Service Connection by Aggravation

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There are many different ways to get service connection for your disability from the VA.  While direct service connection is the more traditional route:  a veteran receives a disability while in service and the VA awards service connection.  There is also a secondary service connection, which provides compensation for conditions due to service-connected disabilities.  But what happens if the condition you want compensation for existed prior to your service?  The answer is service connection by aggravation.

38 U.S.C. § 1153 provides that “A preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service unless there is a specific finding that the increase in disability is due to the natural progress of the disease.”  A veteran claiming his or her disability was aggravated in service usually is granted service through the Presumption of Aggravation.

There are a few requirements to trigger the Presumption of Aggravation:


First, the condition must have existed prior to military service. 

This is usually shown through a veteran’s entrance examination that will make note of a specific disability. If a veteran’s disability is not noted on an entrance examination, the veteran is entitled to the Presumption of Soundness and does not have to prove aggravation unless the VA rebuts this presumption by clear and convincing evidence. Click to read more on the Presumption of Soundness.

Second, the disability must have worsened during service.

The burden of proof here is on the veteran to show—usually through medical records or expert opinions—that the condition worsened in service.  Documentation of treatment for a disability during service is one way to show worsening. Another way is to have a medical expert compare the veteran’s disability before service to its state just after service.

Third, the worsening of the disability must be above and beyond the natural progression of the disability.  

Certain disabilities naturally get worse over time.  The VA will only compensate veterans if the disability was worsened past the extent it would have worsened had there been no service at all.  Again, a medical expert is usually required to give his or her opinion on whether the worsening in the veteran’s condition was above and beyond the natural progression of the disability.

Finally, the worsening must be permanent. 

A temporary worsening in the veteran’s condition, only for it to improve back to the level it was before service is not compensable.  This can be shown through records of continued treatment of the condition, or by a medical expert’s opinion that the condition has remained permanently aggravated.

A few final thoughts on the Presumption of Aggravation—one, the condition must have been worsened during active duty service. Two, the veteran does not have to prove a specific in-service event aggravated the condition—it is only required to show that the disability worsened during service. And three, the worsening in the veteran’s condition does not have to be dramatic enough to warrant a higher rating under the VA’s disability rating schedule.

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