It is important veterans understand what a “well-grounded claim” for disability compensation or other VA benefits means. Simply, it means you have provided needed evidence to successfully support your claim. If your claim is not well-grounded, it will be denied.
For a service-connected disability compensation claim, you must provide current medical evidence and diagnosis of a chronic disability and show how the disability is related to service or, that the claimed condition is a secondary or residual condition of a disability you are already service-connected for, or is a “presumptive” condition such as those related to exposure to Agent Orange in Vietnam. In most cases, service medical records will contain evidence that the claimed condition first arose and was diagnosed on active duty. You do not have to submit SMRs yourself, as VA will already have them or request them from the National Personnel Records Center.
Chronic conditions are disabilities one will always have, as opposed to injuries such as sprains or strains that are considered “acute and transitory” and have resolved with no on-going disability.
Veterans who file claims upon separation or retirement will have their claims decided based on evidence in their service medical records and results of VA compensation and pension examinations. Claims filed years after leaving active duty should include post-service medical evidence of continuing treatment and a current diagnosis of the claimed condition.
Reasons a claim is denied include no evidence of a current diagnosis, or, no evidence that the claimed condition began, was treated or was diagnosed during service.
An example of a claim that is not well-grounded: A veteran was seen once or twice on active duty for complaints of knee pain. The only treatment was Motrin and notes of a “sprain.” Ten years after retirement, the veteran is diagnosed with knee arthritis and files a claim, including evidence of the current diagnosis. This claim will be denied, because though the veteran now has a chronic knee disability, there is no evidence a mild sprain 10 years prior led to the arthritis and because any number of things could have happened to the knee since leaving service.
However, if a veteran files a claim for a painful knee during out-processing from active duty and the VA compensation and pension examiner notes the veteran has pain on motion or finds other abnormalities, the veteran is likely to be granted service-connection based on a diagnosis by the compensation and pension examiner.
In some cases, it is possible to get service-connection for conditions years later even though service medical records may not contain enough evidence. For example, if your doctor provides a medical opinion that links a current diagnosed disability to service with a sound rationale, such as the veteran’s numerous parachute jumps more likely than not led to his knee arthritis because of the known wear-and-tear jumping puts on the knee joints, the medical opinion provides the needed evidence and nexus between a chronic condition and military service.
Numerous factors may be involved in filing well-grounded claims, depending on the specifics of a particular case, so it’s best to consult with an experienced veterans service officer who can explain what may be needed in order for your claim to be successful.