To file for Loss of Use or Amputation, we will need you to complete a statement describing how you believe this condition was caused by your time in the service and how it affects you to this day. How do you believe Loss of Use or Amputation was caused by your time in service? Please use the prompts below to best determine how you believe your Loss of Use or Amputation is service-connected, then fill out the appropriate statement form. If you believe your condition was caused by multiple factors below, please select the factor that outweighs the rest, and then be sure to mention all applicable service-connected reasoning within your statement.

Toxic Exposure - During the Vietnam War, the U.S. military used the herbicide Agent Orange to defoliate jungle areas. Veterans who were exposed to Agent Orange have reported an increased risk of various health conditions, including certain cancers and neurological disorders that may result in the loss of limb function. If you believe your Loss of Use or Amputation was caused by toxic exposure, please click this link to complete your statement. https://www.cognitoforms.com/OperationStandDownRI/presumptions

Direct & Chronicity - Military personnel often face dangerous and life-threatening situations on the battlefield. Explosions, gunfire, shrapnel, and other combat-related incidents can lead to severe injuries, including the loss of limbs. Exposure to extremely cold temperatures without adequate protection can cause frostbite; in severe cases, amputation may be necessary. If you believe your Loss of Use or Amputation was caused by a direct injury or chronicity, please click this link to complete your statement. https://www.cognitoforms.com/OperationStandDownRI/directchronicity

Secondary to other Service-Connected conditions - In some cases, a surgical procedure performed to address an injury sustained during military service may result in complications. These complications could lead to tissue damage, blood flow issues, or infections, which may require further medical intervention, including amputation. If you believe your Loss of Use or Amputation was caused by an already service-connected condition, please click this link to complete your statement. https://www.cognitoforms.com/OperationStandDownRI/secondaryserviceconnection