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Fellow veterans — here’s the brutal truth: you win VA claims with medical evidence.
Not feelings.
Not assumptions.
Not just by telling your story.
The VA decides claims based on proof.
VA disability claims are under more scrutiny than ever, so if you don’t submit the right evidence for your type of claim, you could be setting yourself up for a denial.
At VA Claims Insider, we’ve literally helped thousands of veterans go from denied to approved, from 0% to 100%, and just about everything in between.
The difference-maker is almost always the quality and relevance of their evidence, specifically medical evidence.
In this definitive guide fron VA disability expert Brian Reese, you’ll learn:
- The five main types of VA disability claims
- The exact evidence needed for each type
- Real-world examples to connect the dots to your own case
- The Master VA Evidence Checklist covering every category
- Common mistakes that sink claims — and how to avoid them
Okay, let’s jump in!
Table of Contents
Summary of Key Points
- Service Alone Isn’t Enough: The VA will not award disability benefits simply because you served in the military. You must meet all legal criteria for service connection and provide proof for each element.
- Medical Evidence Wins Claims: The single most important factor in a successful VA claim is strong, credible medical evidence, including diagnoses, nexus statements, and treatment records.
- Lack of Evidence = Likely Denial: Without the right medical documentation, your claim is vulnerable to denial regardless of how valid your condition or story may be.
- Connect the Dots for Every Claim Type: Whether your claim is direct, secondary, presumptive, or based on aggravation, you must clearly link your current disability to service with complete and consistent evidence.
Step #1: Know Your VA Claim Type
You can’t gather the right evidence until you know which path you’re taking.
The VA recognizes five main routes to service connection:
- Primary Claim (Direct Service Connection)
- Secondary Claim (Secondary Service Connection)
- Presumptive Claim (Presumptive Service Connection)
- Aggravation Claim
- 38 U.S.C. § 1151 Claim (injuries caused by VA care)
Each path requires specific evidence.
Miss a single piece, and your claim could fail.
For a deeper breakdown, see Types of VA Disability Claims Explained.
#1. Primary Claim – Direct Service Connection
Definition: You’re claiming that your disability was directly caused or worsened by your military service.
Example 1: You tore your right shoulder during a Marine Corps training accident. Your Service Treatment Records (STRs) document the injury, and you have ongoing treatment for chronic shoulder pain and limited range of motion.
Example 2: You developed hearing loss from repeated weapons fire without hearing protection during deployment. Audiograms in your STRs show the change.
Required Evidence
- DD 214
- Current medical diagnosis (VA, STR, or private medical records)
- Proof of in-service event, injury, or illness (STRs, personnel records, deployment orders)
Recommended
- Nexus Letter from a qualified provider — essential if separated more than 12 months (Learn how to get a Nexus Letter)
Optional
- VA Form 21-4138 (Statement in Support of Claim)
- Buddy Letter from a fellow service member if documentation is limited (How to Write a Buddy Letter)
Pro Tip: The VA uses the Caluza Triangle: diagnosis + in-service event + nexus. Miss one leg, and your claim collapses.
Common Pitfall: Relying only on your STRs without updated medical evidence. The VA wants to see evidence of a current disability.
#2. Secondary Claim – Secondary Service Connection
Definition: You’re claiming that a new disability is caused or aggravated by a service-connected condition.
Example 1: You’re service-connected for PTSD and now have sleep apnea caused by PTSD-related weight gain and disrupted sleep patterns.
Example 2: You’re rated for knee arthritis, which has caused a limp and resulted in hip pain and degeneration.
Required Evidence
- DD 214
- Current diagnosis of the secondary condition
- Proof of a service-connected primary condition (VA.gov, Rating Decision letter)
- Nexus Letter linking the conditions
Optional
- Statement in Support of Claim
Read more in The SECRET Weapon to Proving Your Secondary VA Claim and check out 5 EASY Secondary VA Claims That Can Get Approved Fast.
Pro Tip: For secondary claims, the nexus letter must clearly state whether the secondary condition was proximately due to, caused, or aggravated by your primary service-connected condition.
Common Pitfall: Submitting evidence for the secondary condition without clearly establishing the link to the primary condition.
#3. Presumptive Claim – Presumptive Service Connection
Definition: The VA “presumes” your disability is service-connected because of specific service locations, dates, or exposures.
