To understand the differences between the presumption of soundness and the presumption of aggravation it is important to first understand what each of these presumptions is separately.
The Presumption of Soundness: If a disability is not noted on a veteran’s induction exam, then he is presumed to be sound. If a disability is noted at induction, then the presumption of soundness does not apply and the burden is on the veteran to show that service aggravated the disability. If the presumption does apply, the VA has the burden to prove that the disability pre- existed service was not aggravated by service. The VA must prove this with clear and unmistakable evidence, which is a very high standard. If the VA is able to over the presumption of soundness, the veteran will want to rely on the presumption of aggravation to get their disability service connected.
Presumption of aggravation: If a disability is noted on the veteran’s entrance exam and that disability increases in severity during service, then the veteran is entitled to this presumption. For the presumption of aggravation to apply, there must be evidence of an increase in severity of the disability, but there is no requirement that the aggravation be permanent. In order for the VA to rebut this presumption, they must show that the increase in disability was due to the natural progress of the disease. The VA must show this through clear and unmistakable evidence.
The first difference between these presumptions is whether or not the veteran’s disability is noted at the entrance into service. The presumption of aggravation arises when the disability IS noted at the veteran’s entrance exam. On the other hand, the presumption of soundness arises only if the disability is NOT noted at the veteran’s entrance exam. The second difference between the presumption of aggravation and the presumption of soundness is that the presumption of aggravation requires an additional requirement in order to arise that the presumption of soundness does not require. In addition to the requirement that the veteran’s disability be noted at the entrance exam, the presumption of aggravation requires the disability to have increased in severity during the veteran’s service before the presumption will apply.