Evidence Checklist: Inguinal Hernia

Physical examination documenting hernia presence, reducibility, and symptomsCritical

Clinical examination documenting inguinal hernia location (direct vs. indirect), laterality (unilateral vs. bilateral), reducibility, and symptoms during Valsalva maneuver, coughing, or heavy lifting.

Nexus opinion linking inguinal hernia to service ("at least as likely as not")Critical

A medical opinion connecting the hernia to service-related heavy lifting, physical exertion during training, sudden increase in abdominal pressure, or in-service intraabdominal events.

Chronic post-herniorrhaphy pain documentation (if applicable)

Medical records documenting persistent inguinal pain, mesh-related pain, or nerve entrapment syndrome following hernia repair — chronic pain may support a higher rating than the hernia itself.

Ultrasound or CT of inguinal region confirming hernia

Ultrasound or CT documenting hernia sac, contents, defect size, and reducibility — particularly useful for occult or small hernias not clearly palpable on examination.

Surgical records for hernia repair (herniorrhaphy or mesh repair)

Operative reports documenting open or laparoscopic repair (Lichtenstein, TEP, TAPP), mesh type, bilateral repair, and post-operative complications including recurrence.

Documentation of impact on work and physical activity

Personal statement or employer documentation showing inability to perform heavy lifting, physical labor, or strenuous activity due to the hernia — relevant for employability and functional impairment ratings.

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.

Completed DBQ Hernia ConditionsCritical

Standardized form capturing hernia type and location, reducibility, repair history, and functional limitations from hernia or surgical residuals.

Service treatment records (STRs)Critical

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