Example 1: You served in Vietnam and now have ischemic heart disease — a condition on the Agent Orange presumptive list.
Example 2: You served at Camp Lejeune between 1953–1987 and developed Parkinson’s due to contaminated water exposure.
Required Evidence
- DD 214 showing you served at a qualifying location during the specific period the VA recognizes for presumptive conditions.
- Diagnosis of a presumptive condition
Optional
- Statement in Support of Claim
- Buddy Letter if service location or exposure is not fully documented
See VA Presumptive Conditions by Location and Service for the full list of recognized exposures and conditions.
Pro Tip: Presumptive claims are often the fastest to approve if you meet both the location/date and medical diagnosis requirements.
Common Pitfall: Assuming all conditions are presumptive — only specific illnesses linked to specific service during the eligible period qualify.
#4. Aggravation Claim
Definition: A pre-existing condition worsened beyond its natural progression due to your service.
Example 1: You had mild scoliosis before enlistment. After years of ruck marching, your back pain and curvature worsened significantly.
Example 2: You had asthma before service. After burn pit exposure in Iraq, you now require daily inhalers and have frequent ER visits.
Required Evidence
- DD 214
- Diagnosis of the aggravated condition
- Nexus Letter showing worsening beyond natural progression
Optional
- Statement in Support of Claim
Learn more in VA Disability for Pre-Existing Conditions.
Pro Tip: You must provide evidence of your medical baseline before service and current severity after service.
Common Pitfall: Not documenting the change over time with medical records.
#5. 38 U.S.C. § 1151 Claim – Injury Caused by VA Care
Definition: You suffered a disability due to VA medical treatment, surgery, or rehabilitation.
Example 1: A surgical instrument was left inside you during VA surgery, causing infection and further complications.
Example 2: A medication error by VA staff caused permanent kidney damage.
These claims are complex and often require legal and medical expertise.
You’ll need surgical reports, expert opinions, and detailed medical evidence.
Consider working with an accredited VA representative.
Master VA Disability Claim Evidence Checklist
Regardless of your claim type, use this as your go-to list:
- Military Service Evidence: DD214, STRs, personnel records (deployments, MOS, awards)
- VA Medical Evidence: Complete VA medical records (How to Get Your VA Medical Records)
- Private Medical Evidence: Treatment records, DBQs, Nexus Letters/IMOs, Psychological IMOs, Rebuttal Letters, P&T request (DBQs Explained)
- Lay & Supporting Evidence: Buddy Statements, VA Form 21-4138, daily life impact statements
- Exposure Evidence: Burn pit registry entries, Agent Orange exposure records, radiation logs, contaminated water documentation
- Functional Impact: Vocational expert opinions (for TDIU)
See why regular medical treatment and documentation are critical for winning your VA claim.
Why VA Claims Fail — And How to Win
The VA doesn’t grant benefits just because you wore the uniform.
They grant benefits when you prove every legal element of your claim.
Medical evidence is the #1 factor in winning VA claims.
Without it, your claim isn’t just weak — it’s dead on arrival.
No matter if your claim is direct, secondary, presumptive, or for aggravation, you must connect every dot with clear, credible, and consistent evidence.
That’s how you win.
Conclusion & Wrap-Up
Veterans — you don’t just file a VA claim, you build a VA claim with the right evidence.
The VA will not connect the dots for you.
Your job is to give them a clear, documented case that meets the legal standard — with nothing left to guess.
We’ve seen thousands of veterans go from 0% to 70%, 30% to 100%, or from denied to approved and everything in-between — just by submitting the right evidence in the right order.
If you’re stuck, frustrated, or tired of fighting alone, my team and I have your six!
📞 Call Us Right Now: (737) 295-2226
YOU SERVED; YOU DESERVE!
Now it’s time to get the VA disability benefits you’ve earned for serving our country.
Fellow veterans, here’s the deal:
- Don’t ever settle.
- Don’t suffer in silence.
- And don’t go it alone!
At VA Claims Insider, we’re here to help you maximize your benefits and secure the compensation you rightfully deserve.
We’ve helped 25,000+ veterans increase their VA rating—YOU could be next!
Let’s get you the VA disability benefits you deserve.
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
