C.F.R. » Title 38 » CHAPTER I—DEPARTMENT OF VETERANS AFFAIRS › PART 3—ADJUDICATION › Subpart A—Pension, Compensation, and Dependency and Indemnity Compensation

38 C.F.R. § 3.310

Disabilities that are proximately due to, or aggravated by, service-connected disease or injury

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

(a) General. Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.

(b) Aggravation of nonservice-connected disabilities. Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury. The rating activity will determine the baseline and current levels of severity under the Schedule for Rating Disabilities (38 CFR part 4) and determine the extent of aggravation by deducting the baseline level of severity, as well as any increase in severity due to the natural progress of the disease, from the current level.

(Authority: 38 U.S.C. 1110 and 1131)

(c) Cardiovascular disease. Ischemic heart disease or other cardiovascular disease developing in a veteran who has a service-connected amputation of one lower extremity at or above the knee or service-connected amputations of both lower extremities at or above the ankles, shall be held to be the proximate result of the service-connected amputation or amputations.

(d) Traumatic brain injury. (1) In a veteran who has a service-connected traumatic brain injury, the following shall be held to be the proximate result of the service-connected traumatic brain injury (TBI), in the absence of clear evidence to the contrary:

(i) Parkinsonism, including Parkinson's disease, following moderate or severe TBI;

(ii) Unprovoked seizures following moderate or severe TBI;

(iii) Dementias of the following types: presenile dementia of the Alzheimer type, frontotemporal dementia, and dementia with Lewy bodies, if manifest within 15 years following moderate or severe TBI;

(iv) Depression if manifest within 3 years of moderate or severe TBI, or within 12 months of mild TBI; or

(v) Diseases of hormone deficiency that result from hypothalamo-pituitary changes if manifest within 12 months of moderate or severe TBI.

(2) Neither the severity levels nor the time limits in paragraph (d)(1) of this section preclude a finding of service connection for conditions shown by evidence to be proximately due to service-connected TBI. If a claim does not meet the requirements of paragraph (d)(1) with respect to the time of manifestation or the severity of the TBI, or both, VA will develop and decide the claim under generally applicable principles of service connection without regard to paragraph (d)(1).

(3)(i) For purposes of this section VA will use the following table for determining the severity of a TBI:

MildModerateSevere
Normal structural imagingNormal or abnormal structural imagingNormal or abnormal structural imaging.
LOC = 0-30 minLOC > 30 min and < 24 hoursLOC > 24 hrs.
AOC = a moment up to 24 hrsAOC > 24 hours. Severity based on other criteria.
PTA = 0-1 dayPTA > 1 and < 7 daysPTA > 7 days.
GCS = 13-15GCS = 9-12GCS = 3-8.
Note:

The factors considered are:

Structural imaging of the brain.

LOC—Loss of consciousness.

AOC—Alteration of consciousness/mental state.

PTA—Post-traumatic amnesia.

GCS—Glasgow Coma Scale. (For purposes of injury stratification, the Glasgow Coma Scale is measured at or after 24 hours.)

(ii) The determination of the severity level under this paragraph is based on the TBI symptoms at the time of injury or shortly thereafter, rather than the current level of functioning. VA will not require that the TBI meet all the criteria listed under a certain severity level in order to classify the TBI at that severity level. If a TBI meets the criteria in more than one category of severity, then VA will rank the TBI at the highest level in which a criterion is met, except where the qualifying criterion is the same at both levels.

