Evidence Checklist: Ventral Hernia (Incisional)

Physical examination documenting hernia type, size, and reducibilityCritical

Clinical examination documenting ventral hernia classification (umbilical, epigastric, incisional), defect dimensions, reducibility, and symptoms including pain with activity, Valsalva, or palpation.

CT abdomen documenting hernia defect, contents, and defect sizeCritical

CT scan of the abdomen documenting the hernia defect dimensions, herniated contents (omentum, bowel), and any complications (incarceration, bowel dilation) — standard pre-operative assessment.

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

A medical opinion connecting the ventral hernia to in-service abdominal surgery incision (incisional hernia), abdominal trauma, prolonged heavy lifting during service, or service-connected wound.

Surgical records from prior abdominal surgery and hernia repair

Operative reports from original abdominal surgery (creating the incisional hernia) and any hernia repair procedures, including mesh type, technique, recurrence history, and complications.

Hernia recurrence documentation

Records documenting recurrence after prior repair, size progression on imaging, and escalating symptoms — recurrent or large hernias support higher ratings.

Symptom documentation (pain, limitation of activity, bowel complications)

Medical records documenting pain pattern, activity restrictions from hernia discomfort, episodes of incarceration or strangulation, and impact on daily function.

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.

Completed DBQ Hernia ConditionsCritical

Standardized form capturing ventral hernia type, defect size, reducibility, repair history, recurrence, and functional limitations.

Service treatment records (STRs)Critical

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