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The DMA Compensation and Pension Clinicians' Guide (Section 1.9.a, Types of Service Connection) states that "In deeming a condition as being presumptive, the Secretary of VA alleviates the Veteran of the burden of proof demonstrating that a condition arose from service." This is known as presumptive service connection, and the specific condition allowed is called a presumptive condition.

Common examples are the presumptive diagnoses associated with Agent Orange exposure such as ischemic heart disease and diabetes mellitus type 2. The chemical compound known as Agent Orange was used in different places, including in the Republic of Vietnam (RVN). Once it is established, for example, that a Veteran was in the RVN and develops one of the identified conditions, he or she will be presumed to have developed the condition as a result of Agent Orange exposure. It is important to note that other risk factors are not considered, as it is presumed that the exposure was the cause.

While Veterans who served in RVN have only to demonstrate they were there, other presumptions such as those for Camp Lejeune contaminated water claims have specific components that must be met such as minimum exposure duration.

It is the responsibility of VBA officials to verify that conditions have been met for presumptive service connection as it applies to a claim, so unless it is otherwise specified, a medical opinion from the examiner is not warranted because causality has been presumed.

Presumptive service connection is explained in more detail in the DMA Medical Opinions course.