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Evidence checklist

Chronic Otitis Media

DC 620038 CFR § 4.87Organs of Sense

Evidence strength

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

Target
Saved locally
01

Specialist opinion

Highest value0 of 2 collected
ENT evaluation documenting chronic otitis media and hearing lossCritical

Records from an ENT specialist documenting recurrent ear infections, effusion, perforation, cholesteatoma, or other OM complications.

Private provider · independent opinion
Nexus opinion linking chronic otitis media to serviceCritical

Medical opinion connecting chronic OM to in-service noise-induced Eustachian tube dysfunction, barotrauma (flight/diving), or recurrent in-service infections.

Private provider · independent opinion
02

Diagnostic tests and lab results

0 of 2 collected
Audiogram documenting conductive or mixed hearing lossCritical

Hearing test results showing the type and degree of hearing loss resulting from chronic otitis media.

Imaging or lab facility · records request
CT temporal bone (if cholesteatoma or surgery planned)

CT imaging documenting bony erosion or cholesteatoma when applicable.

Imaging or lab facility · records 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

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
Condition guideRating criteria and what VA looks forBuddy statement builderGuided VA Form 21-10210

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