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The VA's One-Year Rule for Chronic Conditions

7 min read

The VA's One-Year Rule for Chronic Conditions

How 38 CFR 3.307(a)(3) and 3.309(a) presume service connection for listed chronic diseases that appear to a degree of 10 percent within one year of discharge.

One of the oldest presumptions in the VA's regulations has nothing to do with a specific exposure. It applies to any veteran whose listed chronic disease shows up soon after leaving service.

What the rule says

38 CFR 3.307(a)(3) provides that a chronic disease listed in 38 CFR 3.309(a) that becomes manifest to a degree of 10 percent or more within one year of separation from qualifying service is presumed to have been incurred in service.

Some diseases in the regulation carry longer windows - tuberculosis and multiple sclerosis, for example, have their own periods stated in the text.

The chronic disease list

The list in 38 CFR 3.309(a) is long and includes conditions many veterans claim: arthritis, hypertension, diabetes mellitus, organic diseases of the nervous system, endocarditis, nephritis, psychoses, and several cancers among them.

The presumption only reaches the diseases actually named. A condition off that list follows the ordinary route in 38 CFR 3.303.

Where veterans start

Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:

  • Medical records review

    A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.

  • Nexus letter

    When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service.

Why the medical record matters here

This presumption depends entirely on documented timing and severity within that first year. Records from the year after discharge - private treatment, VA care, or a diagnosis date - are what make or break it.

When the timing cannot be documented, the claim falls back to direct service connection, where a medical opinion about the origin of the condition carries more weight. See our guides on how VA service connection works and when a presumptive claim still needs medical evidence.

This guide is educational. It summarizes the VA's own published rules and links to the exact sources it relies on. It is not legal or claims advice, and it is not a substitute for an accredited representative, who can advise you about your specific claim. Accredited help is free - search the VA's accreditation database to find a Veterans Service Organization, accredited agent, or attorney.

Frequently asked questions

What is the VA one-year presumption?

Under 38 CFR 3.307(a)(3), a chronic disease listed in 38 CFR 3.309(a) that becomes manifest to a degree of 10 percent or more within one year of separation is presumed to have been incurred in service.

Which conditions are on the chronic disease list?

38 CFR 3.309(a) lists dozens of chronic diseases, including arthritis, hypertension, diabetes mellitus, organic diseases of the nervous system, psychoses, and certain cancers.

What does manifest to a degree of 10 percent mean?

It means the condition was severe enough within that year to meet the 10 percent level under the rating schedule - not simply that symptoms existed.

Sources

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