What is a Service-Connected VA Disability? Here’s the 5 Types of VA Service Connection Explained.
Understanding what a service-connected VA disability is — and how to establish it — is essential for veterans seeking the benefits they deserve.
The VA offers disability compensation to veterans whose conditions are linked to their military service.
But getting these benefits hinges on one critical factor: establishing service connection.
In this post, I’ll guide you through the five main types of service connections, including their eligibility criteria and real-world examples for each one.
By the end, you’ll have a clear understanding of how these connections work and what it takes to establish them, empowering you to navigate the VA disability system with confidence.
#1. Direct Service Connection
This is the most straightforward form and most common type of VA service connection. A direct service connection is established when a veteran’s disability or condition is directly related to an injury, illness, or event that occurred during military service.
Eligibility Criteria:
- Current Diagnosis: The veteran must have a current diagnosis of the disability.
- In-Service Event: There must be evidence of an in-service event, injury, or illness.
- Nexus: A medical nexus must link the current disability to the in-service event.
- Symptoms: The veteran must have current symptoms in terms of frequency, severity, and duration.
Example: A veteran who sustained a knee injury during a training exercise and later develops chronic knee pain or arthritis directly related to that injury could establish a direct service connection.
Pro Tip: Always ensure your service treatment records (STRs) clearly document any in-service event, injury, or illness. If you didn’t seek medical attention at the time, obtaining buddy statements or personal statements detailing the event can be crucial. If you’ve been out of the military for more than 12 months or if your STRs aren’t clear that your condition existed during service, ensure you get a nexus letter from a healthcare provider that’s specific and directly links your current diagnosis to your in-service event.
#2. Presumptive Service Connection
Some conditions are presumed by the VA to be service-connected based on specific criteria, such as service in certain locations, exposure to certain hazards, or service during particular periods.
Eligibility Criteria:
- Service in a Qualifying Location or Timeframe: The veteran must have served in a location or period specified by the VA, such as Vietnam for Agent Orange exposure or the Middle East for PACT Act burn pit exposure.
- Qualifying Condition: The condition must be one that the VA presumes is related to the specific service or exposure.
Example: A Vietnam veteran who develops ischemic heart disease is presumed to have a service connection due to presumed exposure to Agent Orange.
Pro Tip: Keep track of any legislative changes, such as the PACT Act, which may add new conditions or locations to the presumptive service connection list. If you served in a qualifying location or during a specific period, consult the VA’s list of presumptive conditions regularly to ensure you’re not missing out on potential benefits. Always update your medical records and file claims promptly when new presumptive conditions are added if you’re eligble. Remember, all you need is a medical diagnosis of a condition on the VA’s presumptive list and your DD 214. You don’t need a nexus letter for presumptive conditions.
Source: 38 CFR § 3.309 — Disease subject to presumptive service connection
#3. Secondary Service Connection
This type of service connection is granted when a service-connected condition causes or aggravates another condition. The secondary condition is not directly related to service but is linked to the primary service-connected disability.
Eligibility Criteria:
- Primary Service-Connected Condition: The veteran must already have a service-connected disability.
- Secondary Condition: The secondary condition must be caused or aggravated by the primary service-connected condition.
Example: A veteran with service-connected diabetes develops peripheral neuropathy as a result of the diabetes. The peripheral neuropathy can be service-connected as secondary to diabetes.
Pro Tip: Monitor your health for any conditions that might be related to your primary service-connected disability. If you notice symptoms of a secondary condition, seek medical advice immediately and have your healthcare provider document the connection between the two conditions. You should get a nexus letter if you plan to file for secondary service connection. Ensure the letter clearly explains how the new disability is proximately due to or aggravated by the current service-connected primary disability.
#4. Service Connection by Aggravation
If a pre-existing condition worsens during military service beyond its natural progression, it can be considered service-connected by aggravation.
Eligibility Criteria:
- Pre-Existing Condition: The condition must have existed before the veteran entered service.
- Aggravation: There must be evidence that the condition worsened during service beyond its natural progression.
Example: A veteran with a pre-existing asthma condition that becomes significantly worse during military service could establish service connection by aggravation.
Pro Tip: If you had a pre-existing condition before service, make sure it is well-documented in your enlistment medical records. If the condition worsened during service, gather all relevant medical records, including any treatments or assessments during and after service, to demonstrate how the condition was aggravated. A clear, detailed account of how your condition worsened during service is essential for establishing a connection by aggravation. It’s helpful to get a nexus letter from a private healthcare provider to explain how your disability was aggravated by your service and not by the natural progression of the disability.
Source: 38 CFR § 3.306: Aggravation of pre-service disability
#5. Service Connection Based on 38 U.S.C. 1151
This type of service connection is granted for disabilities caused by VA healthcare, vocational rehabilitation, or compensated work therapy. It applies when a veteran’s condition is worsened or caused by VA treatment.
Eligibility Criteria:
- VA Care or Treatment: The disability or death must be caused by VA healthcare, rehabilitation, or vocational services.
- Additional Disability: The veteran must have an additional disability as a result of the VA’s actions.
Example: A veteran who suffers a surgical complication during a VA-provided surgery, leading to a new disability, may receive compensation under 38 U.S.C. 1151.
Pro Tip: If you believe a VA-provided treatment or procedure has caused or worsened a disability, request copies of all medical records related to the treatment and consult with a medical expert to assess your situation. Ensure that the medical expert can provide a nexus letter that explicitly details how the VA’s care led to your additional disability. Timely filing is crucial, so act quickly to gather evidence and submit your claim.
About the Author
Brian Reese is a leading VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Frustrated with the VA claim process, Brian founded VA Claims Insider to help disabled veterans win their VA disability compensation faster. He has served over 10 million military members and veterans since 2013. A former Air Force officer, Brian deployed to Afghanistan in 2011. He is a Distinguished Graduate from the U.S. Air Force Academy and holds an MBA from Oklahoma State University, where he was a National Honor Scholar.
