Secondary service connection
Erectile dysfunction secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to a back condition in 662 decisions. It granted the issue in 26.7% of them, above the 17.0% grant rate for all erectile dysfunction issues, denied it in 19.8%, and remanded it in 52.6%. Counting only decisions on the merits, 57.5% were granted.
Decisions
662
2017–2026
Granted
26.7%
All erectile dysfunction: 17.0%
Granted on the merits
57.5%
Granted ÷ (granted + denied)
Remanded
52.6%
Denied: 19.8%
See all erectile dysfunction decisions, direct and secondary.
Erectile dysfunction secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 44 | 4.5% | 36.4% | 56.8% | 2.3% |
| 2018 | 64 | 23.4% | 23.4% | 50.0% | 3.1% |
| 2019 | 64 | 25.0% | 25.0% | 46.9% | 3.1% |
| 2020 | 76 | 21.1% | 21.1% | 57.9% | 0.0% |
| 2021 | 59 | 16.9% | 28.8% | 52.5% | 1.7% |
| 2022 | 67 | 29.9% | 14.9% | 55.2% | 0.0% |
| 2023 | 66 | 25.8% | 15.2% | 59.1% | 0.0% |
| 2024 | 96 | 36.5% | 14.6% | 49.0% | 0.0% |
| 2025 | 94 | 36.2% | 12.8% | 51.1% | 0.0% |
| 2026 | 32 | 37.5% | 15.6% | 46.9% | 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 Other: dismissed, withdrawn or no clear outcome.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 erectile dysfunction decisions
For each kind of supporting evidence: how often the Board granted the erectile dysfunction 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 | 156 | 84.7% | 39.1% | +45.5 pts |
| Private medical opinion | 246 | 67.5% | 47.4% | +20.1 pts |
| Favorable VA exam | 83 | 73.0% | 53.5% | +19.5 pts |
| Lay statement | 491 | 53.9% | 70.1% | −16.2 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 78.5% of the decisions that granted erectile dysfunction.
- The Board found the veteran's statements credible in 17.5% of grants and 8.4% 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 erectile dysfunction 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 | 430 | 50.7% | 73.1% | −22.4 pts |
| Unfavorable VA exam | 534 | 53.1% | 78.8% | −25.7 pts |
How these claims are argued
A secondary claim says a back condition caused erectile dysfunction 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)
7.8%
granted, of 204 issues (30.8% of all)
Causation only
caused by the disability, 3.310(a)
35.2%
granted, of 458 issues (69.2% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Service connection for erectile dysfunction (ED) was granted as secondary to the veteran's service-connected low back disability, LLE radiculopathy, femoral nerve, and generalized anxiety disorder.” A26009713 (2026) Denied “The VA examiner stated the thoracolumbar strain did not affect the nerve bundle responsible for erections.” 26001163 (2026) | 77 | 24.7% |
Medication side effects Granted “The Veteran claimed ED due to chronic pain and medication side effects from his back condition.” A26025525 (2026) Denied “Lay statements suggested medication-induced connection” A26037280 (2026) | 42 | 47.6% |
Chronic pain Granted “Private opinion found ED more likely than not due to chronic pain from musculoskeletal conditions.” A26025525 (2026) Denied “The Veteran claimed service connection for erectile dysfunction as secondary to his service-connected lumbar spine degenerative disc disease (DDD), alleging it was the result of chronic pain.” A25014674 (2025) | 28 | 60.7% |
Weight gain or obesity Granted “June 2020 VA opinion found erectile dysfunction not related to lumbar spine disorder, attributed to obesity” 25007244 (2025) Denied “VA examiner attributed condition to obesity and lifestyle..” 26001163 (2026) | 15 | 13.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 23.1% of the 662 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 erectile dysfunction
Most common reasons in grants
- Caused by the service-connected disability43
- Current diagnosis established27
- Service connection established16
- Criteria for service connection met6
- Criteria for secondary service connection met4
- No contrary opinion of record3
- Secondary service connection granted2
- Service connection for back disability conceded2
Most common reasons in denials
- No in-service complaints, treatment or diagnosis17
- VA examiner: less likely than not related to service17
- Service records negative or silent14
- Preponderance of the evidence against the claim9
- Caused by the service-connected disability9
- No current diagnosis8
- Current diagnosis established3
- Aggravated by the service-connected disability3
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 erectile dysfunction decisions
Granted
Positive nexus opinion found probative despite factual inaccuracy.; Spine injury and degenerative changes linked to ED.; Benefit of the doubt applied due to equipoise.
Equipoise of evidence; Benefit of the doubt applied; Secondary to service-connected back disability
Veteran has current diagnosis of erectile dysfunction.; Private medical opinions found degenerative disc disease contributes to erectile dysfunction.; Opinions were probative and well-reasoned, connecting erectile dysfunction to service-connected back disorder.
Denied
Lay statements suggested medication-induced connection; Treatment records lacked notation of connection; VA examiner opined no causation/aggravation from service-connected conditions or medications
No indication of in-service event for ED; Thoracolumbar spine degenerative arthritis not service-connected during review period; No VA medical opinion required or provided for secondary nexus
Service treatment records negative for erectile dysfunction.; VA examiner opined less likely than not related to service.; VA examiner attributed condition to obesity and lifestyle.
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 erectile dysfunction.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): erectile dysfunction was caused by a back condition (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 a back condition
- Paralysis of sciatic nerve secondary to a back condition325 decisions · 57.8% granted
- Radiculopathy secondary to a back condition1,181 decisions · 49.9% granted
- Major depressive disorder secondary to a back condition770 decisions · 47.4% granted
- Paralysis of sciatic nerve or external popliteal nerve secondary to a back condition2,436 decisions · 38.7% granted
- Sleep apnea secondary to a back condition1,166 decisions · 38.2% granted
- Ulnar nerve paralysis secondary to a back condition628 decisions · 34.6% granted
- Peripheral nerve conditions secondary to a back condition307 decisions · 32.2% granted
- Peripheral nerve disorders secondary to a back condition1,204 decisions · 27.8% granted
- Degenerative arthritis of the spine secondary to a back condition679 decisions · 23.7% granted
- Urinary incontinence secondary to a back condition408 decisions · 22.8% granted
- Hypertension secondary to a back condition330 decisions · 20.0% granted
- Migraine secondary to a back condition347 decisions · 18.7% granted
- Hip impairment secondary to a back condition1,856 decisions · 13.6% granted
- Knee conditions secondary to a back condition2,083 decisions · 12.3% granted
- Ankle impairment secondary to a back condition322 decisions · 11.2% granted
- Cervical spine limitation of motion secondary to a back condition1,553 decisions · 8.8% granted
- Shoulder impairment secondary to a back condition647 decisions · 7.3% granted
- Foot impairment secondary to a back condition354 decisions · 6.2% granted
Erectile dysfunction secondary to other conditions
- Erectile dysfunction secondary to hypertension648 decisions · 36.7% granted
- Erectile dysfunction secondary to a psychiatric disorder1,061 decisions · 31.9% granted
- Erectile dysfunction secondary to PTSD1,645 decisions · 30.3% granted
- Erectile dysfunction secondary to diabetes1,811 decisions · 25.8% granted
See all conditions secondary to a back condition.
Rules that apply to secondary erectile dysfunction 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 erectile dysfunction 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 erectile dysfunction issue claimed as secondary to a back condition, 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.