Wood & Smith Legal Services, LLC

Service Connection by Aggravation

Walking with a Cane

Service connection by aggravation is challenging, but not impossible, to establish.  If you are a veteran who had a medical condition before joining the military, and if that medical condition worsened due to an injury received while in active duty service, you may be able to show service connection by aggravation in order to receive VA disability compensation.  Two different presumptions should be evaluated when determining service connection by aggravation: presumption of soundness and presumption of aggravation.

Presumption of Soundness

The law presumes that members of the military are of “sound” (healthy) condition when entering service.  When a service member’s records upon entry into service do not indicate the member was already suffering from a medical condition, the burden falls on the VA to establish the existence of a pre-existing medical condition.  In order to do this, the VA must show that the service member’s condition was a) pre-existing, and b) not aggravated by military service.  This evidence must be shown by “clear and unmistakable evidence.”

Presumption of Aggravation

The presumption of aggravation standard is used to analyze whether or not a veteran’s condition was made worse because of military service.  The presumption of aggravation may work in the service member’s favor because this presumption requires the VA to show by “clear and unmistakable evidence” that the medical condition worsened because of natural progression rather than because of military service.  This is a very high standard, and it can be difficult for the VA to prove.

Both the presumption of soundness and the presumption of aggravation can be confusing concepts for all parties involved in a VA claim.  However, they are important to understand because they could make the difference in proving your VA claim.  Below is an example, taken from an actual court case, of how the VA examines claims of service connection by aggravation.

Real Life Example:

  • Veteran’s enlistment examination conducted in 1942 did not contain any notes about a disability, about a seizure disorder, or about any type of disability.
  • The enlistment examination specifically noted the veteran did not claim epilepsy as a condition at the time of entering military service.
  • A physical exam did not lead to a diagnosis of any nervous system disorders.
  • This veteran was entitled to the presumption of soundness because his military medical examination did not document or detect his condition, even though the veteran had suffered seizures on and off since age 13.

The full analysis of the case is available here.