Secondary service connection
Cataract extraction secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided cataract extraction claimed as secondary to diabetes in 373 decisions. It granted the issue in 22.5% of them, above the 10.9% grant rate for all cataract extraction issues, denied it in 27.3%, and remanded it in 48.3%. Counting only decisions on the merits, 45.2% were granted.
Decisions
373
2017–2026
Granted
22.5%
All cataract extraction: 10.9%
Granted on the merits
45.2%
Granted ÷ (granted + denied)
Remanded
48.3%
Denied: 27.3%
See all cataract extraction decisions, direct and secondary.
Cataract extraction secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 34 | 14.7% | 29.4% | 50.0% | 5.9% |
| 2018 | 53 | 22.6% | 18.9% | 56.6% | 1.9% |
| 2019 | 44 | 15.9% | 43.2% | 38.6% | 2.3% |
| 2020 | 39 | 12.8% | 33.3% | 53.8% | 0.0% |
| 2021 | 47 | 14.9% | 38.3% | 44.7% | 2.1% |
| 2022 | 48 | 27.1% | 25.0% | 47.9% | 0.0% |
| 2023 | 48 | 27.1% | 22.9% | 47.9% | 2.1% |
| 2024 | 33 | 45.5% | 12.1% | 39.4% | 3.0% |
| 2025 | 24 | 20.8% | 29.2% | 50.0% | 0.0% |
Each row counts issues (each condition the Board decided), so the shares add up to 100%. Other: dismissed, withdrawn or no clear outcome. Years with fewer than 20 issues are left out.
Evidence in granted and denied cataract extraction decisions
For each kind of supporting evidence: how often the Board granted the cataract extraction issue on the merits when the decision mentioned it, compared with decisions that did not. These are associations, not causes, and evidence is recorded per decision, not per issue.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Positive nexus opinion | 77 | 77.8% | 28.5% | +49.3 pts |
| Favorable VA exam | 65 | 72.0% | 35.3% | +36.7 pts |
| Private medical opinion | 113 | 48.6% | 42.9% | +5.8 pts |
| Lay statement | 271 | 39.9% | 62.8% | −22.9 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 77.4% of the decisions that granted cataract extraction.
- The Board found the veteran's statements credible in 21.4% of grants and 10.8% of denials.
Negative evidence in the record
An unfavorable exam or a negative nexus opinion often sits in the same record as favorable evidence, and the Board weighs them against each other. So these rows show how often cataract extraction was still granted when the record contained the negative item, not that the item helped.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Negative nexus opinion | 237 | 41.3% | 53.3% | −12.1 pts |
| Unfavorable VA exam | 279 | 42.5% | 55.0% | −12.5 pts |
How these claims are argued
A secondary claim says diabetes caused cataract extraction or made it worse, and names how. Below: whether the Board's decision discussed aggravation, and the medical link each decision names, with how often those issues were granted.
Aggravation discussed
made worse by the disability, 3.310(b)
9.7%
granted, of 124 issues (32.7% of all)
Causation only
caused by the disability, 3.310(a)
28.6%
granted, of 255 issues (67.3% of all)
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 1.6% of the 379 issues name at least one medical link; the rest only say “secondary to” the disability. One issue can name several links. Granted is the share of those issues granted (remands count as not granted). A link named in a denial was often the argument the Board rejected.
Why the Board granted or denied cataract extraction
Most common reasons in grants
- Current diagnosis established16
- Caused by the service-connected disability12
- Service connection established10
- No contrary evidence of record2
- Aggravated by the service-connected disability2
Most common reasons in denials
- Preponderance of the evidence against the claim17
- VA examiner: less likely than not related to service15
- No in-service complaints, treatment or diagnosis13
- Service records negative or silent8
- Current diagnosis established4
- VA examiner opined cataracts were age-related3
- Caused by the service-connected disability2
- Service connection for diabetes mellitus denied2
Numbers are decisions that gave the reason. Reasons are short phrases extracted by AI from each decision; common wordings of the same reason are grouped. Benefit of the doubt is reported above.
Recent cataract extraction decisions
Granted
Favorable findings from AOJ regarding current diagnosis and service-connected diabetes mellitus are binding.; Private and VA treatment records indicate cataracts were associated with diabetes.; VA examiner's negative opinion was inconsistent with treatment records and afforded no probative value.
Current diagnosis of bilateral cataracts; Service-connected diabetes mellitus type 2; Medical opinion notes diabetes accelerates age-related cataracts; Benefit of the doubt applied
Conceded current diagnosis of pseudophakia; Veteran service-connected for diabetes mellitus; VA opinion found diabetes mellitus contributed to cataracts
Denied
No in-service complaints, treatment, or diagnosis for eye condition.; Separation examination showed normal eyes.; VA opinions found cataracts age-related and less likely than not caused by or related to diabetes.; No established baseline for aggravation due to diabetes.; No probative evidence of etiological link to service or diabetes.
No in-service event or injury documented; Cataract resolved prior to claim; No evidence of functional impairment or treatment
Current diagnoses of dry eye syndrome and residuals of bilateral cataracts; In-service injury/aggravation conceded, and service-connected for diabetes; All medical opinions against the claim, citing age-related changes and lack of in-service nexus
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of cataract extraction.
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): cataract extraction was caused by diabetes (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
Other conditions secondary to diabetes
- Peripheral arterial occlusive disease (buerger's disease) secondary to diabetes335 decisions · 37.3% granted
- Retinal dystrophy (including retinitis pigmentosa macular degeneration) secondary to diabetes416 decisions · 37.0% granted
- Peripheral nerve disorders secondary to diabetes3,602 decisions · 33.6% granted
- Kidney disease secondary to diabetes906 decisions · 26.5% granted
- Erectile dysfunction secondary to diabetes1,811 decisions · 25.8% granted
- Sleep apnea secondary to diabetes994 decisions · 23.0% granted
- Hypertension secondary to diabetes2,809 decisions · 15.2% granted
- Glaucoma secondary to diabetes482 decisions · 10.6% granted
See all conditions secondary to diabetes.
Rules that apply to secondary cataract extraction claims
- 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - M21-1 V.ii.2.D
Secondary service connection and aggravation of non-service-connected disabilities
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer
Research your cataract extraction case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.
How these numbers are calculated
- Counts decisions in which the Board decided a cataract extraction issue claimed as secondary to diabetes, by the outcome of that issue.
- The primary disability is read from the decision text ("secondary to …") and grouped by name, so spellings such as "PTSD" and "posttraumatic stress disorder" count together.
- Secondary claims also include aggravation of a non-service-connected condition by a service-connected one (38 CFR 3.310(b)).
- The data comes from CaseScribe's AI extraction of public BVA decisions (2017–2026) and can contain errors. It is updated automatically as new decisions are added.