Evidence Checklist: Autonomic Neuropathy

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.

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.

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.

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).

Treatment records (fludrocortisone, midodrine, compression stockings)

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

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.

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.

Service treatment records (STRs)Critical

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