, of course, Conditions Caused by Service-Connected Conditions), or it will not be eligible to receive Military Disability.
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Conditions Diagnosed While in the Military
The goal of Military Disability is to compensate all veterans for any conditions that they incurred because of military service. The laws in place define these conditions as ones incurred in combat, on duty, and in training (including inactive duty training). This includes conditions that are incurred while traveling directly to and from service or while remaining overnight immediately before service.
For Active Duty members, this is expanded further to include every condition that is diagnosed during their time in the military, even if it occurs when off duty. So if Beth breaks her ankle during training, strains her back while playing basketball with her friends on the weekend, or is diagnosed with cancer, all while she is an active duty military member, each of these conditions will be considered service-connected.
The exceptions to this are all conditions on our Conditions That Are Not Ratable page.
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Conditions Aggravated by Military Service
Service-aggravation applies to conditions that were not initially caused by military service, but were significantly worsened directly by service or by another condition that is service-connected.
Conditions that existed prior to service (EPTS) are not considered service-connected since they happened when the service member had no connection to the military at all and thus are not the military’s fault. These can include anything from injuries to disease and congenital defects. If, however, an EPTS condition is worsened by military service, more than it should have worsened with just the passage of time, it is considered service-aggravated.
Similarly, genetic and hereditary conditions are conditions that will develop in a person’s life no matter what. Some develop before service and are thus considered EPTS. Others may develop later in life. If a genetic condition develops while a service member is in the military, then it is automatically considered service-aggravated unless it can be clearly proven that the condition would have developed at the same time and to the same degree whether or not the service member was in the military. If this can be proven, then it is not considered service-aggravated.
All EPTS, genetic, and hereditary conditions are considered fully service-connected if the service member is on active duty for 8 years or more (DoD only).
To determine if a condition was truly aggravated by military service, the seriousness and timing of the condition is compared to the medically-accepted normal progression of the condition. If the condition is clearly worse or occurred earlier than the norm, it is service-aggravated.
Example: If Juan has a genetic disease that usually starts manifesting at age 30, then it would only be considered service-aggravated if it manifested before age 30. So if his disease manifests at age 25, that’s earlier than the standard age, and so the condition is definitely considered service-aggravated.
Any condition not related to military service can also be considered service-aggravated if it is clearly made worse by a service-connected condition.
Example: Tina is a Reservist who injured her knee in the line of duty and developed service-connected knee instability. Later, she is in an accident while off-duty and breaks her ankle. Without the knee instability, the ankle would have been able to heal completely, however, every time her knee gives out, her ankle is re-injured and unable to properly heal. She eventually develops arthritis in her ankle caused by the combination of the knee instability and the ankle injury. Because it was unable to heal due to her service-connected condition, her ankle would be considered service-aggravated.
Rating Service-Aggravated Conditions
Service-aggravated conditions are not necessarily given the full rating and compensation that would usually be given to the same condition if it were not an EPTS or genetic condition. Instead, it will be compensated for how much it was changed by military service or by the service-connected condition.
For an EPTS condition, the Rating Authorities will review the medical records of the condition at the time the service member entered the military. They will then use the laws of the VASRD to decide what rating the condition would have received at that time if it had been rated. They will then look at the current condition and decide what rating it would be given as is. The first rating is then subtracted from the current rating to find a rating that reflects how much the EPTS condition worsened over the course of military service. This rating is then the official rating assigned for the EPTS condition.
For example, if when Carla first entered the military she could not lift her dominant arm above shoulder height (a condition that would rate 20%, and something that wouldn’t happen—they would never accept her in the military with such a severe EPTS condition—but just go with it), and currently she couldn’t lift it more than 25° from her side (a rating of 40%), then the final military disability rating for her arm would only be 20% (40% minus the original 20%).
For a genetic condition, the same principle is applied, but instead of using the severity of the condition at the time the service member entered the military, the severity that the condition would have been if it had progressed normally is used.
Adjusting the same example: If a genetic condition would normally cause a person at this point to not be able to raise their dominant arm above shoulder height (a 20% rating), but Carla actually can’t raise her arm more than 25° from her side (a 40% rating), then the final military disability rating for her genetic condition would be 20% (40% minus 20%).
EXCEPTIONS:
– This subtraction would not happen for either an EPTS or genetic condition, however, if the service member’s Total Combined Military Disability Rating is 100%, if it is not clear how severe the EPTS condition was upon entering the military, or if the genetic condition began early (there wouldn’t be a comparable severity). In these cases, they would just receive the full current rating.
– If there are two paired organs (two kidneys, two eyes, two ears, etc.), and one has an EPTS or genetic condition, and the other develops a regular condition while in the military, then both will be rated without subtracting the percentage. So if one eye has been blind since the age of ten, and the other loses sight while on active duty, then both eyes will receive full ratings.
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Conditions Caused by Service-Connected Conditions (“Secondary”)
Sometimes a service-connected condition can cause additional conditions to appear in the future. Any condition caused by a service-connected condition is considered service-connected by default.
