What Counts as Sufficient Medical Evidence

VA must have sufficient medical evidence to make an informed decision on your claim. Sufficient evidence means the record contains enough information for a rating official to evaluate your condition and assign an appropriate rating percentage. This typically includes a current diagnosis, medical evidence linking the condition to your service, and findings that describe the current severity of the condition in terms that match the rating criteria. If the evidence is insufficient, VA must take steps to develop additional evidence before denying the claim. This might mean ordering a C&P exam, requesting additional medical records, or asking you to provide more information. VA cannot simply deny a claim because the evidence is incomplete without first fulfilling its duty to assist you. Evidence can come from many sources including VA medical records, private treatment records, C&P exam reports, private medical opinions, buddy statements from people who witnessed your condition, and your own statements. All evidence must be considered, and VA must explain why it found certain evidence more persuasive than other evidence. If you believe your claim was denied based on insufficient evidence, check whether VA fulfilled its duty to assist before challenging the decision on the merits.

Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).