How to Establish VA Service Connection

Veterans can establish service connection by showing a link between a new or pre-existing condition and active duty.

By , J.D. · The Colleges of Law
Updated 2/21/2023

When a veteran files a claim for disability compensation with the VA for an illness or disability that resulted from military service, one of the first things a veteran must establish is that their current condition is related to an event that happened during military service. This is called "establishing service connection."

How to Establish a Service Connection

Here are the five methods of establishing service connection for a current disability, disease, or illness.

Direct Service Connection

While a direct service connection can be established in many ways, it generally means there is clear evidence of an incident that occurred while the veteran was in service and evidence of a link between the incident and the ongoing disability.

Veterans will need to provide medical evidence showing that their ongoing disability was caused or worsened by an event that happened on active duty in order to show a direct connection.

Presumed Service Connection

Certain conditions or diseases are "presumed" to be service-connected. For example, veterans exposed to Agent Orange during their military service and who now have Parkinson's disease are presumed to have a service connection. Veterans don't have to make a direct connection between their current medical condition and their military service -- the law presumes it.

Time can also play a part in a presumed service connection determination. If your symptoms appear within one year after discharge, the VA will conclude that they're related to your service. This is the case even if your symptoms were not present during serving.

The VA has a long list of conditions presumed to be related to active service, so long as they cause the veteran to be at least 10% disabled under the VA rating system. The list of conditions varies depending on the location of your service and whether you were a prisoner of war. Examples of conditions, illnesses, and diseases presumed to be service-connected include:

The complete list of conditions varies depending on the nature and location of your service and whether you were a prisoner of war (POW). Some POWs are presumed to have service connection for disorders related to captivity of 30 days or longer, such as malnutrition or dysentery. Veterans who served in tropical environments have a presumed service connection for illnesses like malaria or West Nile virus, while veterans exposed to nuclear radiation have a presumed service connection for many kinds of cancer.

You can find the full list of presumed service-connected disabilities at the website here. (Please note that you'll need a PDF viewer to read the document.)

Pre-Existing Injury Aggravated by Military Service

This type of service connection is available for veterans who had a condition before military service, and an event occurred in military service that made the pre-existing condition worse.

Typically, the pre-existing condition must be noted on the service member's initial medical exam, showing that the service member was not originally of sound health.

Secondary Service Connection

This type of service connection exists when one service-connected disability is the cause of another disability. The second disability doesn't need to be directly related to military service but wouldn't have occurred without the first disability (the one caused by military service).

A more current example is fibromyalgia. When chronic pain from fibromyalgia is service-connected, conditions such as anxiety and depression should be seriously considered for secondary service connection.

Service Connection due to Injury Caused by Treatment in the VA Health Care System

An injury is automatically treated as service-connected if a veteran is injured because of VA hospitalization, treatment, rehab, or therapy. A veteran who suffered complications from back surgery at a VA hospital due to the doctor's negligence, for example, would establish a service connection by this method.

These types of service connections are difficult to be approved by the VA, so thorough documentation of what went wrong during treatment in the VA Health Care System will be very important.

More Resources

For more information, see our article on filing for veterans disability benefits.

If you are unsure if your disability will be considered service-connected, you may want to talk to a veterans disability attorney.

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