Secondary service connection
Erectile dysfunction secondary to a psychiatric disorder: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to a psychiatric disorder in 1,290 decisions. It granted the issue in 30.1% of them, above the 17.0% grant rate for all erectile dysfunction issues, denied it in 14.3%, and remanded it in 54.8%. Counting only decisions on the merits, 67.8% were granted.
Decisions
1,290
2017–2026
Granted
30.1%
All erectile dysfunction: 17.0%
Granted on the merits
67.8%
Granted ÷ (granted + denied)
Remanded
54.8%
Denied: 14.3%
See all erectile dysfunction decisions, direct and secondary.
Erectile dysfunction secondary to a psychiatric disorder: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 37 | 13.5% | 18.9% | 67.6% | 0.0% |
| 2018 | 103 | 28.2% | 15.5% | 54.4% | 1.9% |
| 2019 | 122 | 16.4% | 16.4% | 65.6% | 1.6% |
| 2020 | 117 | 20.5% | 17.9% | 61.5% | 0.0% |
| 2021 | 146 | 29.5% | 16.4% | 52.7% | 1.4% |
| 2022 | 114 | 31.6% | 10.5% | 57.9% | 0.0% |
| 2023 | 143 | 24.5% | 12.6% | 62.2% | 0.7% |
| 2024 | 185 | 34.1% | 11.9% | 54.1% | 0.0% |
| 2025 | 242 | 40.5% | 12.8% | 45.9% | 0.8% |
| 2026 | 81 | 43.2% | 16.0% | 38.3% | 2.5% |
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 Other: dismissed, withdrawn or no clear outcome.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 | 318 | 94.2% | 48.3% | +45.9 pts |
| Favorable VA exam | 179 | 92.5% | 60.3% | +32.3 pts |
| Treating physician opinion | 78 | 96.3% | 64.9% | +31.4 pts |
| Private medical opinion | 442 | 81.1% | 57.2% | +23.9 pts |
| Combat service | 71 | 78.8% | 67.2% | +11.6 pts |
| Lay statement | 958 | 62.7% | 84.4% | −21.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 77.8% of the decisions that granted erectile dysfunction.
- The Board found the veteran's statements credible in 26.3% of grants and 9.8% 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 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 | 829 | 66.0% | 72.1% | −6.1 pts |
| Unfavorable VA exam | 1,012 | 66.1% | 76.3% | −10.2 pts |
How these claims are argued
A secondary claim says a psychiatric disorder 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)
15.9%
granted, of 383 issues (29.7% of all)
Causation only
caused by the disability, 3.310(a)
36.1%
granted, of 907 issues (70.3% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Medication side effects Granted “Veteran reported sporadic sexual side effects from psychiatric medication” A26000599 (2026) Denied “The veteran claims entitlement to service connection for erectile dysfunction, asserting it is secondary to his service-connected depressive disorder and migraines, including medication side effects.” 24022481 (2024) | 101 | 49.5% |
Weight gain or obesity Granted “VA examiner opined BPH, obesity, and alcohol use disorder caused ED” A25100362 (2025) Denied “Other likely causes identified: obesity, sleep apnea, chronic pain, possible vascular disease.” A26002640 (2026) | 26 | 11.5% |
Stress Granted “Private opinion linked ED to depression, anxiety, stress, and psychiatric disorder” A26005131 (2026) Denied “Service connection for a penile condition as secondary to high blood pressure, stress, PTSD, serious depression, anxiety, and diabetes was denied.” A25032343 (2025) | 20 | 40.0% |
Sleep disruption Granted “Service connection for erectile dysfunction is granted as secondary to the service-connected unspecified depressive disorder with insomnia.” A25101158 (2025) Denied “Service connection for erectile dysfunction as secondary to PTSD, persistent depressive disorder, insomnia disorder, and alcohol use disorder was denied due to the lack of a current diagnosis of erectile dysfunction in the record.” A25052146 (2025) | 18 | 27.8% |
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 Veteran sought service connection for erectile dysfunction, claiming it was secondary to lumbar spine degenerative arthritis, depression, obstructive sleep apnea (OSA), and bilateral lower extremity radiculopathy.” A25100909 (2025) | 17 | 23.5% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 14.6% of the 1,290 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 disability79
- Current diagnosis established71
- Service connection established43
- Aggravated by the service-connected disability7
- Veteran diagnosed with erectile dysfunction5
- Erectile dysfunction diagnosed4
- VA examiner: less likely than not related to service4
- Criteria for service connection met4
Most common reasons in denials
- VA examiner: less likely than not related to service36
- No in-service complaints, treatment or diagnosis25
- Preponderance of the evidence against the claim18
- Service records negative or silent16
- No current diagnosis11
- Current diagnosis established7
- Criteria for secondary service connection not met5
- Aggravated by the service-connected disability5
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 in approximate balance regarding secondary connection to major depressive disorder.; VA examiner found erectile dysfunction less likely than not due to major depressive disorder, but noted it could be a cause.; Private physician opined psychiatric disorder was at least as likely as not the cause, despite lacking detailed rationale.; Board resolved doubt in Veteran's favor, granting service connection.
Service connection may be granted for recurrent disability arising from disease or injury incurred in or aggravated by active service.; The Agency of Original Jurisdiction determined erectile dysfunction was related to the service-connected adjustment disorder with depressed mood.; In the absence of clear and unmistakable error, service connection is granted.
Favorable secondary opinion from May 2024 examiner.; Opinion attributed erectile dysfunction to severity of diagnosed psychiatric disorders.; No opposing secondary opinion found.
Denied
Service connection for the primary psychiatric disorder was denied.; No legal basis for granting secondary service connection without a service-connected primary condition.
No service connection for primary psychiatric disability; No evidence of erectile complaints in service medical records; No competent opinion relating erectile disability to service
No service-connected mental health condition established; Secondary claim fails as a matter of law without predicate disability; No factual or legal basis for secondary service connection
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 psychiatric disorder is already service connected.
- Medical evidence linking them (a nexus opinion): erectile dysfunction was caused by a psychiatric disorder (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 psychiatric disorder
- Migraine secondary to a psychiatric disorder1,181 decisions · 41.2% granted
- Sleep apnea secondary to a psychiatric disorder4,474 decisions · 33.1% granted
- Gastroesophageal reflux disease (GERD) secondary to a psychiatric disorder591 decisions · 25.4% granted
- Diabetes mellitus secondary to a psychiatric disorder418 decisions · 21.3% granted
- Hypertension secondary to a psychiatric disorder1,487 decisions · 20.1% granted
Erectile dysfunction secondary to other conditions
See all conditions secondary to a psychiatric disorder.
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 psychiatric disorder, 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.