Understanding aggravation is one of the trickiest parts of filing VA disability claims. Many veterans run into confusion about what qualifies as an aggravated condition, how the VA determines whether something truly worsened during service, and how the rating for that aggravation is calculated. This guide breaks down everything in clear language, using real-world scenarios and practical advice based on common claim patterns.
Service-Connected Aggravation can feel complicated, but when you understand what it means, what evidence matters, and how the VA evaluates these claims, the process becomes far more manageable.
Table of Contents
What Aggravation Means in the VA Disability System
To qualify for VA disability benefits, a veteran must show a current disability that is connected to service. Most conditions fall into one of two categories:
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They began during service, or
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They are directly caused by service-related activities or exposures.
Aggravation is different. It applies when:
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A condition existed before service,
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It got worse because of service, and
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That worsening went beyond the natural progression of the condition.
The VA will not compensate for the entire disability, only the amount that worsened due to service. In other words, veterans receive the difference between the pre-service baseline level of the disability and the severity after service.
This is why baseline evidence matters so much.
When the VA Considers a Condition Pre-Existing
For the VA to classify something as pre-existing, it must be clearly documented. This means it must be:
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Recorded on the entrance exam, or
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Otherwise proven to have unmistakably existed before service.
Suspicion isn’t enough. If something wasn’t noted during the entrance exam, the VA usually must assume the veteran entered service in sound condition. Many veterans mistakenly accept a VA determination that an issue pre-existed when it actually wasn’t documented.
Understanding this point protects veterans from one of the most frequent VA errors.
A Common Aggravation Example: Flat Feet
One of the most common aggravation scenarios involves flat feet.
Many service members enter duty with flat feet that are asymptomatic. They don’t experience pain, swelling, or functional problems. Once they begin training, ruck marching, or working long hours in military boots with poor arch support, symptoms can appear or worsen significantly.
For example:
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Before service: Flat feet with no pain → typically a 0 percent rating.
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During/after service:
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Foot pain
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Collapsed arches
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Plantar fasciitis
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Swelling
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Difficulty standing or walking for long periods
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Depending on severity, ratings may increase to 10 percent, 30 percent, or higher.
If the condition was painless before service and becomes painful during service, that worsening usually qualifies as aggravation.
What If Symptoms Get Worse After Service Instead of During?
If a condition worsens only after service, it generally does not qualify as aggravated by service.
However, there are exceptions. Sometimes symptoms begin during service but the veteran never sought treatment. In these cases, the veteran must show:
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The symptoms actually started during service, or
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Pre-service symptoms clearly worsened while serving, even without medical documentation.
Evidence becomes key. Veterans often strengthen these cases with:
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Lay statements
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Buddy statements
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Letters from family describing observable symptoms
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Descriptions of over-the-counter self-treatment
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Statements describing reluctance to seek medical care during service (common in many units)
Although harder to prove, these claims can absolutely succeed with proper supporting evidence.
Do Veterans Need a Private Medical Opinion?
While the VA claims that no one needs a private medical opinion, in aggravation cases it can make a substantial difference.
Aggravation claims are complex because they require:
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Establishing a baseline severity before service
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Showing the exact degree of worsening during service
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Distinguishing natural progression from service-related worsening
A private medical expert can:
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Analyze the medical history
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Explain what the normal progression of the condition would look like
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Offer a professional opinion on why service likely aggravated the disability
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Help establish a baseline when no pre-service treatment records exist
C&P examiners can also give positive opinions, but getting a thorough independent review often strengthens the claim.
Useful Evidence When No Treatment Was Received in Service
Many veterans avoid medical treatment because they don’t want to appear weak, burden their unit, or jeopardize career progression. The VA recognizes this happens, but evidence is still necessary.
Useful supporting documentation includes:
Buddy statements
Statements from fellow service members confirming:
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You struggled during PT
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You were slower on runs
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You limped or complained of pain
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You used wraps, braces, or OTC medications
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Your performance declined as symptoms worsened
Statements from family or friends
These can describe:
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Increased pain
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Changes in mobility
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Worsening headaches
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Sleeplessness
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Mood changes due to pain
Profiles or duty restrictions
Even if not treated by a doctor, a profile restricting activity can be powerful evidence.
Private medical records
Records shortly after separation are especially helpful. They can show that:
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Symptoms had already intensified before leaving service
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A doctor recognized an unusually severe presentation for your age
This can demonstrate that the condition didn’t naturally worsen but was aggravated by military activities.
Special Challenges for Reservists
Aggravation for reservists can be more difficult because it must be tied specifically to:
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Drill weekends, or
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Periods of active duty for training
Active duty service connects anything that happens during that period. In contrast, reservists must show that the specific drill or training period directly aggravated their condition.
A line-of-duty (LOD) determination is extremely helpful, but even without one, a reservist can sometimes prove aggravation if:
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Drill dates can be verified, and
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Medical records show treatment immediately after a drill weekend or training period
Reservists should always keep their own drill logs to help tie symptoms to service dates.
The Biggest Mistakes in Aggravation Claims
The two most common problems are:
1. The VA incorrectly assumes a condition pre-existed service
If it wasn’t documented on the entrance exam, the VA must treat the veteran as sound. Veterans often accept this error without challenging it.
2. The VA fails to establish a baseline level of disability
Without a proper baseline, the VA cannot legally determine how much aggravation occurred. This mistake can lead to incorrect ratings or outright denials.
Veterans should review decisions carefully and seek help if something seems wrong.
Final Advice for Veterans Pursuing Service-Connected Aggravation Claims
If you genuinely believe your condition worsened during service, do not give up. Many aggravation claims are denied at first, even when the evidence supports the veteran. The appeals process often corrects these mistakes.
Key takeaways:
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Be honest with yourself about when and how your symptoms worsened.
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Collect all possible evidence: medical records, buddy letters, lay statements.
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Challenge VA errors, especially regarding pre-existing conditions and baselines.
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Seek help from an accredited representative, attorney, or claims agent if needed.
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Keep fighting if you know your claim is valid. Many aggravation cases succeed on appeal.
Aggravation may be complicated, but when properly documented and pursued, it can absolutely lead to the benefits veterans deserve.
Also Read: Veterans COLA 2026: New Rates and How They Affect You
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
