Evidence Checklist: Secondary Adrenal Cortical Insufficiency

Endocrinology evaluation and steroid replacement recordsCritical

Records documenting hydrocortisone/fludrocortisone dosing, sick-day rules, and monitoring.

Nexus opinion linking adrenal insufficiency to serviceCritical

Medical opinion connecting adrenal insufficiency to service, including secondary causes such as prolonged steroid use for a SC condition, pituitary tumor from head trauma, or autoimmune disease acquired during service.

Adrenal crisis hospitalization records

Emergency records documenting adrenal crises and hospitalizations — supports higher severity rating.

Morning cortisol, ACTH stimulation test, ACTH level, aldosterone, reninCritical

Laboratory results distinguishing primary (low cortisol, high ACTH, low aldosterone) from secondary (low cortisol, low ACTH) adrenal insufficiency.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.