inception in service. All pertinent or relevant medical and lay evidence must be considered, including the service records (which may show the places, types, and circumstances of service and the official history of the organization in which the Veteran served). For more information on References: principles relating to SC, see guidance on the current disability requirement, see M21-1, Part IV, Subpart ii, 2.B.1.b evaluating evidence, see M21-1, Part III, Subpart iv, 5 requesting evidence from the claimant, see M21-1, Part III, Subpart iii, 1.B.1, and the benefit of the doubt rule, see , and M21-1, Part III, Subpart iv, 5.1.k. b. Establishing Chronicity is a key concept for establishing direct SC. Department of Direct SC Veterans Affairs (VA) disability compensation is based on current chronic Based on (ongoing, lasting) disability. Direct SC requires that the current disability Chronicity must have begun during active duty service either by manifestation of the disease entity or by the occurrence of an injury or traumatic event during service resulting in the current, chronic, ongoing disability. To establish SC under based on the chronicity of a disease shown in service, the evidence must include manifestations sufficient to identify the disease entity onset of the condition and/or evidence of injury or trauma during active duty service, and evidence sufficient to establish chronicity from merely isolated findings or a diagnosis that includes the the evidence does not word “chronic,” so long as show a superseding post-service disability. When a chronic disease listed under is shown in service, consider all subsequent manifestations of the same chronic disease as service-connected (SC), unless they are clearly shown to be due to inter-current causes. Notes: A careful review of the evidence may reveal that chronic disability from a condition had its onset during active duty service and has chronically persisted from active service to the present, even when service medical providers did not conclude that there were residuals or continuation of a disease or injury. Application of the chronicity provisions of is limited to the chronic diseases listed under . For any disability not listed under SC must be established under by associating a current disability to service by a nexus consisting of
inception in service. All pertinent or relevant medical and lay evidence must be considered, including the service records (which may show the places, types, and circumstances of service and the official history of the organization in which the Veteran served). References: For more information on principles relating to SC, see guidance on the current disability requirement, see M21-1, Part IV, Subpart ii, 2.B.1.b evaluating evidence, see M21-1, Part III, Subpart iv, 5 requesting evidence from the claimant, see M21-1, Part III, Subpart iii, 1.B.1, and the benefit of the doubt rule, see , and M21-1, Part III, Subpart iv, 5.1.k. b. Establishing Direct SC Based on Chronicity Chronicity is a key concept for establishing direct SC. Department of Veterans Affairs (VA) disability compensation is based on current chronic (ongoing, lasting) disability. Direct SC requires that the current disability must have begun during active duty service either by manifestation of the disease entity or by the occurrence of an injury or traumatic event during service resulting in the current, chronic, ongoing disability. To establish SC under based on the chronicity of a disease shown in service, the evidence must include manifestations sufficient to identify the disease entity onset of the condition and/or evidence of injury or trauma during active duty service, and evidence sufficient to establish chronicity from merely isolated findings or a diagnosis that includes the word “chronic,” so long as the evidence does not show a superseding post-service disability. When a chronic disease listed under is shown in service, consider all subsequent manifestations of the same chronic disease as service-connected (SC), unless they are clearly shown to be due to inter-current causes. Notes: A careful review of the evidence may reveal that chronic disability from a condition had its onset during active duty service and has chronically persisted from active service to the present, even when service medical providers did not conclude that there were residuals or continuation of a disease or injury. Application of the chronicity provisions of is limited to the chronic diseases listed under . For any disability not listed under SC must be established under by associating a current disability to service by a nexus consisting of