{"page":"https://casescribe.ai/explorer/secondary/diabetes-mellitus-secondary-to-psychiatric-disorder","generated_at":"2026-10-03T18:34:32.525Z","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 a psychiatric disorder","secondary_condition":"Diabetes mellitus","service_connected_disability":"a psychiatric disorder","decisions":495,"years":"2017-2026","granted_pct":20,"denied_pct":16.6,"remanded_pct":62.8,"granted_on_merits_pct":54.7,"by_year":[{"year":2018,"issues":37,"granted_pct":2.7,"denied_pct":37.8,"remanded_pct":56.8},{"year":2019,"issues":39,"granted_pct":7.7,"denied_pct":30.8,"remanded_pct":61.5},{"year":2020,"issues":38,"granted_pct":7.9,"denied_pct":18.4,"remanded_pct":73.7},{"year":2021,"issues":60,"granted_pct":16.7,"denied_pct":15,"remanded_pct":68.3},{"year":2022,"issues":59,"granted_pct":15.3,"denied_pct":11.9,"remanded_pct":72.9},{"year":2023,"issues":55,"granted_pct":16.4,"denied_pct":18.2,"remanded_pct":65.5},{"year":2024,"issues":72,"granted_pct":23.6,"denied_pct":8.3,"remanded_pct":68.1},{"year":2025,"issues":87,"granted_pct":40.2,"denied_pct":8,"remanded_pct":50.6},{"year":2026,"issues":37,"granted_pct":32.4,"denied_pct":13.5,"remanded_pct":51.4}],"benefit_of_doubt_in_grants_pct":79.8,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":80,"granted_pct_with":69.1,"granted_pct_without":48.4},{"evidence":"va_exam_unfavorable","decisions_with":370,"granted_pct_with":51.4,"granted_pct_without":69.7},{"evidence":"nexus_positive","decisions_with":134,"granted_pct_with":81.7,"granted_pct_without":26.1},{"evidence":"nexus_negative","decisions_with":316,"granted_pct_with":50,"granted_pct_without":68.1},{"evidence":"private_opinion","decisions_with":182,"granted_pct_with":70.5,"granted_pct_without":37.2},{"evidence":"lay_statement","decisions_with":386,"granted_pct_with":48.2,"granted_pct_without":76.2}],"top_reasons":{"granted":[{"reason":"current diagnosis established","decisions":15},{"reason":"service connection established","decisions":15},{"reason":"caused by the service-connected disability","decisions":14},{"reason":"obesity as intermediate step","decisions":5},{"reason":"no contrary medical opinion","decisions":2},{"reason":"aggravated by the service-connected disability","decisions":2}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":18},{"reason":"preponderance of the evidence against the claim","decisions":10},{"reason":"no in-service complaints, treatment or diagnosis","decisions":9},{"reason":"aggravated by the service-connected disability","decisions":7},{"reason":"service records negative or silent","decisions":7},{"reason":"no current diagnosis","decisions":3}]},"recent_examples":{"granted":[{"case_id":"A26036527","year":2026,"judge":"L. STEPANICK","rationale":"AOJ favorably found diabetes related to service-connected acquired psychiatric disorder; Board bound by favorable AOJ finding; Criteria for service connection met"},{"case_id":"A26036320","year":2026,"judge":"J. T. HUTCHESON","rationale":"Private evaluation found diabetes at least as likely as not caused/aggravated by PTSD; PTSD causes neuroendocrine dysregulation and impaired glucose metabolism; Temporal relationship between PTSD and diabetes onset supports PTSD as etiological factor; Evidence in equipoise, doubt resolved in Veteran… [truncated, 8 chars omitted]"},{"case_id":"A26033961","year":2026,"judge":"MICHAEL MARTIN","rationale":"Evidence in relative equipoise regarding secondary service connection; Benefit of the doubt applied in Veteran's favor; Private medical opinion linked diabetes to stress eating from anxiety"}],"denied":[{"case_id":"A26035680","year":2026,"judge":"MARCUS N. FULTON","rationale":"Criteria for entitlement not met; Evidence persuasively weighs against service connection; No nexus to in-service immunizations"},{"case_id":"26001129","year":2026,"judge":"M. TENNER","rationale":"Evidence weighed against secondary service connection for diabetes due to psychiatric disability.; VA medical opinions found diabetes pathophysiologically different from psychiatric disability.; Diabetes diagnosed before significant obesity, making secondary link less likely."},{"case_id":"26000995","year":2026,"judge":"THOMAS H. O'SHAY","rationale":"No evidence of diabetes in service treatment records.; Diagnosis of diabetes approximately 1.5 years after service.; VA examiner opined diabetes less likely than not due to service-connected adjustment disorder.; Examiner cited obesity and metabolic factors as primary cause of diabetes.; No direct p… [truncated, 113 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":498,"aggravation_discussed":{"issues":201,"granted_pct":12.9},"causation_only":{"issues":297,"granted_pct":24.9},"issues_naming_a_pathway_pct":46.6,"pathways":[{"pathway":"Weight gain or obesity","issues":205,"granted_pct":27.3,"examples":[{"case_id":"A26000473","year":2026,"outcome":"GRANTED","quote":"Obesity as an intermediate step between psychological condition and diabetes."},{"case_id":"26000995","year":2026,"outcome":"DENIED","quote":"Examiner cited obesity and metabolic factors as primary cause of diabetes."}]},{"pathway":"Stress","issues":15,"granted_pct":13.3,"examples":[{"case_id":"A26010898","year":2026,"outcome":"GRANTED","quote":"Private medical opinion linked diabetes to psychiatric disability via weight gain and stress."},{"case_id":"A25017314","year":2025,"outcome":"DENIED","quote":"Examiner noted diabetes mellitus, type II, is caused by genetic factors, obesity, overeating, lack of exercise, stress, and aging."}]},{"pathway":"Sleep disruption","issues":15,"granted_pct":26.7,"examples":[{"case_id":"A26011078","year":2026,"outcome":"GRANTED","quote":"Claimed as secondary to service-connected insomnia disorder with major depressive disorder."}]},{"pathway":"Medication side effects","issues":14,"granted_pct":14.3,"examples":[{"case_id":"26000253","year":2026,"outcome":"GRANTED","quote":"Secondary causation due to medication for service-connected conditions"},{"case_id":"22015279","year":2022,"outcome":"DENIED","quote":"A VA examiner opined DMII was less likely than not related to service, occurring after service and potentially linked to corticosteroid treatment for breast cancer, with no specific causal mechanism identified."}]},{"pathway":"Reduced activity or mobility","issues":13,"granted_pct":15.4,"examples":[{"case_id":"A24074586","year":2024,"outcome":"GRANTED","quote":"Private medical opinions linked DM to weight gain from depression and inability to exercise."},{"case_id":"23004349","year":2023,"outcome":"DENIED","quote":"Risk factors for diabetes mellitus (genetics, obesity, inactivity, diet) were identified as primary contributors, not psychiatric conditions.."}]}]},"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."}}