Aggravation of a Preexisting (Pre-service) Condition

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When your military service worsens a preexisting condition

Before you joined the military you underwent a physical examination at a Military Entrance Processing Station (MEPS). During this examination any preexisting issues is recorded. Anything NOT recorded during that examination, the VA is instructed to 'presume soundness' - that is, if nothing is recorded that the Veteran came in with nothing wrong!

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Now with that said, there are exceptions:

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• If a chronic condition is diagnosed shortly after service starts, AND it could be medically concluded (more likely than not) that this condition existed before service - the VA will just NOT assume the condition just popped up during service.

  • This said, it is still possible to get service connection!

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• If medical evidence shows a condition existed prior to service.

  • Examples include: medical records dated prior to service starting or x-rays that show well healed preexisting bone fractures.

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IMPORTANT NOTE:

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• HOWEVER, statements from the Veteran themselves or others that a condition existed BEFORE service hold ZERO WEIGHT! UNLESS, there is medical evidence that backs up those statements!

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Setting up consideration

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So your MEPS records indicated that a condition existed before service:

In order for the VA to consider a condition under aggravation of a preexisting (pre-service) condition the VA must establish two things:

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1. What the level of severity* was BEFORE service; and

2. What the level of severity was DURING/AFTER service.

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*severity for VA purposes is as established by the Rating schedule.

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For number one, in most cases (unless you say got a medical waiver), your severity before service will be established as 0%.

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Now number two, is where things get tricky for a lot of Veterans...

If there are NO complaints or treatment made in service for the preexisting condition - You Lose! Good day sir! The VA NEEDS proof that your service made your condition worse!

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Now, if you never made any complaints in service or got treatment then there is still hope! You can submit Buddy statements in support of your claim! Alternatively, if the source of your aggravation is related to combat then you do NOT need documentation! You just need to submit a Personal statement explaining how the injury that aggravated your condition occurred.

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Additionally, if your aggravation occurred as a result of a specialized skill IE parachutist. You can state as much, as it is fairly well established that taking hard landings can mess stuff up.

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Making a decision

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The VA now armed with elements one and two - can now get a medical opinion on aggravation.

The VA will now ask a medical professional to provide a medical opinion as to if your military service worsened your preexisting condition at least as likely as not beyond it's natural progression.

If the opinion is favorable then you are good to go.

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Aggravation of an Existing (Post-service) Condition

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If your service connected condition (or a condition that eventually becomes service connected) aggravates an existing condition it can be service connected.

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Setting up consideration

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In order for the VA to consider a condition under aggravation of an existing (post-service) condition the VA must establish two things:

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1. What the level of severity* was BEFORE aggravation; and

2. What the level of severity was AFTER aggravation.

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*severity for VA purposes is as established by the Rating schedule.

It is REQUIRED that you supply evidence to the VA that shows the level of severity of the condition BEFORE aggravation, OR as soon as possible after aggravation, but before the date of receipt of the evidence establishing the current level of severity of the aggravated condition.

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• In short - if you do not show the VA how much your service connected condition aggravated a condition, you CANNOT get service connection!

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Making a decision

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The VA now armed with elements one and two - can now get a medical opinion on aggravation.

The VA will now ask a medical professional to provide a medical opinion as to if your service connected condition worsened your existing condition at least as likely as not beyond it's natural progression.

If the opinion is favorable then you are good to go.

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Ratings for Aggravated Conditions

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Rating service connected aggravated conditions has an additional layer of complication. Instead of the traditional assigning a rating based upon the rating schedule, aggravated conditions involve some subtraction:

Current severity - preexisting condition severity = aggravated rating

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IMPORTANT NOTES:

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• If the preexisting (pre-service) condition would rate 100% severity, the final aggravated rating WILL BE 100%!

  • This does NOT apply to aggravations of conditions AFTER separation!

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• If the VA cannot determine the severity of a preexisting (pre-service) condition, the VA will assume the severity was 0%.