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Evidence checklist

Menstrual Irregularities

DC 761538 CFR § 4.116Gynecological/Breast

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
Gynecology evaluation documenting menstrual problemsCritical

Records from a gynecologist showing your diagnosis (heavy periods, painful periods, absent periods, or irregular cycles), test results, and treatment plan.

Private provider · independent opinion
Nexus opinion linking menstrual irregularities to serviceCritical

A medical opinion stating it is "at least as likely as not" that your menstrual problems started during or were caused by military service, stress, physical demands, or a service-connected condition.

Private provider · independent opinion
02

Treatment records

0 of 1 collected
Treatment records showing ongoing management

Records showing what treatments you have tried (hormones, birth control, iron supplements, surgery) and how well they worked.

VA or private records · written request
03

Diagnostic tests and lab results

0 of 2 collected
Hormone panel and blood work resultsCritical

Lab results showing hormone levels (FSH, LH, estrogen, progesterone, thyroid), complete blood count for anemia, and any other relevant blood work.

Imaging or lab facility · records request
Pelvic ultrasound or imaging

Ultrasound or other imaging to rule out structural causes like fibroids, polyps, or ovarian abnormalities.

Imaging or lab facility · records request
04

Lay statements

0 of 3 collected
Menstrual diary or cycle tracking records

A record of your menstrual cycles showing irregular patterns, heavy flow days, pain severity, and days missed from work or activities.

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 →
05

Benefits questionnaire

0 of 1 collected
DBQ — Gynecological Conditions

Disability Benefits Questionnaire completed by your doctor documenting your symptoms, treatment, and how the condition affects your daily life.

Provider-completed · VA DBQ formHow to get this →
06

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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