**§3.304 Direct service connection; wartime and peacetime.**

\(a\) *General*. The basic considerations relating to service connection
are stated in §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 and was not
aggravated by such service. 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 whether disability
manifested subsequent to service is etiologically related to the
prisoner of war experience.

\(f\) *Posttraumatic stress disorder*. Service connection for
posttraumatic stress disorder requires medical evidence diagnosing the
condition in accordance with §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. The following provisions apply to claims
for service connection of posttraumatic stress disorder diagnosed during
service or based on specified in-service stressors:

\(1\) If the evidence establishes a diagnosis of posttraumatic stress
disorder during service and the claimed stressor is related to that
service, 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 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.

\(3\) If the evidence establishes that the veteran was a prisoner-of-war
under the provisions of §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.

\(4\) If a posttraumatic 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
posttraumatic 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)

\[26 FR 1580, Feb. 24, 1961, as amended at 31 FR 4680, Mar. 19, 1966; 39
FR 34530, Sept. 26, 1974; 58 FR 29110, May 19, 1993; 64 FR 32808, June
18, 1999; 67 FR 10332, Mar. 7, 2002; 70 FR 23029, May 4, 2005; 73 FR
64210, Oct. 29, 2008\]

**Supplement *Highlights* references**: 7(9), 38(5), 51(2), 66(1),
83(2).

Reserved