Evidence Checklist: Myasthenia Gravis
DC 8025
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Anti-acetylcholine receptor (AChR) or anti-MuSK antibody testingCritical
Serological testing showing positive AChR binding, blocking, or modulating antibodies (positive in approximately 85% of generalized MG), or anti-MuSK antibodies in seronegative cases. Positive results confirm the autoimmune diagnosis.
Repetitive nerve stimulation test (RNST) or single-fiber EMG (SFEMG)Critical
Repetitive nerve stimulation showing decremental response at 3 Hz, or single-fiber EMG showing increased jitter — the most sensitive electrodiagnostic test for myasthenia gravis.
Nexus opinion linking myasthenia gravis to service (at least as likely as not)Critical
Medical opinion connecting MG to in-service stress, infection, medication, or toxic exposure that triggered autoimmune dysfunction during military service.
CT chest documenting thymic status (thymoma or thymic hyperplasia)
CT of the chest documenting thymoma or thymic enlargement, which is present in 10-15% of MG patients and is surgically significant.
Treating Physician
MGFA clinical classification and QMG score
Myasthenia Gravis Foundation of America (MGFA) clinical classification (Class I-V) and Quantitative MG (QMG) score documenting the distribution and severity of weakness.
Treatment Records
Treatment records (pyridostigmine, immunosuppression, IVIG, thymectomy)
Records of acetylcholinesterase inhibitor use, immunosuppressive therapy, IVIG/PLEX for crises, and thymectomy records.
Lay Statements & Personal Documentation
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.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Myasthenia GravisCritical
VA standardized form for MG capturing muscle weakness distribution, crisis history, and functional limitations for rating under DC 8025.
Service Records
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.