Service connection is the relationship of a particular disabling condition to the veteran’s service. This is accomplished by showing that the condition began during service (incurrence), or that a pre-existing condition was made permanently worse than it would have otherwise been, or by the application of certain statutory presumptions. The following paragraphs details the four ways to accomplish service connection for a disabling condition(s).

Direct: The injury or disease was incurred in, or began during, a qualifying period of service and was not due to misconduct. In order for a condition to be considered under “Direct”, the veteran must show there is a current condition and an incident or treatment in-service for that condition or symptoms related to that condition. It is not required that the condition be shown in the service records, only that the evidence taken as a whole shows the condition must have begun during service, or was the result of service or some incident thereof. Examples of direct connection would be losing a leg in combat or developing cancer while you are on active duty.

Aggravation: The injury or disease existed prior to military service is now worse because of participation in service. A veteran is presumed to be in sound condition at the time of entry into service except for conditions noted on the entrance examination. In order to be considered for “Aggravation”, the veteran must provide medical evidence that the condition has progressed beyond its normal course due to participation in active duty service. An example of aggravation connection would be a veteran who entered the military with a correctable vision problem but due to exposures while on active duty, his vision became permanently worse.

Secondary: A disease or injury that is directly attributed to a condition for which the veteran is already service connected. In order for a condition to be listed a “Secondary”, there must be medical evidence linking the secondary condition to the primary service connected condition in a cause an effect nature. An example of a secondary connection would be a veteran who was receiving service connected disability compensation for a permanent knee injury sustained while on active duty. After leaving the military, because of his knee injury, he had a permanent limp which eventually resulted in a hip defect. The hip issue is then compensable as a secondary result of the knee problem.

Presumptive: Certain chronic and tropical diseases will be presumed to have begun during service if they manifest to a compensable degree within a specified time (generally, one year). In addition, specified diseases are presumed to be the result of certain incidents of service (prisoner of war, participation in radiation-risk activities, herbicide exposure) if they become compensable at any time after service. Other presumptive periods are set out for undiagnosed illnesses associated with service in the Persian Gulf area, and for certain other diseases associated with herbicide exposure (Agent Orange). These presumptions are intended to be a liberalizing feature, to allow service connection when the evidence would not otherwise support it. Only diseases specifically listed in the Code of Federal Regulations, and no others, are subject to presumptions of service connection.

There is no minimum length of service required to establish direct service connection by incurrence or aggravation. Presumptive service connection for a chronic or tropical disease requires that the veteran have at least 90 consecutive days of active service during a wartime period or after January 31, 1946.

This is just a brief summary of the ways to qualify for a service connected injury or disease. Please contact me should you have questions regarding this subject. I am here to assist all veterans and their families to see they receive the benefits they have earned.