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L3 compression fracture sustained in IED blast (Oct 2016), documented continuously across three commands with X-ray, CT, and MRI imaging all on file. Persistent pain rated 6/10 at separation physical. Treated with physical therapy, naproxen, and cyclobenzaprine throughout remainder of service. The clear in-service event, imaging corroboration, and unbroken continuity of care make this a direct service connection under 38 CFR §3.303. Rating will depend on range of motion measured at C&P exam.

Diagnosed with mild TBI following loss of consciousness at blast site. Neuropsychological evaluation at Camp Pendleton confirmed deficits in processing speed and working memory. Persistent headaches documented at 3–4 per week in follow-up notes through separation. No prior head injury documented at accession physical. Rating is determined by the most severe facet across 10 neurological domains evaluated at the C&P exam.

Accession audiogram was within normal limits; separation audiogram shows bilateral sensorineural threshold shift consistent with noise-induced hearing loss. MOS 0311 Infantry Rifleman involves continuous occupational noise exposure from weapons fire, explosives, and armored vehicles — a well-established qualifying exposure. Rating is determined by combining the pure tone threshold average with speech recognition score using VA Tables VI and VIA for each ear separately, then combined.

Tinnitus reported at post-deployment health reassessment following 2016 deployment and again at separation physical. MOS 0311 Infantry Rifleman involves continuous exposure to weapons fire, explosives, and heavy vehicle noise — a qualifying occupational noise exposure. Combined with the IED blast acoustic trauma, this is among the most consistently granted VA claims for combat infantry veterans. Tinnitus is assigned a single fixed rating of 10% as a standalone condition.

Referred to sleep clinic prior to separation with Epworth Sleepiness Scale score of 19/24 (severe). Witnessed apneic events documented by provider. Home sleep study ordered confirmed OSA requiring CPAP. If CPAP use is verified at C&P exam, VA assigns a fixed 50% rating — making this the single highest-value claim in this record. Can also be argued as secondary to TBI under 38 CFR §3.310.

Right knee pain onset documented in 2018 following sustained running and land navigation activities. MRI confirmed chondromalacia patella Grade II–III with lateral patellar tilt. Physical therapy notes document pain with stair climbing, kneeling, and prolonged standing. Rated under limitation of flexion criteria; actual C&P exam flexion measurement will determine final rating. Patellofemoral syndrome with documented functional limitation typically rates 10%.

PTSD diagnosis confirmed at post-deployment mental health evaluation following Helmand Province deployment. PCL-5 score of 52 at separation. Documented stressor: IED blast resulting in casualty of fellow Marines. Sleep disturbance, hypervigilance, avoidance behaviors, and intrusive thoughts documented across multiple clinical notes. Prescribed sertraline and referred to behavioral health. Rating under 38 CFR §4.130 is based on the level of occupational and social impairment demonstrated at C&P exam.

Radiating pain and paresthesias in the left lower extremity documented beginning in 2018, two years after the L3 fracture. MRI confirmed left-sided disc protrusion at L3–L4 with nerve root impingement. Provider notes document positive straight leg raise and diminished patellar reflex on left. Nexus to the service-connected lumbar fracture is established under secondary service connection (38 CFR §3.310). Rating depends on severity of nerve function loss demonstrated at C&P exam.