Aggravation

Aggravation, in VA usage, means a lasting worsening of a condition beyond its natural progression. The term does two jobs in the regulation. A condition that existed before service can be aggravated by service, which is covered at 38 CFR 3.306. A condition that is not service-connected can be aggravated by one that is, which is covered at 38 CFR 3.310.

For the service form, a veteran is presumed to have been in sound condition on entering service except for defects noted at the entrance examination. Where a preexisting condition increased in disability during service, the regulation treats that increase as aggravation unless the evidence specifically shows it was due to the natural progress of the disease. Natural progress is the exception the regulation names, so what the record says changed, and when, is what the VA reads.

Either form is a question about connection rather than about severity, which puts it in the claims lane. The medical record's job is unchanged: it documents what the condition is now and what it limits, in terms the rating schedule can apply. Whether aggravation is established in a given case is decided by the VA and argued by the veteran with an accredited representative or VSO, and representation through a recognized VSO is free.