Establishing a Service Connection for VA Disability Claims

4 Ways to Establish Service Connection with Your VA Disability Claim

There are three basic requirements that a Veteran needs to meet to be entitled to disability compensation. They must have a medical diagnosis for a current disability, the injury must have occurred during their service, and there has to be a connection established between the service and the disability. That service connection is called a “nexus.”

In this blog we’re going to be discussing that third and final requirement of service connection or nexus. The most common reason that VA claims are denied for compensation is failure to prove a service connection between their disability and their service. The key to success with VA disability claims is proving that service connection or nexus. There are a few exceptions where we don’t have to prove service connection (called presumptive conditions), but in most cases you must prove it.

There are five different legal theories or methods that we use to show the VA that your disability is service connected.

1. Direct Service Connection
This is a direct or contributory link between your disability and something that happened during your military service. We call that a direct service connection.

2. Aggravation
Your current disability may have pre-existed your service, but was aggravated or made worse as a result of your military service. This is known as “aggravation.”

3. Presumptive
Your currently disability is a condition that did not manifest during your service, but was manifested after your service time. This is called a presumptive condition and we’ve discussed these in detail in other blogs.

4. Secondary Service Connection
Your currently disability is caused, aggravated, or worsened by your primary medical condition, which is connected to your military service. This is called a secondary service connection. For example, your right knee is inured during service. Because you favor your right knee, your left knee starts to suffer due to overuse. This would be a secondary service connection.

5. Caused by the VA Itself
We don’t discuss this last one much, but it is worth mentioning. In this case your current condition is a consequence of an injury caused by the VA itself. This is more like a medical malpractice claim.

Proving a Service Connection

The VA must consider whether you are entitled to disability compensation under each of those first four theories. They’re looking for reasonable proof that you have raised. This includes stressor statements, medical records, and more. But the most important consideration in presenting compensation claims is showing the link or service connection via medical evidence. That is the key.

It’s not necessarily the specific theory that you use, but what you have raised with the facts presented. The VA has a duty to assist you to meet the requirements by obtaining medical opinions on whether the service connection exists. But I’d rather not rely on the VA to help you. You can do it on your own or we can help you get the independent medical advice that you need to submit to the VA.

You might think that you’re saddled with a high standard of proof when submitting a disability compensation claim. But you’re not. You don’t have to prove that your disability is without a shadow of a doubt due to your service. But you do need to be aware of some specific buzzwords that can help your medical professionals bolster your claim.

We like to use the terminology that it’s “as least likely as not that your injury was caused by your service.” In other words, it’s more likely than not that your currently disability is a result of your service. You don’t need 99% proof, just “least likely as not.” So the burden of proof isn’t that high, but you do need the medical evidence. That’s why we like to work with your doctors when they’re completing the DBQ forms or writing opinion letters. We consult with them and tell them how to word their statements so they’re more likely to be accepted by the VA.

The Four Theories of Service Connection

Direct Service Connection

Now let’s dig back into those four theories that we use to show that your disability has a service connection. We’ll start with the direct service connection. In this case your disability occurred during your service. For example, you broke your leg or arm during service, went to the hospital, and there are medical records showing that. But the problem we face many times is that service members don’t always get medical attention for injuries occurring during their service.

I had one client who was in a Bradley fighting vehicle. He was blown out the turret after his gunner drug shells across the metal of the vehicle. He was unconscious for several minutes, regained consciousness, and had no visible physical injuries. He took the rest of the day off, but was good to return to training the following day. There are no medical records of this event, but he remembers it.

If you have medical evidence from the VA, that’s great. But if you don’t, you’ll need to get medical evidence from your independent doctors. We need that medical evidence to link your disability and establish that service connection. This is where those DBQ forms are especially handy. Don’t ever file a disability compensation claim without a DBQ.


Compensation can also be paid for disabilities caused by aggravation that occurred during the period of service. Maybe you had a pre-existing injury when you went into the service, and it worsened as a result of your service. The key issue here is whether the injury was noted on your service records. If you were examined and your condition was noted at the time of your entry into military service, a presumption of soundness will apply. That’s the easy route.

However, we have a tougher road if your injury was not noted at the time of your entrance into service. I had a client who had a chest issue when he was a child. He had surgery when he was younger and had a large scar on his chest. When he went into the military, they noted the scar on his chest and ran him through a series of test to make sure he was okay. They noted the scar, but rated him at a zero.

He was then shipped to the Middle East to serve and was exposed to burn pits. His chest condition was aggravated due to the smoke exposure around the burn pit. We were able to get him qualified for compensation showing that his condition worsened due to the burn pit exposure.

To take advantage of the presumption of aggravation, you need to have medical evidence documenting the increase in your disability. You may have that in your service treatment records, but you can also obtain it from private doctors. You need to prove that you were at a certain rating or condition prior to service, and that it is now worse after service. You can also use statements from spouses or other relatives who have observed you and noticed that your condition has worsened.

Presumptive Conditions

What happens if your injury surfaces many years after your service in the form of a cancer, respiratory illness, or some other disease? These illnesses or conditions arose because of your exposure to toxins during service. Those toxins could include contaminated water at Camp Lejeune, smoke from burn pits, agent orange, asbestos, etc.

If you served in any of the areas where toxic exposure has been well-documented, the law provides a presumption for your service connection. You don’t have to prove the service connection if you served in certain areas and have certain conditions as a result. But I always recommend presenting medical evidence to support your claim. Don’t rely completely on the presumption. Let’s give the VA all the information we can possibly provide.

Secondary Service Connection

Service connection can be established for almost any disability that is a result of another service-connected disability. This is called a secondary service connection. This is not the same as an increased rating claim. This is a totally separate claim for a separate, secondary condition. Basically, this is a disability that is related to another established service-connected injury or disability. Recall the knee example from above where your left knee starts hurting due to a service-connected injury of your right knee.

Many of these secondary service connections can be handled through the DBQ forms. When service connection is established for a secondary condition, the secondary condition is usually now considered part of the original condition. Secondary service connection can be established where it aggravates an existing condition, or contributes to the creation of a new disability.

The Secret Sauce to Service Connection

The secret sauce for all service connected disabilities is medical opinion from a private doctor, not a VA doctor. That’s where the DBQ comes into play. Don’t rely on the VA to do this for you. You will benefit immensely from getting your own private doctor to complete a DBQ to show the service connection. Your medical experts should provide you with an opinion as to whether it is probable that your disability was caused or aggravated by your service.

It’s even better if your physician can “beef up” the language and document that “it’s very likely your claimed disability was caused or aggravated by your service.” This kind of statement provides strong medical evidence to establish that service connection or nexus that you need. Get that and you’ll have a high chance of your compensation claim being approved.

Contact Us So We Can Help!

If you need assistance with VA disability compensation benefits or other VA benefits, complete this form or give us a call at (229) 226-8183. If you’d like to see this blog in video format, you can watch it below. Please be sure to SUBSCRIBE to our YouTube channel and click the bell notification button so that you’re notified each time we publish a new video.