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Evidence checklist

Autonomic Neuropathy

DC 8599-852038 CFR § 4.124aNeurological

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 3 collected
Autonomic function testing (QSART, tilt-table, cardiovagal testing)Critical

Quantitative sudomotor axon reflex test (QSART), deep breathing cardiovagal test, Valsalva ratio, and head-up tilt-table test documenting the pattern and severity of autonomic failure.

Private provider · independent opinion
Neurologist evaluation documenting autonomic symptoms and domains affectedCritical

Evaluation documenting orthostatic hypotension, cardiac autonomic dysfunction, sudomotor dysfunction, gastrointestinal dysmotility, bladder dysfunction, or sexual dysfunction attributable to autonomic neuropathy.

Private provider · independent opinion
Nexus opinion linking autonomic neuropathy to service-connected conditionCritical

Medical opinion connecting autonomic neuropathy to service-connected diabetes mellitus, Guillain-Barre syndrome, or other causative service-connected condition.

Private provider · independent opinion
02

Treatment records

0 of 2 collected
Orthostatic blood pressure measurements

Serial lying-standing or tilt-table blood pressure readings documenting the degree of orthostatic hypotension (fall of 20 mmHg systolic or 10 mmHg diastolic on standing).

VA or private records · written request
Treatment records (fludrocortisone, midodrine, compression stockings)

Records of medications and supportive measures for autonomic dysfunction, documenting the refractory or controlled nature of symptoms.

VA or private records · written request
03

Lay statements

0 of 2 collected
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.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
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.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Peripheral Nerves ConditionsCritical

VA standardized form capturing the extent of autonomic dysfunction affecting multiple organ systems for rating under peripheral nerve diagnostic codes.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

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

NPRC / milConnect · SF-180

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