Claim Raven explanation
What this means
This rule addresses aggravation of a condition that existed before service. An increase in disability during service and whether it reflects the condition’s natural progress are central questions.
A condition can exist before service and still raise a claim question if the disability increased during service. VA must consider whether that change reflects natural progression under the applicable provisions. Records from before, during, and after service help distinguish the starting condition from what changed.
How this helps your claim
This rule helps when VA says a condition existed before service and the question is whether it worsened there. A before-and-after timeline makes the evidence easier to review. The applicable service-period rules and the reason for the worsening matter, so an increase in symptoms alone does not settle every aggravation question.
What to check in your records
Gather records from before, during and after service that show how the condition changed. Ask a qualified representative how the applicable provisions fit the record.
- Compare entrance and preservice records with treatment, restrictions, and findings during service.
- Look at separation and later records for evidence of the condition’s course, including any improvement or continuing limitations.
- Find any medical explanation of natural progression or service-related worsening. Check which facts it relies on and whether VA addressed the relevant history.
Compare the condition before and during service
Aggravation involves the history of a preexisting disability, so the starting condition matters. Entrance findings, earlier medical records and the service course can help show what changed. A description of a difficult day is different from evidence about the disability's overall course.
Read the decision for both an increase-in-disability finding and any discussion of natural progression under the applicable standard. Records after service can provide context, but they should not be used to silently replace missing facts about the relevant period. Keep the dates and source of each observation clear.
Is aggravation before service the same as secondary aggravation?
No. This section concerns a disability that preexisted service and was aggravated during service. Secondary aggravation concerns worsening due to an already service-connected disability and is addressed in section 3.310. The histories and governing requirements differ, even though both use the word aggravation.
Official regulatory text
38 CFR § 3.306
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 3.306 Aggravation of preservice disability.
(a) General. A preexisting injury or disease will be considered to have been aggravated by active military, naval, air, or space 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.
(Authority: 38 U.S.C. 1153)
(b) Wartime service; peacetime service after December 31, 1946. Clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where the preservice disability underwent an increase in severity during service. This includes medical facts and principles which may be considered to determine whether the increase is due to the natural progress of the condition. Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service.
(1) The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, including postoperative scars, absent or poorly functioning parts or organs, will not be considered service connected unless the disease or injury is otherwise aggravated by service.
(2) Due regard will be given the places, types, and circumstances of service and particular consideration will be accorded combat duty and other hardships of service. The development of symptomatic manifestations of a preexisting disease or injury during or proximately following action with the enemy or following a status as a prisoner of war will establish aggravation of a disability.
(Authority: 38 U.S.C. 1154)
(c) Peacetime service prior to December 7, 1941. The specific finding requirement that an increase in disability is due to the natural progress of the condition will be met when the available evidence of a nature generally acceptable as competent shows that the increase in severity of a disease or injury or acceleration in progress was that normally to be expected by reason of the inherent character of the condition, aside from any extraneous or contributing cause or influence peculiar to military service. Consideration will be given to the circumstances, conditions, and hardships of service.
[26 FR 1580, Feb. 24, 1961, as amended at 57 FR 59296, Dec. 15, 1992; 87 FR 26125, May 3, 2022]
Related references
- 38 USC § 1153: Aggravation of a preservice disability
- 38 CFR § 3.303: VA service connection explained
- 38 USC § 1154: Service Circumstances and Combat Evidence
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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