Secondary service connection
Erectile dysfunction secondary to hypertension: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to hypertension in 694 decisions. It granted the issue in 37.0% of them, above the 17.0% grant rate for all erectile dysfunction issues, denied it in 17.6%, and remanded it in 44.7%. Counting only decisions on the merits, 67.8% were granted.
Decisions
694
2017–2026
Granted
37.0%
All erectile dysfunction: 17.0%
Granted on the merits
67.8%
Granted ÷ (granted + denied)
Remanded
44.7%
Denied: 17.6%
See all erectile dysfunction decisions, direct and secondary.
Erectile dysfunction secondary to hypertension: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 39 | 33.3% | 35.9% | 30.8% | 0.0% |
| 2018 | 65 | 23.1% | 20.0% | 53.8% | 3.1% |
| 2019 | 64 | 23.4% | 12.5% | 64.1% | 0.0% |
| 2020 | 73 | 28.8% | 30.1% | 41.1% | 0.0% |
| 2021 | 75 | 32.0% | 22.7% | 44.0% | 1.3% |
| 2022 | 66 | 33.3% | 15.2% | 51.5% | 0.0% |
| 2023 | 98 | 39.8% | 13.3% | 45.9% | 1.0% |
| 2024 | 80 | 45.0% | 16.3% | 37.5% | 1.3% |
| 2025 | 100 | 50.0% | 9.0% | 41.0% | 0.0% |
| 2026 | 35 | 62.9% | 8.6% | 28.6% | 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 Other: dismissed, withdrawn or no clear outcome.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 | 177 | 91.3% | 52.4% | +38.9 pts |
| Favorable VA exam | 118 | 90.9% | 59.6% | +31.3 pts |
| Private medical opinion | 236 | 76.1% | 61.8% | +14.3 pts |
| Lay statement | 502 | 62.0% | 82.9% | −20.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 72.4% of the decisions that granted erectile dysfunction.
- The Board found the veteran's statements credible in 18.7% of grants and 10.7% 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 | 466 | 65.6% | 72.6% | −7.0 pts |
| Unfavorable VA exam | 555 | 65.4% | 80.3% | −14.9 pts |
How these claims are argued
A secondary claim says hypertension 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)
17.9%
granted, of 190 issues (27.3% of all)
Causation only
caused by the disability, 3.310(a)
44.2%
granted, of 505 issues (72.7% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Medication side effects Granted “Stopped hydrochlorothiazide for hypertension due to side effects including erectile dysfunction.” A26013253 (2026) Denied “Lay statements suggested medication-induced connection” A26037280 (2026) | 28 | 46.4% |
Weight gain or obesity Granted “While acknowledging hypogonadism and obesity as contributing factors, the Board found medical reasoning supported a causal nexus between ED and migraine medication, hypertension, and mental health disorder, granting the claim on a...” 24033724 (2024) Denied “However, the Board found that the erectile dysfunction was not caused or aggravated by the service-connected hypertension, citing multiple non-service-connected risk factors including age, obesity, and sedentary lifestyle as the primary...” A24039950 (2024) | 13 | 7.7% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 7.8% of the 695 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 disability59
- Current diagnosis established49
- Service connection established33
- Erectile dysfunction diagnosed4
- Criteria for secondary service connection met4
- Service connection for hypertension granted4
- Hypertension is service-connected4
- Evidence evenly balanced3
Most common reasons in denials
- No in-service complaints, treatment or diagnosis18
- VA examiner: less likely than not related to service14
- Hypertension not service-connected13
- No current diagnosis7
- Preponderance of the evidence against the claim7
- Service records negative or silent5
- Service connection for hypertension denied4
- Current diagnosis established4
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
Evidence weighed in favor of claim; Private physician opinion found probative; ED caused by medication for service-connected hypertension
Current diagnosis of erectile dysfunction established by treatment records and prescription of Sildenafil.; Veteran is service-connected for hypertension.; Evidence regarding causation/aggravation by hypertension was in approximate balance, leading to benefit of the doubt grant.
Erectile dysfunction is etiologically related to hypertension; Hypertension is service-connected; Board resolves doubt in Veteran's favor to establish nexus
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
Probative evidence favors finding erectile dysfunction did not begin during service.; No competent indication of in-service nexus.; Claim denied as secondary to hypertension, which was not service-connected.
No in-service complaints or diagnosis of erectile dysfunction.; VA examiner provided negative opinion for direct and secondary service connection.; Erectile dysfunction attributed to hypertension medications, which were not service-connected.; Lack of competent evidence linking erectile dysfunction to service or service-connected condition.
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.
- Hypertension is already service connected.
- Medical evidence linking them (a nexus opinion): erectile dysfunction was caused by hypertension (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 hypertension
Erectile dysfunction secondary to other conditions
- 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
- Erectile dysfunction secondary to diabetes1,811 decisions · 25.8% granted
See all conditions secondary to hypertension.
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 hypertension, 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.