Did you know?

Conditions service made worse

You do not have to prove service caused a condition from scratch. If service made it worse, that can be service connected too. VA calls this aggravation, and it covers two different situations.

VA: evidence needed for a claim
Veterans Crisis Line — dial 988, then press 1. Text 838255. Chat at veteranscrisisline.net. For TTY, call 711 then 988, or 1-800-799-4889. 24 hours a day, 7 days a week. You do not have to be enrolled in VA benefits or health care to connect. Mental health conditions are on this page. If today is a hard day, make that call first.
Why I built this page. I have watched too many Soldiers and veterans read the word "aggravated," decide it does not describe them, and never file. Service connection has more than one door. Direct, secondary, presumptive, and aggravated are all real routes. Aggravated by itself means two different things under two different rules, and a veteran who only hears about one of them can walk away from a claim he would have won. Both are below.
Path one

You came in with it. Service made it worse.

This is the one most people never hear about.

You had a bad knee, a bad back, asthma, migraines, a mental health condition — something that existed before you raised your hand. It got worse while you were on active duty. That worsening can be service connected. The rule is 38 CFR 3.306, Aggravation of preservice disability.

VA's own words: a preexisting condition "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."
Read that twice. The increase in disability is presumed to be aggravation. For wartime service and peacetime service after 1946, VA can only knock that presumption down with clear and unmistakable evidence — a high bar, and the burden is on VA, not on you. There is a companion rule called the presumption of soundness at 38 CFR 3.304(b) that works alongside it.

Read 38 CFR 3.306 yourself · for 3.304(b), search section 3.304 at ecfr.gov/current/title-38.

★ It did not have to start in service.
Path two

A rated condition made something else worse.

Different situation. Different rule. Same word.

You have a disability VA already pays you for. It is making a second condition worse — a condition that is not service connected on its own. That increase can be service connected. The rule is 38 CFR 3.310(b).

VA's own words: "Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury ... will be service connected."

The paragraph right above it, 38 CFR 3.310(a), is plain secondary service connection: "Disability which is proximately due to or the result of a service-connected disease or injury shall be service connected." That one is for a whole new condition your rated condition caused. Paragraph (b) is for one that already existed and got worse.

Do not mix the two paths up. If your condition existed before service and got worse on active duty, 3.310 is not your rule — 3.306 is. Reading only about 3.310 is how a qualified veteran talks himself out of filing.

Read 38 CFR 3.310 yourself

★ Two doctrines. One word.
How to file

The forms, in order

  1. VA Form 21-0966, Intent to File. File this first. It locks in your effective date, and you then have 1 year to complete and file the claim. This is the cheapest money-protecting step there is, and almost nobody does it.
  2. VA Form 21-526EZ — the disability compensation claim itself.
  3. Say plainly on the claim which path you are on: the condition existed before service and worsened during service, or your service-connected condition is worsening this one.

VA: your intent to file · va.gov/disability

★ Intent to file costs you nothing.
Your records

Your entrance exam is the evidence

A worsening claim is won on before-and-after.

You need what your condition looked like when you came in, and what it looked like later. Three different places hold those papers, and sending everyone to one of them wastes months.

  • Military personnel file and DD214 — archives.gov/veterans. Online at vetrecs.archives.gov (identity verification through ID.me is required), or mail Standard Form 180.
  • DoD records and DD214 for a recent separation — milConnect.
  • VA medical records — your VA.gov account or My HealtheVet.
★ Get the paper before you argue the point.
If VA said no

Three lanes, and the rule that sinks most of them

Picking the wrong lane can cost you the year.

  • Higher-Level Review — VA Form 20-0996. Within 1 year of the decision. VA's own words: "You can't submit new evidence with a Higher-Level Review." A senior reviewer looks again at what was already there.
  • Supplemental Claim — VA Form 20-0995. No deadline — you may file at any time. But unless it is based on a change in law, "you'll need to submit supporting evidence that's new and relevant." New means VA has not considered it before. Relevant means it proves or disproves something in your claim.
  • Board Appeal — VA Form 10182. Within 1 year. Three options: Direct Review (no new evidence, no hearing), Evidence Submission — "You must submit new evidence with your Board Appeal or within 90 days" — or a hearing.
  • Contested claims — Board Appeal only, within 60 days of the date on the decision letter.
This is where the money goes. If you have a new nexus letter or a new exam, a Higher-Level Review is the one lane that cannot look at it. And filing a Supplemental Claim within 1 year of the decision protects your effective date — file later and you can still win, but you may lose back pay.

va.gov/decision-reviews · Higher-Level Review · Supplemental Claim · Board Appeal

★ Match the lane to your evidence.
Getting help

Free help exists. Know the fee rules.

An accredited Veterans Service Organization representative's services on your VA claim are always free. Under 38 CFR 14.636, recognized organizations and their accredited representatives "are not permitted to receive fees." Appoint one with VA Form 21-22.

An accredited attorney or claims agent is a different thing and uses a different form — VA Form 21-22a. They may charge a fee, but only after VA issues its initial decision on the claim.

The numbers, exactly. A fee not exceeding 20 percent of past-due benefits awarded is presumed reasonable if the representation continued through the date of the decision awarding benefits. A fee exceeding 33⅓ percent is presumed unreasonable. Both presumptions can be rebutted by clear and convincing evidence. Anyone charging you to prepare an initial claim is outside VA's rules.

Find an accredited representative · Read 38 CFR 14.636

★ Free help first. Always.
Straight talk. Knowing the rule does not guarantee eligibility. Every claim is unique and eligibility turns on your own facts and your own records. Laws and benefits change over time, so verify against VA's own pages before you act. But a rule you never heard of cannot help you either, and that is the part I can fix. If a claim for a worsened condition has already been denied, that is not the end — read the decision review panel above and pick the right lane. For VA phone numbers, use VA's own list at va.gov/resources/helpful-va-phone-numbers.