(Authority: 38 U.S.C. 501, 1110 and 1131) [44 FR 50340, Aug. 28, 1979, as amended at 66 FR 18198, Apr. 6, 2001; 71 FR 52747, Sept. 7, 2006; 78 FR 76208, Dec. 17, 2013]
Notes of Decisions
Cited in 667 cases (71 in the last 5 years), 1989–2025 · leading case: Benny R. Roper v. R. James Nicholson, 20 Vet. App. 173 (Vet. App. 2006).
Sort: Relevance Newest Treatment
Benny R. Roper v. R. James Nicholson, 20 Vet. App. 173 (Vet. App. 2006). · cites it 12× “On appeal, the Court must resolve the following two questions: (1) Whether the regulatory provision governing secondary service connection ( 38 C.F.R. § 3.310 (2005)), which provides in relevant *175 part that a secondarily service-connected condition “shall be considered a part…”
William F. Allen, Claimant-Appellant v. Anthony J. Principi, Sec'y of Vets. Affairs, 237 F.3d 1368 (Fed. Cir. 2001). · cites it 10× “The Board noted that under 38 C.F.R. § 3.310 (a), “[w]hen service connection is .”
Ellington v. Peake, 541 F.3d 1364 (Fed. Cir. 2008). · cites it 9× “” 38 C.F.R. § 3.310 (a). One month later, the RO assigned each disability a September 10,1998 effective date.”
Allen v. Brown, 7 Vet. App. 439 (Vet. App. 1995). · cites it 3× “With respect to the last of these holdings, the Court stated as follows: It may be that appellant’s initial arthritis in both his left and right knees is not service-connected and that it is only the increase in the amount of arthritis in appellant’s left knee which is secondary…”
Lawrence M. Tropf v. R. James Nicholson, 20 Vet. App. 317 (Vet. App. 2006). · cites it 2× “521, 522 (1996); 38 C.F.R. § 3.310 (a) (2006). The Secretary does not offer an example of a situation where a hyphenated rating code would be an appropriate vehicle merely adding information about how an injury is being rated instead of avoiding awarding two separate ratings…”
Daniel G. Ross v. James B. Peake, 21 Vet. App. 528 (Vet. App. 2008). · cites it 5× “Ross argues: (1) that the Board, when deciding the effective date, erred by not assigning him an earlier effective date based on the provisions of 38 C.F.R. § 3.310 (a) (2007); and (2) that the effective date for his award of secondary service connection should be the same as…”
Patrick D. MacPhee Claimant-Appellant v. R. James Nicholson, Sec'y of Vets. Affairs, 459 F.3d 1323 (Fed. Cir. 2006). · cites it 3× “MacPhee also appears to argue in this appeal that 38 C.F.R. § 3.310 4 (the regulation governing secondary conditions) together with 38 C.”
Dale S. Horn v. Eric K. Shinseki, 25 Vet. App. 231 (Vet. App. 2012). · cites it 2× “38 C.F.R. § 3.310 (2011). The comparison of the preservice baseline with the condition soon after service could be a reliable and straightforward method of proving lack of aggravation.”
Lawrence Delisio v. Eric K. Shinseki, 25 Vet. App. 45 (Vet. App. 2011). · cites it 2× “Underlying Causal Disabilities Leading to Secondary Service Connection Moreover, pursuant to 38 C.F.R. § 3.310 (allowing for secondary service connection of a "disability which is proximately due to or the result of a service-connected disease or injury"), the relationship…”
Libertine v. Brown, 9 Vet. App. 521 (Vet. App. 1996). · cites it 3× “Under 38 C.F.R. § 3.310 (a) (1995), secondary service connection shall be awarded when a disability “is proximately due to or the result of a service-connected disease or injury.”
Brown v. Gardner, 513 U.S. 115 (1994). “during other than a period of war,” is compensable) with 38 CFR § 3.310 (a) (1993) (“Disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.”
Thom as Ellington, Jr. v. R. Jam Es Nicholson, 22 Vet. App. 141 (Vet. App. 2007). · cites it 3× “The first of these authorizes an award of service connection for disabilities that are “proximately due to or the result of a service-connected disease or injury” and states that “[w]hen service connection is thus established for a secondary condition, the secondary condition…”
Show all 667 citing cases →
— 38 C.F.R. § 3.310(a) — 2 cases
180918-341 (Board of Vet. App. 2019).
190318-6372 (Board of Vet. App. 2019).
— 38 C.F.R. § 3.310(b) — 2 cases
Nehmer v. United States Vets.' Admin., 712 F. Supp. 1404 (N.D. Cal. 1989).
Hrvatin v. Principi, 3 Vet. App. 426 (Vet. App. 1992).
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.