Evidence checklist

Tympanic Membrane Perforation

DC 621138 CFR § 4.87Organs of Sense

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target

Saved locally

Specialist opinion

Highest value

ENT evaluation documenting TM perforation size, location, and hearing impactCritical

Records from an ENT specialist documenting perforation size (as percentage of TM), anterior/posterior/marginal location, and associated hearing loss.

Private provider · independent opinion

Nexus opinion linking TM perforation to service (blast, barotrauma, head injury)Critical

Medical opinion connecting TM perforation to in-service blast overpressure, barotrauma (aviation/diving), or direct trauma to the ear.

Private provider · independent opinion

Diagnostic tests and lab results

Audiogram documenting conductive hearing lossCritical

Hearing test results showing the conductive hearing loss gap from the TM perforation.

Imaging or lab facility · records request

Lay statements

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 →

Service records

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 for C&P exam prepWhat the examiner will ask Buddy statement builderGuided VA Form 21-10210

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