Educational example · Fictional scenario
Musculoskeletal
A fictional veteran has an MRI of the lumbar spine and a sick-call note from a fall in service. No one has measured how far the back moves.
Evidence present
- MRI report
- In-service sick-call note for a fall
Evidence missing
- Measured range of motion
- Clinician notes on spasm or neurologic findings
- A description of time lost from work
Educational discussion
Imaging can support a diagnosis. Public spine criteria also talk about motion and function. The MRI does not answer those questions. Nothing here estimates a rating or says the fall caused the current MRI findings.
Educational example · Fictional scenario
Hearing and tinnitus
A fictional veteran was a crew chief, has a private audiogram that mentions tinnitus, and does not have the in-service hearing-conservation printouts.
Evidence present
- Private audiogram noting tinnitus
- A written description of flight-line work
Evidence missing
- In-service or separation audiogram
- A VA-protocol hearing test if hearing loss is also at issue
- A clinician opinion if onset was years after service
Educational discussion
Tinnitus and hearing loss are different public topics. A note that tinnitus is present does not measure hearing loss. Flight-line duty can be relevant exposure. It is not, by itself, a decision.
Educational example · Fictional scenario
Mental health
A fictional veteran has a current diagnosis of major depression from a VA clinician and no description in the packet of how work or relationships are affected.
Evidence present
- Current diagnosis from a qualified clinician
Evidence missing
- Notes on occupational and social function
- Any documented link to service
- Treatment notes, if the veteran chooses to include them
Educational discussion
A diagnosis and a service connection are separate facts. Public mental-health language looks at function, not at a list of symptoms alone. This example does not diagnose and does not suggest how to describe symptoms.
Educational example · Fictional scenario
Burn pit exposure
A fictional veteran served in a country that appears on VA's public airborne-hazard list, has a sinusitis diagnosis, and has not put the deployment orders with the medical note.
Evidence present
- A sinusitis diagnosis
- The veteran's own account of the country and years
Evidence missing
- Orders, a DD-214 entry, or other proof of location and dates
- Treatment records for the sinusitis
Educational discussion
The PACT Act and VA's public pages name places and conditions. They do not decide an individual file. A registry note, if one existed, would show participation, not a grant. This example does not say the sinusitis is service-connected.
Educational example · Fictional scenario
Gulf War
A fictional veteran served in Southwest Asia, has years of fatigue and joint pain, and has not had a clinician write up a workup.
Evidence present
- Service in Southwest Asia shown on a DD-214
- A personal log of fatigue and joint pain
Evidence missing
- A clinician workup
- A medical description of which symptoms are diagnosed and which are not
- Records of how long the symptoms have lasted
Educational discussion
Public Gulf War rules include undiagnosed illness. That label is a medical and adjudicative conclusion after evaluation. A symptom log is a start. It is not a diagnosis of a Gulf War illness.
Educational example · Fictional scenario
Agent Orange
A fictional veteran has a private diagnosis of type 2 diabetes and believes service was in a place VA lists for herbicide exposure. The DD-214 in the folder does not show that location.
Evidence present
- Private diagnosis of type 2 diabetes
Evidence missing
- Service location and dates that match a public herbicide location
- Unit, ship, or base records if the location is not on the DD-214
Educational discussion
A condition on a public list is not exposure and not a grant. Location still has to be shown. This example does not say the diabetes is related to herbicides.
Educational example · Fictional scenario
MST awareness
A fictional veteran has a current mental-health diagnosis and has not decided whether to speak with a VA MST coordinator. No narrative of the event is part of this example.
Evidence present
- A current diagnosis from a qualified clinician
Evidence missing
- Whatever records the veteran later chooses to share with a person they trust
- Contact with a VA MST coordinator, if the veteran wants that
Educational discussion
VA's public guidance says markers are not limited to a police report. This website does not collect the story and does not tell anyone how to write it. If this topic is unsafe, stop and call or text 988, then press 1.
Educational example · Fictional scenario
Secondary conditions
A fictional veteran is already service-connected for a knee and later developed back pain. The folder has the knee decision and no clinician opinion about the back.
Evidence present
- A decision that the knee is service-connected
- A later complaint of back pain
Evidence missing
- A diagnosis of a back condition
- A clinician opinion on whether the knee caused or aggravated the back
- Dates that show sequence
Educational discussion
A secondary theory needs the primary service-connected condition, a current diagnosis, and a medical link. An article about knees and backs is not an opinion about this person. This example does not find that the knee caused the back pain.
Educational example · Fictional scenario
GERD as secondary
A fictional veteran is already service-connected for PTSD and later developed GERD. The folder has the PTSD decision and a private diagnosis of GERD, but no clinician opinion about the link.
Evidence present
- Service-connected PTSD decision
- Private diagnosis of GERD
Evidence missing
- Clinician opinion on whether PTSD caused or aggravated the GERD
- Treatment records for the GERD
- Dates showing sequence
Educational discussion
A secondary theory needs the primary service-connected condition, a current diagnosis, and a medical opinion. This example does not say PTSD caused the GERD.
