
[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38 CFR 3.304]
[Page 145-148]
TITLE 38 -- PENSIONS, BONUSES, AND VETERANS' RELIEF
CHAPTER I --
DEPARTMENT OF VETERANS AFFAIRS
PART 3 -- ADJUDICATION -- Table of Contents
Subpart A -- Pension, Compensation, and Dependency and Indemnity Compensation
Sec. 3.304 Direct service connection; wartime and peacetime.
(a) General. The basic considerations relating to service connection
are stated in Sec. 3.303. The criteria in this section apply only to
disabilities which may have resulted from service in a period of war or
service rendered on or after January 1, 1947.
(b) Presumption of soundness. The veteran will be considered to have
been in sound condition when examined, accepted and enrolled for
service, except as to defects, infirmities, or disorders noted at
entrance into service, or where clear and unmistakable (obvious or
manifest) evidence demonstrates that an injury or disease existed prior
thereto. Only such conditions as are recorded in examination reports are
to be considered as noted.
(Authority: 38 U.S.C. 1111)
(1) History of preservice existence of conditions recorded at the
time of examination does not constitute a notation of such conditions
but will be considered together with all other material evidence in
determinations as to inception. Determinations should not be based on
medical judgment alone as distinguished from accepted medical
principles, or on history alone without regard to clinical factors
pertinent to the basic character, origin and development of such injury
or disease. They should be based on thorough analysis of the evidentiary
showing and careful correlation of all material facts, with due regard
to accepted medical principles pertaining to the history,
manifestations, clinical course, and character of the particular injury
or disease or residuals thereof.
(2) History conforming to accepted medical principles should be
given due consideration, in conjunction with basic clinical data, and be
accorded probative value consistent with accepted medical and
evidentiary principles in relation to value consistent with accepted
medical evidence relating to incurrence, symptoms and course of the
injury or disease, including official and other records made prior to,
during or subsequent to service, together with all other lay and medical
evidence concerning the inception, development and manifestations of the
particular condition will be taken into full account.
(3) Signed statements of veterans relating to the origin, or
incurrence of any disease or injury made in service if against his or
her own interest is of no force and effect if other data do not
establish the fact. Other evidence will be considered as though such
statement were not of record.
(Authority: 10 U.S.C. 1219)
(c) Development. The development of evidence in connection with
claims for service connection will be accomplished when deemed necessary
but it should not be undertaken when evidence present is sufficient for
this determination. In initially rating disability of record at the time
of discharge, the records of the service department, including the
reports of examination at enlistment and the clinical records during
service, will ordinarily suffice. Rating of combat injuries or other
conditions which obviously had their inception in service may be
accomplished pending receipt of copy of the examination at enlistment
and all other service records.
(d) Combat. Satisfactory lay or other evidence that an injury or
disease was incurred or aggravated in combat will be accepted as
sufficient proof of service connection if the evidence is consistent
with the circumstances, conditions or hardships of such service even
though there is no official record of such incurrence or aggravation.
(Authority: 38 U.S.C. 1154(b))
(e) Prisoners of war. Where disability compensation is claimed by a
former prisoner of war, omission of history or findings from clinical
records made upon repatriation is not determinative of service
connection, particularly if evidence of comrades in support of the
incurrence of the disability during confinement is available. Special
attention will be given to any disability first reported after
discharge, especially if poorly defined and not obviously of
intercurrent origin. The circumstances attendant upon the individual
veteran's confinement and the duration thereof will be associated with
pertinent medical principles in determining
[[Page 234]]
whether disability manifested subsequent to service is etiologically
related to the prisoner of war experience.
(f) Post-traumatic stress disorder. Service connection for post-
traumatic stress disorder requires medical evidence diagnosing the
condition in accordance with Sec. 4.125(a) of this chapter; a link,
established by medical evidence, between current symptoms and an in-
service stressor; and credible supporting evidence that the claimed in-
service stressor occurred. Although service connection may be
established based on other in-service stressors, the following
provisions apply for specified in-service stressors as set forth below:
(1) If the evidence establishes that the veteran engaged in combat
with the enemy and the claimed stressor is related to that combat, in
the absence of clear and convincing evidence to the contrary, and
provided that the claimed stressor is consistent with the circumstances,
conditions, or hardships of the veteran's service, the veteran's lay
testimony alone may establish the occurrence of the claimed in-service
stressor.
(2) If the evidence establishes that the veteran was a prisoner-of-
war under the provisions of Sec. 3.1(y) of this part and the claimed
stressor is related to that prisoner-of-war experience, in the absence
of clear and convincing evidence to the contrary, and provided that the
claimed stressor is consistent with the circumstances, conditions, or
hardships of the veteran's service, the veteran's lay testimony alone
may establish the occurrence of the claimed in-service stressor.
(3) If a post-traumatic stress disorder claim is based on in-service
personal assault, evidence from sources other than the veteran's service
records may corroborate the veteran's account of the stressor incident.
Examples of such evidence include, but are not limited to: records from
law enforcement authorities, rape crisis centers, mental health
counseling centers, hospitals, or physicians; pregnancy tests or tests
for sexually transmitted diseases; and statements from family members,
roommates, fellow service members, or clergy. Evidence of behavior
changes following the claimed assault is one type of relevant evidence
that may be found in these sources. Examples of behavior changes that
may constitute credible evidence of the stressor include, but are not
limited to: a request for a transfer to another military duty
assignment; deterioration in work performance; substance abuse; episodes
of depression, panic attacks, or anxiety without an identifiable cause;
or unexplained economic or social behavior changes. VA will not deny a
post-traumatic stress disorder claim that is based on in-service
personal assault without first advising the claimant that evidence from
sources other than the veteran's service records or evidence of behavior
changes may constitute credible supporting evidence of the stressor and
allowing him or her the opportunity to furnish this type of evidence or
advise VA of potential sources of such evidence. VA may submit any
evidence that it receives to an appropriate medical or mental health
professional for an opinion as to whether it indicates that a personal
assault occurred.
(Authority: 38 U.S.C. 501(a), 1154)
[26 FR 1580, Feb. 24, 1961, as amended at 31 FR 4680, Mar. 19, 1966; 39
FR 34530, Sept. 26, 1974; 58 FR 29110, May 19, 1993; 64 FR 32808, June
18, 1999; 67 FR 10332, Mar. 7, 2002]
Editorial Note: For Federal Register citations affecting Sec. 3.1,
see the List of Sections Affected, which appears in the Finding Aids
section of the printed volume and on GPO Access.
PART I -- DEPT OF VA
CFR


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