In a valiant effort to better myself and do my part to protect our environment, I have committed myself to occasionally riding my bicycle to work. As I was peddling one morning, my mind began to wander. As a “comp nerd,” my thoughts naturally wandered to the concept of aggravation. It dawned on me that, in the workers’ compensation world, the term is a noun. Aggravation, in the realm of workers’ compensation, has a different meaning than it does to the rest of the world. Dictionary.com defines aggravation as: “an increase in the intensity, seriousness, or severity, or act of making worse: an aggravation of pain.” This definition is understood by everyone. An example I often use is of my personal experience. As a result of an active youth I have knee issues. My job entails a significant amount of travel in a cramped car or plane, which causes my knees to ache. I have no doubt, if I explain my symptoms to a doctor, he would tell me traveling aggravates my knees. So, does that mean if I travel for work and experience knee pain I have a work-related compensable injury? I believe the answer is no.
In the workers’ compensation context, the term “aggravation” has a unique meaning, different than that typically understood outside the workers’ compensation context. Aggravation refers to a preinjury condition that has progressed to the extent that it becomes a compensable injury. In order to constitute a compensable aggravation of a pre-existing condition, there must be more than the remanifestation of symptoms; there must be some enhancement, acceleration, or worsening of an underlying condition. There must be some new damage or harm to the physical structure of the body. An aggravation is not the mere recurrence or remanifestation of symptoms which is not the equivalent of a new compensable injury. Similarly, subsequent pain and medical problems are not automatically an aggravation amounting to a new injury.
In discussing the term aggravation, legal authorities most often use the term as a noun, indicating that a work-related incident either did or did not cause an aggravation of preexisting condition. However, often people use the term aggravation as a verb, analyzing whether a work-related incident aggravated a preexisting condition. In the workers’ compensation world, the “verb” use of the term is inappropriate in analyzing whether an aggravation is compensable, because of the legal definition of producing cause.
For a work-related injury to be compensable, the incident must be a producing cause of the injury. In Transcontinental Ins. Co. v. Crump, the Supreme Court held “producing cause in workers’ compensation cases is defined as a substantial factor in bringing about an injury or death, and without which the injury or death would not have occurred.” Under this analysis, it is the “bringing about” and “would not have” that are the verbs in the analysis. So, in analyzing aggravation in the context of whether the work-related incident was a producing case, it is essential to remember that aggravation is the noun.
Approaching the concept of aggravation from this standpoint clarifies the ambiguity and conflict between the ordinary meaning of “aggravation” with the technical, legal definition of “aggravation” in the worker’s compensation context.
So, when struggling with an aggravation question, remember, aggravation is a noun. While this realization may be nothing new, it was the proverbial “click” for me that simplified the way I approach aggravation questions.
 See e.g. Division of Workers’ Compensation Appeal Nos. 94428; 962183.
 Tex. Lab. Code § 401.011(26) defines injury, in part, as “damage or harm to the physical structure of the body.”
 Division of Workers’ Compensation Appeal No. 94428.
 Division of Workers’ Compensation Appeal No. 93696.
 Transcon. Ins. Co. v. Crump, 330 S.W.3d 201 (Tex. 2010).