Continuity of Symptomatology: VA Service Connection

CCK Law: Our Vital Role in Veterans Law

When veterans seek VA disability benefits, one concept that often comes up is “continuity of symptomatology.” This term refers to the ongoing presence of symptoms from the time of service through the present day. Understanding how VA evaluates it, and when it applies, can make a major difference in proving service connection for chronic conditions.

This article will explain:

• What continuity of symptomatology means
• How to prove it
• Why VA sometimes denies claims based on it
• And more

What Is VA Service Connection?

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To qualify for VA disability compensation, VA must determine that your condition was caused or aggravated by your military service. This is called “service connection.” There are many different ways veterans can demonstrate service connection, including, but not limited to, the following: direct, secondary, presumptive, and aggravation.

To establish service connection on a direct basis, veterans must show evidence of:

• A current, diagnosed condition;
• An in-service event, injury, or illness; and
• A medical nexus between the current diagnosed condition and the in-service event.

However, there are situations in which veterans do not have a specific in-service event, but instead experience the development of a condition over time. Under these circumstances, a veteran may be able to show continuity of symptomatology to establish service connection.

What Is Continuity of Symptomatology?

Continuity of symptomatology means showing that the same symptoms you experienced during or soon after service have continued to the present day. VA outlines continuity of symptomatology in 38 CFR § 3.303(b). VA uses this rule to help veterans prove service connection for certain chronic conditions even when there is no record of a specific in-service diagnosis.

Continuity of symptomatology plays an important role in VA claims because it allows veterans to demonstrate a consistent pattern of symptoms even if they were not formally diagnosed while in service. Veterans do not need an actual diagnosis of the condition during service. Instead, they only need to experience symptoms of the condition either from the time they were in service or shortly after discharge. It is important when veterans have medical evidence of a current condition but lack an in-service event.

Generally speaking, veterans may qualify for service connection based on continuity of symptomatology if symptoms of a chronic condition have recurred regularly, without some intervening cause, since the time they left the military. Importantly, the symptoms must be present since the time they were in service, or since a short period of time after leaving service, despite any intermittent periods of improvement.

For example, you experience back pain during service, and continue to experience it following discharge. After several years of experiencing back pain, you are diagnosed with degenerative disc disease. Here, service connection based on continuity of symptomatology may be warranted.

How To Prove Continuity of Symptomatology

To prove continuity of symptomatology, VA looks for four key elements:

• Your disability is a chronic condition listed under 38 CFR § 3.309(a)
• Symptoms of the current disability were “noted” while you were in the military, or shortly after discharge
• These same symptoms have continued since separation from service
• A medical nexus (i.e., link) between the post-service symptoms and your current condition

In short, veterans must show a chronic condition, symptoms that began during or soon after service, and medical evidence that connects those symptoms to their current diagnosis.

Veterans can submit lay evidence detailing the onset and progression of their condition to support the continuity of symptomatology. Lay evidence can also include statements from your friends and/or family who have also witnessed the presence of your symptoms and how they have worsened over time.

As mentioned above, it is also crucial for veterans to submit medical evidence linking their symptoms to their current condition. A medical opinion can be obtained from either a VA healthcare professional or a private physician.

Common Reasons VA Denies Claims Based on Continuity of Symptomatology

VA may deny a claim based on continuity of symptomatology if it finds the veteran’s symptoms were not continuous or well-documented.

• Your symptoms were not continuous because you did not mention them during your separation (i.e., exit) examination
• Your symptoms were not continuous because you never mentioned them during other medical appointments
• Your symptoms were not continuous because you did not continuously seek formal medical treatment

In other words, VA often mistakes gaps in medical treatment for gaps in symptoms — something veterans can challenge on appeal.

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