Secondary service connection
Erectile dysfunction secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to diabetes in 1,846 decisions. It granted the issue in 26.0% of them, above the 17.0% grant rate for all erectile dysfunction issues, denied it in 26.1%, and remanded it in 46.5%. Counting only decisions on the merits, 49.9% were granted.
Decisions
1,846
2017–2026
Granted
26.0%
All erectile dysfunction: 17.0%
Granted on the merits
49.9%
Granted ÷ (granted + denied)
Remanded
46.5%
Denied: 26.1%
See all erectile dysfunction decisions, direct and secondary.
Erectile dysfunction secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 190 | 17.9% | 35.8% | 43.7% | 2.6% |
| 2018 | 249 | 22.1% | 32.9% | 43.4% | 1.6% |
| 2019 | 248 | 22.6% | 25.4% | 50.8% | 1.2% |
| 2020 | 275 | 21.1% | 25.5% | 50.9% | 2.5% |
| 2021 | 222 | 27.9% | 23.0% | 47.7% | 1.4% |
| 2022 | 214 | 23.4% | 22.4% | 52.3% | 1.9% |
| 2023 | 175 | 29.7% | 29.7% | 40.0% | 0.6% |
| 2024 | 135 | 40.0% | 16.3% | 43.0% | 0.7% |
| 2025 | 102 | 39.2% | 17.6% | 42.2% | 1.0% |
| 2026 | 39 | 48.7% | 17.9% | 30.8% | 2.6% |
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 Other: dismissed, withdrawn or no clear outcome.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 | 404 | 86.9% | 32.0% | +54.9 pts |
| Favorable VA exam | 287 | 84.5% | 39.0% | +45.5 pts |
| Treating physician opinion | 139 | 73.0% | 47.3% | +25.7 pts |
| Private medical opinion | 609 | 63.3% | 41.4% | +21.9 pts |
| Buddy statement | 54 | 63.0% | 49.6% | +13.4 pts |
| Combat service | 167 | 60.2% | 49.0% | +11.3 pts |
| Lay statement | 1,353 | 45.1% | 69.3% | −24.1 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 74.8% of the decisions that granted erectile dysfunction.
- The Board found the veteran's statements credible in 27.5% of grants and 8.7% 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 | 969 | 46.9% | 54.0% | −7.1 pts |
| Unfavorable VA exam | 1,201 | 47.4% | 56.1% | −8.6 pts |
How these claims are argued
A secondary claim says diabetes 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)
13.3%
granted, of 512 issues (27.7% of all)
Causation only
caused by the disability, 3.310(a)
30.8%
granted, of 1,337 issues (72.3% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Diabetes increases risk and damages nerves/blood supply for ED.” 26001687 (2026) Denied “December 2023 VA examiner opined ED and peripheral neuropathies are due to DM.” A25062493 (2025) | 43 | 53.5% |
Weight gain or obesity Denied “The Board found the condition arose post-service and was not related to service or toxic exposures, citing contributing factors like age, low testosterone, smoking, and obesity.” 24002690 (2024) | 15 | 0.0% |
Medication side effects Granted “The Board determined that the VA examiner's opinion, despite initial negative language, effectively confirmed that atherosclerosis and autonomic neuropathy associated with DM and CAD, as well as medication side effects, contribute to ED.” 25000573 (2025) Denied “His treatment records suggest the condition was related to medication side effects for his psychiatric disorder, which is not service-connected.” 19129152 (2019) | 13 | 46.2% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 4.5% of the 1,849 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 disability95
- Current diagnosis established67
- Service connection established50
- Aggravated by the service-connected disability9
- Veteran diagnosed with erectile dysfunction5
- Criteria for secondary service connection met5
- Criteria for service connection met4
- Veteran diagnosed with ed4
Most common reasons in denials
- VA examiner: less likely than not related to service58
- No in-service complaints, treatment or diagnosis52
- Preponderance of the evidence against the claim37
- Service records negative or silent37
- No current diagnosis17
- Service connection established16
- Diabetes mellitus not service-connected15
- Service connection for diabetes mellitus denied12
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
Current disability (ED) established.; Veteran service-connected for diabetes and panic disorder.; Conflicting medical opinions presented.; Evidence evenly balanced.; Benefit of the doubt applied.
Veteran has a current diagnosis of ED.; Veteran is service-connected for DM II.; A private medical opinion found ED to be at least as likely as not due to DM II.; Benefit of the doubt applied to grant secondary service connection.
ED is secondary to service-connected type 2 diabetes; VA physician found ED at least as likely as not due to diabetes; Medical literature links ED to long-standing diabetes
Denied
No verifiable herbicide exposure; Service treatment records silent for erectile dysfunction; VA examiner opined less likely than not caused by toxic exposure; No nexus to service or diabetes; Diabetes not service-connected
No in-service event, injury, or disease documented; No continuity of symptomatology; Earliest evidence post-service
ED not incurred in service; ED not secondary to service-connected disability; DM not service-connected
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.
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): erectile dysfunction 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
- Sleep apnea secondary to diabetes994 decisions · 23.0% granted
- Cataract extraction secondary to diabetes372 decisions · 22.6% granted
- Hypertension secondary to diabetes2,809 decisions · 15.2% granted
- Glaucoma secondary to diabetes482 decisions · 10.6% 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 a back condition619 decisions · 27.6% granted
See all conditions secondary to diabetes.
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 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.