Knee claims are won on documentation of function over time - a record showing the knee was injured or worked hard in service, records showing what it has done since, and an opinion connecting the two. Missing any of the three leaves the claim incomplete.
Service treatment records
Look for more than sick call entries: orthopedic and physical therapy consults, temporary and permanent profiles limiting running, jumping, or load bearing, line-of-duty determinations, and treatment for the athletic injuries and sprains that mark the beginning of a degenerative history. For airborne and dismounted units, operational records establishing cumulative exposure support theories that do not depend on a single documented injury.
The first year after separation
Degenerative arthritis that manifests to a compensable degree within one year of separation is presumptively service connected under 38 CFR 3.307 and 3.309(a). Urgent care visits, a first orthopedic appointment, early imaging, and physical therapy from that window are the records veterans most often have not gathered - and the ones with the highest payoff.
Lay evidence
Your own account is evidence. A personal statement describing flare-ups, giving-way episodes, and what the knee has cost you - written concretely, with dates and frequency - gives the examiner and rater the functional picture measurements miss. Statements from family members who witness the falls and the stairs you avoid corroborate it. Our personal statement guide covers how to structure one, and the records checklist covers the documents themselves.
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 knee 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 knee condition and your service or an already service-connected disability.
What imaging can and cannot do
Imaging establishes the diagnosis and sometimes the timeline, but it cannot establish cause and it never sets the rating. A claim built on films alone - without an opinion addressing the connection to service and without functional documentation - is incomplete on both ends.
The opinion
When the connection to service is the contested element, a reasoned medical opinion is the evidence that answers it. A useful opinion reviews the actual records, identifies the mechanism, addresses competing causes such as age, weight, and civilian occupation, and states a conclusion under the at-least-as-likely-as-not standard when the evidence supports one. Our nexus letter guide explains what such an opinion contains.
When records are thin
Many veterans cannot tell whether their file supports a knee claim at all - and that is a question worth answering before anything else. A physician-level review of the records you already have can identify which conditions the evidence may support and which pathways fit. Our medical records review does exactly that, for a flat fee that is refunded if nothing supportable is identified, and our nexus letter service provides the opinion itself when the records support one.
Frequently asked questions
What records matter most in a knee claim?
Service treatment records - sick call visits, orthopedic consults, physical therapy notes, temporary profiles limiting running or marching - plus the records from the first year after separation, where early arthritis often first appears.
I never went to sick call for my knee. Is there anything to find?
Often yes. Indirect evidence - profiles, line-of-duty paperwork, athletic injury treatment, airborne or ruck records establishing exposure - plus post-service continuity records and lay statements can carry a claim built under the theories that apply when records are silent.
Does an X-ray prove my knee claim?
An X-ray diagnoses; it does not connect. Imaging cannot establish that service caused the degeneration - that requires a medical opinion. And the rating itself follows function, not the film.
What should a nexus opinion for a knee claim address?
The mechanism - a specific injury or cumulative load-bearing exposure - the timeline, competing causes such as age, weight, and civilian occupation, and a conclusion under the at-least-as-likely-as-not standard, supported by review of the actual records.