Strip away the forms and the jargon, and a VA disability claim stands on three evidence elements. The VA lists them on its evidence needed page, and nearly every denial traces back to one of the three.
The three elements
Per the VA, supporting a service-connected disability claim takes evidence of:
- A current diagnosed disability - a condition a qualified clinician has actually diagnosed, documented in medical records
- An in-service event, injury, or illness - something in service that could have caused or aggravated the condition, shown in service records, personnel records, or credible statements
- A link between the two - medical evidence connecting the current diagnosis to the in-service element
The third element is where claims fail
Diagnosis is usually documented. The in-service event is often documented too. The link - the nexus - is the element most often missing, because it requires a medical professional to review the evidence and state an opinion. Our guide on where medical evidence fits explains how the VA evaluates those opinions, and the step-by-step claim process shows where this evidence enters the claim.
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.
What the VA will help you get
Under 38 CFR 3.159, the VA has a duty to assist. It will make reasonable efforts to obtain relevant records you adequately identify, and it must try harder for federal records - service treatment records, VA medical center records, Social Security records - than for private ones.
The duty to assist is real but bounded. The VA is not required to obtain private medical opinions on your behalf, and it is not required to keep trying endlessly for records that do not exist.
What you are responsible for
Private treatment records, private medical opinions, and lay statements generally come from you. So does the one thing no regulation can supply: making sure the evidence in the file actually addresses all three elements before the rater reads it. When a claim is denied over a missing element, the Supplemental Claim process exists to add it.
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 are the three things a VA claim needs?
A current diagnosed disability, an event, injury, or illness that happened during service, and a medical link between the two. The VA lists these elements on its evidence page. A claim missing any one of them is typically denied.
What is the VA's duty to assist?
Under 38 CFR 3.159, the VA must make reasonable efforts to help you get relevant records you adequately identify - including federal records like service treatment records and VA medical records. Private records and opinions are generally your responsibility to obtain and submit.
What is a nexus in a VA claim?
Nexus is the medical link between your current condition and your service. It is usually established by a medical opinion. When a claim is denied for lack of nexus, an independent medical opinion such as a nexus letter is the evidence that speaks directly to that element.