Evidence Checklist: Lateral Epicondylitis (Tennis Elbow)

Orthopedic or sports medicine evaluation with lateral epicondyle examinationCritical

Examination documenting tenderness at the lateral epicondyle/common extensor origin, positive Cozen's test, Mill's test, and grip strength measurement. Elbow range of motion in degrees should also be documented.

Nexus opinion linking lateral epicondylitis to service ("at least as likely as not")Critical

A medical opinion connecting your tennis elbow to repetitive military occupational duties (gripping tools, weapons maintenance, typing, heavy lifting) or a specific in-service elbow injury.

MRI or diagnostic ultrasound of lateral epicondyle

MRI showing common extensor tendon pathology (tendinosis, partial or complete tear) at the lateral epicondyle. Ultrasound can show tendon thickening, hypoechoic changes, or neovascularization.

Documentation of dominant vs. non-dominant arm

Medical records specifying which elbow is affected and which arm is dominant. The major extremity receives a higher rating.

Treatment records (physical therapy, bracing, corticosteroid or PRP injections, surgery)

Records documenting counterforce bracing, eccentric wrist extensor strengthening, corticosteroid injections, PRP injections, extracorporeal shock wave therapy, and any surgical release.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Elbow and Forearm ConditionsCritical

Standardized form capturing elbow range of motion, tendon findings, grip strength, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.