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Veterans Law

Continuity of Symptomatology: VA Service Connection

Alyse Phillips

November 21, 2019

Updated: June 20, 2024

veteran looking out window experiencing chronic continuity of symptomatology

What is VA Service Connection?

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

What is Continuity of Symptomatology?

VA outlines continuity of symptomatology in 38 CFR § 3.303(b).  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 you were in service, or since a short period of time after leaving the service, despite any intermittent periods of improvement.

Again, continuity of symptomatology is important when veterans have medical evidence of a current condition, but lack an in-service event.  Therefore, 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.

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 establish service connection based on continuity of symptomatology, you must demonstrate the following:

  • 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

Veterans can submit lay evidence detailing the onset and progression of their condition in order 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 often denies veterans’ claims for service connection due to continuity of symptomatology based on the following rationale:

  • 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

If VA denies your claim for any of the above-mentioned reasons, you have the right to appeal.  It is not uncommon for veterans to avoid seeking treatment for a number of reasons; however, a lack of treatment does not mean a lack of symptomatology.  Veterans should explain their reasoning to VA, or reach out to a veterans advocate to assist in the appeals process.

About the Author

Bio photo of Alyse Phillips

Alyse is a Supervising Attorney at Chisholm Chisholm & Kilpatrick. Since joining the firm in August of 2016, she has specialized in representing disabled veterans and their dependents before the United States Department of Veterans Affairs and the United States Court of Appeals for Veterans Claims.

See more about Alyse