## Facts

- Alfred E. Allen served on active duty from 1955 to 1957 and sustained a right-knee ligament sprain shortly before separation.
- After reopened proceedings, VA granted service connection for traumatic arthritis of the right knee and assigned a 20% rating.
- Allen sought secondary service connection for osteoarthritis affecting the left knee and hips, asserting his service-connected right-knee disability altered his gait and caused or worsened those conditions.
- VA framed the claim to include whether the non-service-connected conditions were caused by, or merely aggravated by, the service-connected right-knee disability.
- The Board of Veterans’ Appeals denied secondary service connection, finding no evidence the left-side osteoarthritis was proximately caused by the service-connected right-knee disability and did not award benefits based on aggravation.
- Allen appealed to the United States Court of Veterans Appeals (en banc).

## Issues

1. Whether “disability” under 38 U.S.C. § 1110 includes additional impairment of earning capacity resulting from a service-connected condition aggravating a non-service-connected condition.
2. Whether 38 C.F.R. § 3.310(a) authorizes secondary service connection based on aggravation and requires compensation limited to the increase in severity attributable to the service-connected condition.
3. Whether the Board applied an incorrect legal standard by addressing only proximate causation and not aggravation.

## Decision

- The court held that “disability” in 38 U.S.C. § 1110 refers to impairment of earning capacity and includes additional impairment resulting from aggravation by a service-connected disability.
- The court construed 38 C.F.R. § 3.310(a) to permit secondary service connection where a service-connected disability aggravates a non-service-connected disability.
- Compensation is payable only for the degree of disability over and above the level that existed before the aggravation.
- The court vacated the Board’s decision and remanded for application of the correct aggravation standard.

## Legal Principles

- For veterans’ compensation purposes, “disability” means impairment of earning capacity.
- Secondary service connection is available not only when a service-connected condition causes another condition, but also when it aggravates a non-service-connected condition.
- When aggravation is shown, VA must award compensation only for the incremental increase in severity attributable to the service-connected disability, measured against the pre-aggravation baseline.
- A decision that limits secondary service connection to direct proximate causation, without considering aggravation, applies an incorrect legal standard and requires remand.

## Conclusion

The court required VA to treat aggravation as a valid basis for secondary service connection and to compensate only the additional disability attributable to the service-connected condition’s worsening of a non-service-connected condition, vacating and remanding because the Board failed to analyze aggravation.


Allen v. Brown, 7 Vet. App. 439 (1995) (en banc)