The Evidence a TDIU Claim Rests On

TDIU decisions turn on function. A file can be full of diagnoses and rating percentages and still leave the central question unanswered: what does this veteran's day actually look like, and can that day be repeated on an employer's schedule?

Medical records that describe function

The most useful clinical documentation goes beyond the diagnosis to the limitation. Treatment notes that record missed appointments due to symptoms, medication side effects, hospitalizations, and specific restrictions are worth more than a long problem list.

• Restrictions on sitting, standing, walking, lifting, and carrying
• Documented limits on concentration, memory, pace, or tolerance for interaction
• Frequency and duration of flare-ups or incapacitating episodes
• Treatment burden: appointment frequency, procedures, and recovery time
• Side effects of prescribed medication that affect alertness or reliability

Employment records

Employment evidence establishes the other half of the picture. Attendance and leave records, performance reviews that reference reliability, accommodation requests, separation letters, and earnings records all speak to whether work was competitive and whether it was sustainable.

Earnings records also matter for the marginal employment analysis described in our guide to substantially gainful versus marginal employment.

Lay statements

Statements from a spouse, adult child, former coworker, or former supervisor describe things the medical record rarely holds: the days that start and end early, the tasks quietly reassigned, the shifts covered by someone else. They should be specific and first-hand - what the writer personally observed, and when.

Our personal statement guidance covers how a veteran's own statement is best written.

Where an independent medical opinion fits

An independent opinion does not decide unemployability. What it can do is review the record as a whole and describe, in medical terms and with reasoning, the functional capacity that the service-connected conditions leave intact.

A useful opinion identifies the records reviewed, describes specific functional limits rather than conclusions, explains the medical basis for each limit, and addresses contrary evidence rather than ignoring it. Our guides to what a nexus letter is and to the role of medical evidence explain what separates a usable opinion from a form letter.

Before ordering anything

Not every record supports an opinion, and no honest provider can know before reading the file. A paid medical records review is the ordinary first step: a licensed physician reads the record and identifies what the evidence may support, and the fee is refunded in full if nothing supportable is identified.

Patriot NEXUS Letters does not file claims, provide legal advice, or handle appeals. Free accredited assistance with the claim itself is available through a VSO - see how to find a VSO. For the framework behind all of this, start with our TDIU overview.