Presumptive conditions are medical conditions that the VA assumes are service-connected. Because of this, veterans who are affected by these conditions don't need to provide proof of service connection. But what about their effective dates regarding VA disability benefits?
In case you missed it, we previously covered the basics of effective dates and also a few recent updates that the VA made regarding them. Today, we'll be going over Section 4 of the VA's M21-1, Part V, Subpart ii, Chapter 4, Section A - Effective Dates. This section details how the VA determines effective dates for presumptive conditions.
Here's some information specifically for veterans with presumptive service-connected (SC) conditions:
How the VA determines effective dates for presumptive SC conditions
The VA determines effective dates for presumptives in accordance with the 38 CFR 3.400(b)(2)(ii). For presumptive conditions, there are two different routes this can take.
The effective date will be exactly one day following a veteran's separation from service if all of these criteria from the M21-1 are met:
Claim is received within 1 year of separation from active duty, and
The requirements for SC are met during service, including evidence showing that the disability 1) became manifest, and 2) was incurred or aggravated during active service
There was continuous active service following the period of service on which the presumption is based.
The effective date will be the date entitlement arose (basically the date that all the boxes for qualification are checked) if these two criteria are met:
Claim is received within one year of separation from active duty, and
The requirements for SC are not met during service.Â
Two examples of how this works
The VA has some examples listed in the M21-1 about how effective dates for SC conditions are determined. We'll break them down a bit here:
Example 1: Hypertension
The veteran's time in service:Â June 21, 2012 to June 22, 2016
The date the claim was submitted: May 12th, 2017
Details:Â There was no evidence of treatment or diagnosis during service, but the veteran has private medical evidence to show the hypertension reached a compensable (worthy of compensation) level by March 19, 2017.
Result:Â The veteran's claim was filed within a year of release from active duty, but they did not have the requirements for SC during service. So, the effective date is March 19th, 2017, when the diagnosis happened.
Example 2: Type 2 Diabetes MellitusÂ
The veteran's time in service:Â After serving in Vietnam, the veteran was discharged March 3rd, 1972.
The date the claim was submitted:Â February 22, 2017
Details:Â The veteran submitted the claim for diabetes mellitus type 2 with an association to herbicide exposure in Vietnam. The veteran also had private treatment records that confirmed a diagnosis and usage of an oral hypoglycemic medication since 2015.
Result:Â The claim was received more than one year following discharge, and all entitling criteria (see the first section) were met on the date the claim was submitted. So, the effective date is the date the claim was received.
Why are effective dates for presumptive conditions important?
Understanding the effective dates for presumptive conditions is important because there are clear rules around them, and a lot of caveats. Unless you clearly understand the rules and how they apply to you, we don't recommend going down the rabbit hole. There are better things to focus your energy on than trying to fight the VA on effective dates. Very few are successful to fight for an adjustment of a presumptive effective date – so it's better to get the information right from the start.
Get the VA disability benefits you need to move forward
Building a solid VA disability benefits claim begins with the right documentation. That's where we come in. From Nexus Letters and DBQs to comprehensive chart reviews, we provide the support you need to strengthen your case. Schedule a chart review today and explore our full range of services. Don’t navigate the process alone; work with our experienced medical professionals to get the precise documentation required for your claim.
