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Evidence checklist

Sacroiliac Joint Dysfunction

DC 523638 CFR § 4.71aMusculoskeletal

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
Orthopedic evaluation with sacroiliac joint provocation testsCritical

Examination documenting positive SI joint provocation tests (FABER, FADIR, Gaenslen's, distraction/compression tests, thigh thrust), pain location (over SI joint/buttock), and spinal range of motion.

Private provider · independent opinion
Nexus opinion linking sacroiliac joint dysfunction to service ("at least as likely as not")Critical

A medical opinion connecting your SI joint dysfunction to military service, including load-carrying activities, parachute landings, vehicle accidents, or chronic postural stress.

Private provider · independent opinion
02

Treating physician

0 of 1 collected
SI joint diagnostic injection results

Documentation of a fluoroscopy- or ultrasound-guided SI joint injection with 75% or greater pain relief, confirming the SI joint as the pain generator.

Your treating provider · written request
03

Treatment records

0 of 2 collected
Imaging studies (X-ray, CT, or MRI of sacroiliac joints)

Radiographs or cross-sectional imaging showing SI joint sclerosis, erosions, or arthritic changes. MRI can show active sacroiliitis (edema/enhancement) or structural damage.

VA or private records · written request
Treatment records (physical therapy, SI belt, injections, ablation)

Records documenting sacroiliac belt use, stabilization physical therapy, corticosteroid injections, radiofrequency ablation, or SI joint fusion.

VA or private records · written request
04

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 →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Back (Thoracolumbar Spine) ConditionsCritical

Standardized form capturing lumbosacral range of motion, SI joint findings, and functional limitations. VA rates SI joint dysfunction under the spine schedule.

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
Condition guideRating criteria and what VA looks forC&P exam prepWhat the examiner will askBuddy statement builderGuided VA Form 21-10210

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