{"page":"https://casescribe.ai/explorer/secondary/diabetes-mellitus-secondary-to-hypertension","generated_at":"2026-10-03T18:34:31.896Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Diabetes mellitus secondary to hypertension","secondary_condition":"Diabetes mellitus","service_connected_disability":"hypertension","decisions":477,"years":"2017-2026","granted_pct":14.5,"denied_pct":26.8,"remanded_pct":57.7,"granted_on_merits_pct":35,"by_year":[{"year":2017,"issues":33,"granted_pct":9.1,"denied_pct":57.6,"remanded_pct":30.3},{"year":2018,"issues":35,"granted_pct":5.7,"denied_pct":31.4,"remanded_pct":62.9},{"year":2019,"issues":38,"granted_pct":5.3,"denied_pct":26.3,"remanded_pct":63.2},{"year":2020,"issues":49,"granted_pct":12.2,"denied_pct":28.6,"remanded_pct":59.2},{"year":2021,"issues":60,"granted_pct":10,"denied_pct":25,"remanded_pct":65},{"year":2022,"issues":56,"granted_pct":5.4,"denied_pct":25,"remanded_pct":69.6},{"year":2023,"issues":71,"granted_pct":12.7,"denied_pct":21.1,"remanded_pct":64.8},{"year":2024,"issues":59,"granted_pct":27.1,"denied_pct":25.4,"remanded_pct":47.5},{"year":2025,"issues":54,"granted_pct":25.9,"denied_pct":14.8,"remanded_pct":59.3},{"year":2026,"issues":25,"granted_pct":32,"denied_pct":28,"remanded_pct":36}],"benefit_of_doubt_in_grants_pct":69.6,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":49,"granted_pct_with":75,"granted_pct_without":28.4},{"evidence":"va_exam_unfavorable","decisions_with":373,"granted_pct_with":31.3,"granted_pct_without":54.8},{"evidence":"nexus_positive","decisions_with":86,"granted_pct_with":75,"granted_pct_without":19.1},{"evidence":"nexus_negative","decisions_with":315,"granted_pct_with":27.7,"granted_pct_without":53.6},{"evidence":"private_opinion","decisions_with":158,"granted_pct_with":43.8,"granted_pct_without":27.8},{"evidence":"lay_statement","decisions_with":339,"granted_pct_with":25.5,"granted_pct_without":68.2}],"top_reasons":{"granted":[{"reason":"service connection established","decisions":9},{"reason":"caused by the service-connected disability","decisions":8},{"reason":"current diagnosis established","decisions":6},{"reason":"aggravated by the service-connected disability","decisions":3}],"denied":[{"reason":"no in-service complaints, treatment or diagnosis","decisions":25},{"reason":"va examiner: less likely than not related to service","decisions":21},{"reason":"preponderance of the evidence against the claim","decisions":13},{"reason":"service records negative or silent","decisions":12},{"reason":"no continuity of symptomatology","decisions":7},{"reason":"benefit of the doubt / evidence in equipoise","decisions":3}]},"recent_examples":{"granted":[{"case_id":"A26039980","year":2026,"judge":"WILLIAM H. DONNELLY","rationale":"Evidence in equipoise regarding diabetes causation by hypertension medication; Benefit of the doubt applied to grant service connection; No evidence of diabetes in service treatment records"},{"case_id":"A26039607","year":2026,"judge":"M. HYLAND","rationale":"Granted as secondary to service-connected hypertension; At least as likely as not that DM is a result of hypertension; Hypertension is a significant risk factor for diabetes"},{"case_id":"A26035341","year":2026,"judge":"MICHAEL A. HERMAN","rationale":"Multiple VA opinions support a link between diabetes and medications for service-connected conditions.; Veteran's testimony supported by medical evidence regarding beta blocker use and diabetes risk.; One VA opinion specifically linked diabetes to hydrochlorothiazide (HCTZ) use."}],"denied":[{"case_id":"A26028459","year":2026,"judge":"M. MILLS","rationale":"Service records negative for diabetes during service.; Earliest diagnosis over 15 years post-service.; VA examiner found no link to service or exposures.; No competent medical opinion supporting service connection."},{"case_id":"A26022893","year":2026,"judge":"HARVEY P. ROBERTS","rationale":"Weight of the evidence does not show diabetes mellitus is etiologically related to service.; No competent medical opinion supports a link between diabetes mellitus and service or service-connected hypertension.; VA opinions found diabetes mellitus less likely than not related to ship fire exposure o… [truncated, 15 chars omitted]"},{"case_id":"26002664","year":2026,"judge":"K. CONNER","rationale":"No in-service complaints, findings, treatment, or diagnoses of diabetes.; STRs show normal endocrine system and urinalysis at separation.; Initial diagnosis post-service in 2000; private records suggest onset around that time.; VA opinions consistently found diabetes less likely than not related to … [truncated, 208 chars omitted]"}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":480,"aggravation_discussed":{"issues":229,"granted_pct":8.7},"causation_only":{"issues":251,"granted_pct":19.5},"issues_naming_a_pathway_pct":14.6,"pathways":[{"pathway":"Weight gain or obesity","issues":55,"granted_pct":9.1,"examples":[{"case_id":"26002007","year":2026,"outcome":"GRANTED","quote":"Obesity contributes to other service-connected conditions"},{"case_id":"26000895","year":2026,"outcome":"DENIED","quote":"Diabetes likely due to independent risk factors (obesity, family history).."}]}]},"how_va_rates":{"citation":"38 CFR 4.119","diagnostic_code":"7913","name":"Diabetes mellitus","url":"https://www.ecfr.gov/current/title-38/section-4.119","levels":[{"criteria":"Requiring more than one daily injection of insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational activities) with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if separately evaluated","rating":100},{"criteria":"Requiring one or more daily injection of insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated","rating":60},{"criteria":"Requiring one or more daily injection of insulin, restricted diet, and regulation of activities","rating":40},{"criteria":"Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet","rating":20},{"criteria":"Manageable by restricted diet only","rating":10}],"notes":["Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100-percent evaluation. Noncompensable complications are considered part of the diabetic process under DC 7913.","Note (2): When diabetes mellitus has been conclusively diagnosed, do not request a glucose tolerance test solely for rating purposes."]},"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}