M21-1 and 38 CFR changes, week of Apr 27, 2026

Added

• pre-service aggravation claims
• May 1, 2026
• However, there is no presumption of credibility for the purpose of determining whether Element 1 has been satisfied.
• This element relates most clearly and directly to direct SC claims based on in-service incurrence.
• However, in-service findings and diagnoses are important to other claim types, specifically aggravation of a pre-service condition and presumptive SC.
• When direct SC has been claimed but evidence shows that the claimed disability clearly and unmistakably existed prior to service, follow the procedures in
• pre-service disability is warranted.
• The Veteran claims SC for a right shoulder injury and asserts that the condition originated from loading heavy cargo onto an airplane during an exercise in Korea in June 2009.

and 36 more added passages

Removed

• preservice aggravation claims
• August 13, 2025
• However, there is no presumption of credibility for the purposes of determining whether Element 1 has been satisfied.
• This element relates most clearly and directly to direct SC claims based on incurrence.
• However, in-service findings and diagnoses are important to other claim types, specifically aggravation of a preservice condition and presumptive SC.
• When direct SC has been claimed but evidence shows that the claimed disability clearly and unmistakably existed prior to service, follow the procedures at
• preservice disability is warranted.
• Veteran claims SC for a right shoulder injury and asserts that the condition originated from loading heavy cargo onto an airplane during an exercise in Korea in June 2009.

and 42 more removed passages

Added

• establishing a baseline to show an NSC disability was aggravated by an SC disability
• developing for evidence of baseline disability in NSC aggravation claims
• handling NSC aggravation claims when a baseline cannot be established
• assigning an evaluation for an NSC disability that was aggravated by an SC disability
• aggravation with a 0-percent evaluation
• May 1, 2026
• disabilities that are the result of, or would not have occurred but for, a service-connected (SC) disability, or
• aggravation of a non-service-connected (NSC) disability that is the result of an SC disability, including

and 121 more added passages

Removed

• medical evidence required to show an NSC disability was aggravated by an SC disability
• developing for medical evidence of baseline in NSC aggravation claims
• determining the extent to which an NSC disability was aggravated by an SC disability
• aggravation with a zero percent evaluation
• August 6, 2019
• disabilities that are proximately due to, or the result of, a service-connected (SC) condition, or
• the increase in severity of a non-service-connected (NSC) disability that is attributable to aggravation by an SC disability, and not to the natural progression of the NSC disability.

and 48 more removed passages

Added

• is one that is not explicitly identified by the claimant on one of the forms listed in
• When an individual expressly claims a specific disability and is later diagnosed with a different but potentially related condition, if a sympathetic reading of the claim shows that the diagnosed condition is encompassed by the claim, VA must address the claim as including the diagnosed condition, as discussed in
• Decreased sound tolerance (hyperacusis) reasonably falls within the the scope of the claim for an audiological condition manifested by hearing deficits and ear pain.
• , 557 F.3d 1355 (Fed.
• identifying and developing reasonably raised IU claims, see
• The Veteran is granted a 100-percent SC evaluation for amyotrophic lateral sclerosis (ALS) and complications.
• VA examination shows that the Veteran requires assistance with activities of daily living.

and 60 more added passages

Removed

• is one that is not explicitly identified by the claimant on a one of the forms listed in
• When an individual expressly claims a specific disability and is later diagnosed with a different but potentially-related condition, if a sympathetic reading of the claim shows that the diagnosed condition is encompassed by the claim, VA must address the claim as including the diagnosed condition, as discussed in
• Decreased sound tolerance (hyperacusis) reasonably falls within the claim for an audiological condition manifested by hearing deficits and ear pain.
• , 557 F.3d 1355 (Fed.Cir.
• identifying and developing for reasonably raised IU claims, see
• The Veteran is granted a 100-percent evaluation for amyotrophic lateral sclerosis (ALS) and complications.
• VA examination shows that the Veteran requires daily assistance with activities of daily living.
• The rating activity addresses the issues of aid and attendance (A&A), Dependents' Educational Assistance (DEA), specially adapted housing (SAH), and automobile allowance and adaptive equipment in the rating decision.

and 46 more removed passages

Added

• Disability Associated With Functional Impairment of Earning Capacity
• This topic contains information on the general principles for review of diagnoses in claims for disability compensation, including
• In a determination of service connection (SC), the evidence must show that a disability exists as is described in
• In other situations, there are no statutory or regulatory criteria for diagnosis of a given disability.
• M21-1, Part V, Subpart ii, 1.A
• When specific medical diagnostic criteria exist for a disability, a treating physician may utilize a subthreshold diagnosis for the purpose of treating the symptoms when not all symptoms required for the diagnosis are present.
• Elective procedures, such as vasectomy, cosmetic breast reduction, or kidney donation, are not congruent with the disability requirement for the purpose of SC for a disease or injury incurred coincident with a Veteran’s active service.
• Disability Associated With Functional Impairment of Earning Capacity

and 52 more added passages

Removed

• Diagnoses Associated With Functional Impairment of Earning Capacity
• This topic includes information on the general principles for review of diagnoses in claims for disability compensation, including
• In a determination of service connection (SC) , the evidence must show that a disability exists as is described in
• In other situations, there is no statutory or regulatory prescription for a given disability.
• M21-1, Part V, Subpart i, 1.A
• When specific diagnostic criteria exist for a disability, a treating physician may utilize a subthreshold diagnosis for the purpose of treating the symptoms when not all symptoms required for the diagnosis are present.
• Elective procedures, such as vasectomy, cosmetic breast reduction, or kidney donation, are not congruent with the provisions required for the purpose of SC of a disease or injury incurred coincident with a Veteran’s active service.
• Diagnoses Associated With Functional Impairment of Earning Capacity

and 42 more removed passages