Secondary service connection
Peripheral arterial occlusive disease (buerger's disease) secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided peripheral arterial occlusive disease (buerger's disease) claimed as secondary to diabetes in 336 decisions. It granted the issue in 37.2% of them, above the 21.1% grant rate for all peripheral arterial occlusive disease (buerger's disease) issues, denied it in 21.7%, and remanded it in 39.6%. Counting only decisions on the merits, 63.1% were granted.
Decisions
336
2017–2026
Granted
37.2%
All peripheral arterial occlusive disease (buerger's disease): 21.1%
Granted on the merits
63.1%
Granted ÷ (granted + denied)
Remanded
39.6%
Denied: 21.7%
See all peripheral arterial occlusive disease (buerger's disease) decisions, direct and secondary.
Peripheral arterial occlusive disease (buerger's disease) secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 30 | 16.7% | 40.0% | 36.7% | 6.7% |
| 2018 | 45 | 20.0% | 28.9% | 51.1% | 0.0% |
| 2019 | 67 | 35.8% | 14.9% | 47.8% | 1.5% |
| 2020 | 77 | 48.1% | 18.2% | 32.5% | 1.3% |
| 2021 | 77 | 40.3% | 18.2% | 41.6% | 0.0% |
| 2022 | 69 | 37.7% | 21.7% | 34.8% | 5.8% |
| 2023 | 75 | 52.0% | 21.3% | 26.7% | 0.0% |
| 2024 | 51 | 33.3% | 11.8% | 47.1% | 7.8% |
| 2025 | 24 | 41.7% | 25.0% | 33.3% | 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 Other: dismissed, withdrawn or no clear outcome.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 peripheral arterial occlusive disease (buerger's disease) decisions
For each kind of supporting evidence: how often the Board granted the peripheral arterial occlusive disease (buerger's disease) 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 | 94 | 86.5% | 49.2% | +37.3 pts |
| Favorable VA exam | 70 | 87.7% | 53.2% | +34.5 pts |
| Private medical opinion | 128 | 69.3% | 58.2% | +11.1 pts |
| Lay statement | 235 | 54.9% | 85.2% | −30.3 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 71.2% of the decisions that granted peripheral arterial occlusive disease (buerger's disease).
- The Board found the veteran's statements credible in 24.8% of grants and 9.6% 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 peripheral arterial occlusive disease (buerger's disease) 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 | 158 | 58.9% | 67.0% | −8.0 pts |
| Unfavorable VA exam | 208 | 59.1% | 71.2% | −12.1 pts |
How these claims are argued
A secondary claim says diabetes caused peripheral arterial occlusive disease (buerger's disease) 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)
31.2%
granted, of 93 issues (17.6% of all)
Causation only
caused by the disability, 3.310(a)
40.4%
granted, of 436 issues (82.4% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Secondary service connection for left lower extremity peripheral neuropathy was granted, as it was found to be proximately due to the veteran's service-connected diabetes.” A26019952 (2026) Denied “Service connection for left lower extremity diabetic peripheral neuropathy, sciatic nerve, was denied an earlier effective date prior to January 17, 2024.” A25016583 (2025) | 253 | 49.4% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 49.1% of the 529 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 peripheral arterial occlusive disease (buerger's disease)
Most common reasons in grants
- Caused by the service-connected disability28
- Current diagnosis established28
- Service connection established22
- Aggravated by the service-connected disability4
- Secondary service connection granted3
- Dm is service-connected2
- Criteria for secondary service connection met2
- Service records negative or silent2
Most common reasons in denials
- No current diagnosis13
- Preponderance of the evidence against the claim10
- VA examiner: less likely than not related to service9
- Service connection established4
- No in-service complaints, treatment or diagnosis4
- Service records negative or silent2
- No evidence of pvd during service or within one year of discharge2
- Current diagnosis established2
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 peripheral arterial occlusive disease (buerger's disease) decisions
Granted
Current diagnosis of peripheral vascular disease.; DM is service-connected.; VA examiners found peripheral vascular disease caused by DM.
Diagnosis of bilateral lower extremity diabetic peripheral neuropathy; Secondary to service-connected diabetes mellitus type 2
AOJ favorable finding in January 2025 rating decision; Board is bound by AOJ's favorable finding; Criteria for secondary service connection met
Denied
No in-service diagnosis or continuity of symptoms.; Arterial disease not presumptively linked to herbicide exposure.; VA examiner opined less likely than not related to service.; No probative medical opinion linking arterial disease to service or diabetes.
DMII not service-connected; Secondary service connection requires service-connected underlying condition; Lack of legal merit for secondary claim
Service connection for DM denied.; No direct service connection for peripheral vascular disease established.; VA examiner opined peripheral vascular disease was due to DM, not service.
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 peripheral arterial occlusive disease (buerger's disease).
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): peripheral arterial occlusive disease (buerger's disease) 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
- 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
- Glaucoma secondary to diabetes482 decisions · 10.6% granted
See all conditions secondary to diabetes.
Rules that apply to secondary peripheral arterial occlusive disease (buerger's disease) 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 peripheral arterial occlusive disease (buerger's disease) case
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How these numbers are calculated
- Counts decisions in which the Board decided a peripheral arterial occlusive disease (buerger's disease) 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.