What evidence should I submit with a supplemental claim to get a denied condition service-connected?

A successful service connection claim generally requires three things: a current diagnosis of the condition, evidence of an in-service event, injury, illness, or aggravation, and a medical nexus opinion linking the current diagnosis to that in-service event. When a claim is denied for lack of service connection, it is almost always because one of these three elements was missing or not well documented, and a supplemental claim under 38 CFR 3.156(a) requires submitting new and relevant evidence that addresses that specific gap.

For a shoulder claim, strong evidence typically includes service treatment records showing any shoulder complaint, injury, or treatment during service, even if minor at the time. If no in-service record exists, lay statements (including your own) and buddy statements from fellow service members who witnessed the injury or heard you complain about it can help establish the in-service event. Post-service treatment records showing a continuous or recurring history of shoulder problems since discharge are also valuable, since gaps in treatment are often used to argue against connection.

The most important piece of new evidence is usually a nexus letter from a treating physician or independent medical examiner. This letter should state, to at least the "at least as likely as not" (50 percent or greater) standard, that the current shoulder condition is related to the documented in-service event. A letter that simply confirms a diagnosis without addressing causation generally will not move the needle. If the VA scheduled a Compensation and Pension exam previously, reviewing that report can reveal exactly what the examiner found insufficient, which helps target the new evidence.

For the anxiety, migraines, and foot conditions, the same framework applies: document in-service onset or aggravation, keep a record of ongoing symptoms, and obtain supporting opinions once you have current diagnoses from your primary care provider.

Board of Veterans' Appeals decisions measured by VetAid (vetaid.ai/bva/outcomes) show that among reopening claims involving new and material evidence, roughly 29 percent were granted, 38 percent denied, and 31 percent remanded for further development; broader service connection issues at the Board were granted about 19 percent of the time, denied 30 percent, and remanded 46 percent. These figures reflect only cases that were already appealed to the Board, not initial claims, and are not predictive of how any individual supplemental claim will be decided.

The concrete next step is to file VA Form 20-0995 (Supplemental Claim) along with the new and relevant evidence described above, ideally including a detailed nexus opinion, rather than resubmitting the same record that led to the original denial.