Secondary service connection
Glaucoma secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided glaucoma claimed as secondary to diabetes in 482 decisions. It granted the issue in 10.6% of them, close to the 10.8% grant rate for all glaucoma issues, denied it in 25.1%, and remanded it in 62.9%. Counting only decisions on the merits, 29.7% were granted.
Decisions
482
2017–2026
Granted
10.6%
All glaucoma: 10.8%
Granted on the merits
29.7%
Granted ÷ (granted + denied)
Remanded
62.9%
Denied: 25.1%
See all glaucoma decisions, direct and secondary.
Glaucoma secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 36 | 0.0% | 47.2% | 50.0% | 2.8% |
| 2018 | 44 | 18.2% | 27.3% | 54.5% | 0.0% |
| 2019 | 51 | 7.8% | 23.5% | 68.6% | 0.0% |
| 2020 | 63 | 4.8% | 20.6% | 73.0% | 1.6% |
| 2021 | 84 | 9.5% | 26.2% | 61.9% | 2.4% |
| 2022 | 73 | 8.2% | 24.7% | 65.8% | 1.4% |
| 2023 | 55 | 21.8% | 18.2% | 58.2% | 1.8% |
| 2024 | 38 | 7.9% | 23.7% | 65.8% | 2.6% |
| 2025 | 33 | 18.2% | 12.1% | 69.7% | 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 Other: dismissed, withdrawn or no clear outcome.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 glaucoma decisions
For each kind of supporting evidence: how often the Board granted the glaucoma 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 | 58 | 68.2% | 16.4% | +51.8 pts |
| Favorable VA exam | 45 | 61.3% | 22.7% | +38.6 pts |
| Private medical opinion | 126 | 40.7% | 23.9% | +16.8 pts |
| Lay statement | 311 | 20.3% | 56.8% | −36.5 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 70.6% of the decisions that granted glaucoma.
- The Board found the veteran's statements credible in 11.8% of grants and 5.0% 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 glaucoma 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 |
|---|---|---|---|---|
| Unfavorable VA exam | 348 | 24.1% | 48.7% | −24.7 pts |
| Negative nexus opinion | 308 | 22.1% | 48.0% | −25.9 pts |
How these claims are argued
A secondary claim says diabetes caused glaucoma 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)
5.0%
granted, of 201 issues (41.3% of all)
Causation only
caused by the disability, 3.310(a)
14.7%
granted, of 286 issues (58.7% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Denied “The record did not reflect direct service relation, nor did it show peripheral neuropathy manifesting within a year of service.” A23031034 (2023) | 10 | 0.0% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 2.9% of the 487 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 glaucoma
Most common reasons in grants
- Caused by the service-connected disability6
- Service connection established3
- Service connection granted3
- Service records negative or silent2
- Secondary to diabetes mellitus2
- Current diagnosis established2
- Medical literature supports link between diabetes and glaucoma2
Most common reasons in denials
- Preponderance of the evidence against the claim18
- No in-service complaints, treatment or diagnosis16
- VA examiner: less likely than not related to service14
- Service records negative or silent12
- No current diagnosis4
- Current diagnosis established3
- Caused by the service-connected disability3
- No evidence of in-service incurrence or aggravation2
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 glaucoma decisions
Granted
Evidence in equipoise regarding relationship to Type II diabetes mellitus; Medical literature suggests link between diabetes and glaucoma; Doubt resolved in veteran's favor
Conceded current diagnosis of glaucoma; Veteran service-connected for diabetes mellitus; VA opinion found diabetes mellitus contributed to glaucoma
Conflicting medical opinions regarding etiology.; October 2023 VA opinion linked glaucoma suspect/pigment dispersion to diabetes.; Approximate balance of evidence resolved in Veteran's favor.
Denied
No competent medical opinion links glaucoma to diabetes or herbicide exposure; Glaucoma has no positive association with herbicide exposure per VA regulations; Veteran's lay testimony regarding glaucoma was not medically competent
No diagnosis of glaucoma or diabetic retinopathy.; Diagnosed cataracts considered age-related.; No medical opinion linking cataracts to service-connected diabetes.
No competent medical or lay evidence linking eye issues to service.; Veteran suggested link to non-service-connected DM II.; VA examiner opined conditions less likely than not caused by TERA.; Cataracts attributed to age, retinopathy to DM II.
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 glaucoma.
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): glaucoma 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
- Cataract extraction secondary to diabetes372 decisions · 22.6% granted
- Hypertension secondary to diabetes2,809 decisions · 15.2% granted
See all conditions secondary to diabetes.
Rules that apply to secondary glaucoma 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 glaucoma 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 glaucoma 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.