TERA Flowchart

TERA Determination This flowchart details the process for determining when TERA is applicable to the claimed issue in disability compensation claims. An exam and opinion are not START Is there lay or other evidence of NO warranted for the claimed A substantially complete claim is received. the claimed disability? condition. YES YES Is the condition a result of physical trauma? Implementation SOP content titled Evaluating Competent Medical or Scientific NO Is the claimed disability being TERA exam and opinion are not warranted for the claimed disability. NO Is the condition a mental considered on a presumptive Is there credible evidence to overcome this exception? (See PACT Act YES disorder? basis? NO YES Review the claim for other avenues of service connection. Did the condition YES manifest during military YES Is the claim for a sign or symptom NO Follow guidance specific to the service? of a Gulf War undiagnosed illness or MUCMI under § 3.317(b)? presumptive condition. NO Is there evidence that Evidence for TERA Examination Exceptions.) NO YES Complete the TERA Memorandum. the condition is related Does the TERA Memorandum show to an etiology not participation in a TERA other than associated with TERA? Follow PACT Act Implementation herbicide exposure? (See the TERA Is the claim for a sign or symptom YES YES SOP section titled Presumptive Memorandum Job Aid of a Gulf War undiagnosed illness for instructions.) Service Connection of Undiagnosed NO or MUCMI under § 3.317(b)? Illnesses and MUCMIs for Persian YES Gulf Veterans. Is the claim based on herbicides, and Complete the TERA Memorandum. for a condition which has been Does the TERA Memorandum NO YES determined to have no positive indicate that the Veteran association with herbicide participated in a TERA? (See the exposure? (See the TERA Exception TERA Memorandum Job Aid for Job Aid for a list of exceptions.) instructions.) YES TERA exam and opinion are warranted for the claimed disability. NO Follow the TERA exam procedures in the PACT Act Implementation SOP. NO NO