Since the DoD only gives disability for conditions at the time the service member leaves the military, these secondary conditions will not really be an issue for DoD Disability.
The VA, however, rates conditions over time, so if a secondary condition develops later in life, the VA will consider it service-connected and will provide VA Disability Benefits for it. You can simply submit a new VA Disability Claim for that condition.
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Conditions Caused by Exposure
As a part of their military duties, service members are often exposed to chemicals, radiation, or other substances that can negatively affect their health over time. If a condition develops after a service member leaves the military that is known to be caused by a substance that they were exposed to while in the military, then that condition is service-connected.
The service member must, however, prove that they were indeed exposed to the substance. If exposure occurs, service members can get documents detailing exactly what they were exposed to, how much, and for how long.
If you are unable to get a document detailing your exposure, your condition will only be considered service-connected if it is on the VA Presumptive List, like conditions caused by exposure to Agent Orange or radiation, or if your MOS was one that is known to regularly deal with the substance you were exposed to.
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Conditions on the VA Presumptive List
Over time, the VA noticed trends in the medical conditions that veterans developed after serving in certain circumstances at certain times. Although there is no definitive medical proof that these conditions were caused by the circumstances of service, there was enough evidence to convince the VA that it was not coincidental.
Because of this, the VA compiled their VA Presumptive List. This list basically says that if a service member served in this place at this time and developed this condition, then it must have been caused by that service and is thus service-connected and eligible for VA Disability.
The VA Presumptive List includes exposure to Agent Orange for Vietnam and Korean vets, exposure to radiation, conditions in prisoners of war, conditions in Gulf War veterans, and more.
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Service-Connection After 8 Years of Active Duty Service (DoD ONLY)
EPTS and genetic conditions are normally not eligible for DoD Disability or VA Disability unless they are service-aggravated. If a service member served in the military on active duty for 8 years or more, however, then their EPTS or genetic conditions are automatically considered service-aggravated, and thus eligible for DoD disability, unless it can be proven otherwise.
It must, however, also make the service member Unfit for Duty since the DoD will only rate conditions that are unfitting.
Basically, if the service member served 8 years or more and the condition has worsened until it now makes them unfit, then the EPTS or genetic condition is considered service-aggravated and ratable. It’s a bit of a gift for giving so much of their life to the service.
While this rule does not directly apply to the VA, the VA usually considers EPTS conditions that have progressed enough to make a service member unfit as service-aggravated and so will usually rate these conditions as well.
This 8-year service-connection rule does not include the other conditions noted on our Conditions That Are Not Ratable page.
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Service-Connection for Reservists
For a condition to be service-connected for Reservists, it must have occurred directly in the line of duty. This means that it must have occurred while on active duty or during active duty training, and includes conditions that were service-aggravated by these activities.
This doesn’t include conditions that occurred while off duty or diseases that aren’t directly caused or aggravated by military service. For example, conditions that take months or years to develop, like diabetes, that simply could not have done so between the start of active duty and diagnosis would not qualify as service-connected.
The only conditions that can be considered service-connected that occurred during inactive duty training are injuries, heart attacks, and strokes.
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FAQs
What is Service-Connection?
Service-connection means that a veteran's medical condition was directly caused by their military service. Both the VA and the DoD only give disability benefits for service-connected conditions.
Do my conditions qualify for service-connection?
There are multiple ways for conditions to qualify for service-connection. The simplest way is to have clear proof of their diagnosis and treatment in your service treatment records. You can also show proof that they are aggravated by service, secondary to another service-connected condition, caused by exposure during active duty, or on the VA's Presumptive List.
Why does service-connection matter?
By law, the military disability system is set up to compensate veterans for any conditions that are the result of their military service. This is to ensure that our veterans are properly cared for in return for their service to our country. Proving service-connection is necessary, however, to avoid claims for conditions that had nothing at all to do with military service.
Why do I have to prove service-connection?
Both the VA and the DoD can only compensate veterans for conditions caused by their military service. Veterans are required to provide proof of service-connection in order to ensure that our taxpayer money is correctly going to help those with conditions resulting from their military service.
How do I prove service-connection?
To prove service-connection, submit all documentation you have that shows that your conditions meet the requirements for one of the categories of service-connection or one of the categories on the Presumptive List.
I am a Reservist. How do I prove service-connection?
Reservists have to show that the condition occurred not only during their military service, but also directly in the Line of Duty. This means that the condition occurred while on active duty or during active duty training.
Can conditions that existed prior to service be service-connected?
Conditions that existed prior to service (EPTS) can only be considered service-aggravated. They can still qualify for compensation, but you'll have to show that they developed faster because of military factors than they would have in a civilian occupation.
How do I prove service-connection from secondary conditions?
The VA will provide disability benefits for any condition caused by another service-connected condition, even if it develops years after discharge. To support a claim for a secondary condition, you need to provide evidence that the new condition is clearly the result of the service-connection condition. A NEXUS letter from you physician will greatly strengthen claims for secondary conditions.
