The game is Digital Combat Simulator, DCS.
Thanks for the great debugging tip of sending visible output to notepad - worked.
Interestingly, the joystick combo works in the DCS game control setup page. Doesn't work in game.
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Further testing found that if a joystick button is setup as a modifier in DCS, the button will be blocked - why this was not working.
I could use two buttons in VA, one as a modifier, and it would work. Tried the same setup in DCS, and would work. Then tried again in VA, with one button still designated as a modifier in DCS, would not work. Removed the modifier designation - and again would work in VA.
Does VA have a means of getting around this problem?