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Evidence checklist

Epilepsy — Petit Mal (Absence)

DC 891138 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
EEG showing 3-Hz spike-and-wave or other petit mal patternCritical

An EEG documenting the characteristic 3-Hz spike-and-wave discharges of absence epilepsy or other petit mal patterns. This is the primary objective diagnostic evidence.

Private provider · independent opinion
Nexus opinion linking petit mal epilepsy to serviceCritical

A medical opinion connecting your absence epilepsy to an in-service head injury, TBI, or other service event.

Private provider · independent opinion
Neurologist evaluation confirming absence epilepsy diagnosisCritical

Neurologist evaluation confirming the diagnosis, documenting seizure semiology, and assessing functional impact.

Private provider · independent opinion
02

Treatment records

0 of 1 collected
Anti-epileptic drug records and treatment response

Prescription records for AEDs (ethosuximide, valproate) and documentation of treatment response or breakthrough seizures.

VA or private records · written request
03

Lay statements

0 of 3 collected
Seizure diary documenting absence or petit mal episode frequencyCritical

A log recording frequency and duration of absence episodes. VA rates petit mal under DC 8911 based on seizure frequency. Because petit mal episodes are brief and frequent, detailed daily logging is essential.

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

VA standardized form capturing seizure type, frequency, and functional impact for rating under DC 8911 (petit mal epilepsy).

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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