Secondary service connection
Peripheral nerve disorders secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided peripheral nerve disorders claimed as secondary to diabetes in 3,604 decisions. It granted the issue in 33.5% of them, above the 20.9% grant rate for all peripheral nerve disorders issues, denied it in 21.7%, and remanded it in 45.4%. Counting only decisions on the merits, 60.7% were granted.
Decisions
3,604
2017–2026
Granted
33.5%
All peripheral nerve disorders: 20.9%
Granted on the merits
60.7%
Granted ÷ (granted + denied)
Remanded
45.4%
Denied: 21.7%
See all peripheral nerve disorders decisions, direct and secondary.
Peripheral nerve disorders secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 418 | 25.1% | 30.6% | 42.1% | 2.2% |
| 2018 | 790 | 28.7% | 27.2% | 42.8% | 1.3% |
| 2019 | 1,020 | 27.2% | 15.5% | 56.2% | 1.2% |
| 2020 | 979 | 30.0% | 19.2% | 50.1% | 0.7% |
| 2021 | 906 | 30.6% | 21.6% | 47.1% | 0.7% |
| 2022 | 1,008 | 34.2% | 17.9% | 47.3% | 0.6% |
| 2023 | 945 | 39.4% | 21.2% | 38.9% | 0.5% |
| 2024 | 818 | 42.5% | 16.0% | 41.2% | 0.2% |
| 2025 | 592 | 46.1% | 18.2% | 35.6% | 0.0% |
| 2026 | 192 | 49.5% | 25.0% | 24.5% | 1.0% |
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 Other: dismissed, withdrawn or no clear outcome.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 nerve disorders decisions
For each kind of supporting evidence: how often the Board granted the peripheral nerve disorders 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 | 713 | 87.6% | 49.7% | +37.8 pts |
| Favorable VA exam | 550 | 87.4% | 52.7% | +34.6 pts |
| Treating physician opinion | 303 | 86.9% | 57.6% | +29.3 pts |
| Buddy statement | 160 | 73.0% | 59.9% | +13.1 pts |
| Combat service | 286 | 71.9% | 59.7% | +12.1 pts |
| Private medical opinion | 1,178 | 68.1% | 56.1% | +12.0 pts |
| Lay statement | 2,770 | 57.2% | 76.8% | −19.6 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 72.4% of the decisions that granted peripheral nerve disorders.
- The Board found the veteran's statements credible in 35.2% of grants and 10.1% 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 nerve disorders 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 | 1,552 | 53.7% | 66.5% | −12.9 pts |
| Unfavorable VA exam | 2,273 | 55.7% | 70.7% | −15.0 pts |
How these claims are argued
A secondary claim says diabetes caused peripheral nerve disorders 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)
15.6%
granted, of 860 issues (11.2% of all)
Causation only
caused by the disability, 3.310(a)
36.4%
granted, of 6,808 issues (88.8% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Chronic pain Granted “A June 2022 VA examiner opined that the neuropathy was at least as likely as not caused by diabetes mellitus and aggravated by PTSD due to increased neuropathic pain.” 23023833 (2023) Denied “Failure to demonstrate functional impairment of earning capacity due to pain alone..” 18138917 (2018) | 12 | 91.7% |
Altered gait or overuse Granted “The Board found the balance of evidence favored the Veteran, noting a factual error in a VA opinion that relied on an incorrect diabetes diagnosis date, making it less probative.” 1819485 (2018) Denied “Normal strength, reflexes, gait.” A22019206 (2022) | 11 | 18.2% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 0.4% of the 7,668 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 nerve disorders
Most common reasons in grants
- Caused by the service-connected disability352
- Current diagnosis established259
- Service connection established156
- Secondary service connection granted23
- Criteria for secondary service connection met18
- Service connection for diabetes mellitus granted18
- Secondary service connection criteria met11
- Diabetes mellitus is service-connected11
Most common reasons in denials
- No current diagnosis141
- Service records negative or silent68
- No in-service complaints, treatment or diagnosis64
- Preponderance of the evidence against the claim60
- Current diagnosis established45
- VA examiner: less likely than not related to service37
- Diabetes mellitus not service-connected26
- Service connection for diabetes mellitus denied20
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 nerve disorders decisions
Granted
38 C.F.R. § 3.310; Diabetes mellitus is now service-connected; Podiatry note: 'diabetes mellitus with neuropathy'; Endocrinology note: neuropathy as complication of diabetes
Diagnosed with bilateral lower extremity diabetic peripheral neuropathy post-service.; Recognized complication of diabetes mellitus.; Private medical opinion confirmed condition is approximately due to Type I diabetes.
Condition is a complication of service-connected diabetes mellitus.; Manifested or diagnosed prior to the 2004 claim.; Effective date of July 14, 2004, granted as it is the later of the claim date and when entitlement arose.
Denied
Peripheral neuropathy claimed secondary to diabetes mellitus, which was not service-connected.; Condition did not onset during service or within one year of separation.; No continuity of symptoms from service to diagnosis.
Complication of diabetes mellitus; Veteran not service-connected for diabetes mellitus
No in-service complaints, findings, treatment, or diagnosis; Diagnosed approximately 30 years post-service; VA opinions found no nexus to service or TERA; Attributed to diabetes mellitus; No evidence of aggravation from service-connected conditions
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 nerve disorders.
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): peripheral nerve disorders 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
- 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
Peripheral nerve disorders secondary to other conditions
See all conditions secondary to diabetes.
Rules that apply to secondary peripheral nerve disorders 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 nerve disorders 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 peripheral nerve disorders 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.