Secondary service connection
Retinal dystrophy (including retinitis pigmentosa macular degeneration) secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided retinal dystrophy (including retinitis pigmentosa macular degeneration) claimed as secondary to diabetes in 416 decisions. It granted the issue in 37.0% of them, above the 20.1% grant rate for all retinal dystrophy (including retinitis pigmentosa macular degeneration) issues, denied it in 20.2%, and remanded it in 42.1%. Counting only decisions on the merits, 64.7% were granted.
Decisions
416
2017–2026
Granted
37.0%
All retinal dystrophy (including retinitis pigmentosa macular degeneration): 20.1%
Granted on the merits
64.7%
Granted ÷ (granted + denied)
Remanded
42.1%
Denied: 20.2%
See all retinal dystrophy (including retinitis pigmentosa macular degeneration) decisions, direct and secondary.
Retinal dystrophy (including retinitis pigmentosa macular degeneration) secondary to diabetes: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 38 | 18.4% | 47.4% | 28.9% | 5.3% |
| 2018 | 52 | 23.1% | 42.3% | 32.7% | 1.9% |
| 2019 | 58 | 27.6% | 12.1% | 58.6% | 1.7% |
| 2020 | 62 | 37.1% | 19.4% | 43.5% | 0.0% |
| 2021 | 47 | 40.4% | 14.9% | 44.7% | 0.0% |
| 2022 | 43 | 51.2% | 14.0% | 34.9% | 0.0% |
| 2023 | 54 | 53.7% | 7.4% | 38.9% | 0.0% |
| 2024 | 37 | 40.5% | 13.5% | 45.9% | 0.0% |
| 2025 | 29 | 37.9% | 20.7% | 41.4% | 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 Other: dismissed, withdrawn or no clear outcome.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 retinal dystrophy (including retinitis pigmentosa macular degeneration) decisions
For each kind of supporting evidence: how often the Board granted the retinal dystrophy (including retinitis pigmentosa macular degeneration) 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 | 80 | 87.3% | 56.6% | +30.7 pts |
| Favorable VA exam | 70 | 83.3% | 59.2% | +24.1 pts |
| Private medical opinion | 136 | 75.8% | 57.3% | +18.4 pts |
| Lay statement | 331 | 62.1% | 77.5% | −15.4 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 75.3% of the decisions that granted retinal dystrophy (including retinitis pigmentosa macular degeneration).
- The Board found the veteran's statements credible in 35.1% of grants and 8.3% 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 retinal dystrophy (including retinitis pigmentosa macular degeneration) 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 | 233 | 58.8% | 72.5% | −13.7 pts |
| Negative nexus opinion | 167 | 52.0% | 73.6% | −21.5 pts |
How these claims are argued
A secondary claim says diabetes caused retinal dystrophy (including retinitis pigmentosa macular degeneration) 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)
7.7%
granted, of 65 issues (15.2% of all)
Causation only
caused by the disability, 3.310(a)
42.4%
granted, of 363 issues (84.8% of all)
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 1.6% of the 428 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 retinal dystrophy (including retinitis pigmentosa macular degeneration)
Most common reasons in grants
- Caused by the service-connected disability50
- Current diagnosis established24
- Service connection established16
- Criteria for secondary service connection met5
- Diabetic retinopathy is a known complication of diabetes3
- Diabetic retinopathy diagnosed3
- Secondary service connection granted3
- Criteria for service connection met3
Most common reasons in denials
- No current diagnosis11
- Service records negative or silent8
- No in-service complaints, treatment or diagnosis7
- Service connection for diabetes mellitus denied5
- VA examiner: less likely than not related to service5
- Preponderance of the evidence against the claim3
- Current diagnosis established3
- No evidence of in-service onset 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 retinal dystrophy (including retinitis pigmentosa macular degeneration) decisions
Granted
Diagnosed with diabetic retinopathy and cataracts post-service.; Recognized complications of diabetes mellitus.; Private medical opinion confirmed these conditions are approximately due to Type I diabetes.
Diagnosed with diabetic retinopathy in January 2014; January 2025 VA eye exam found retinopathy related to Type II diabetes mellitus
Veteran diagnosed with proliferative diabetic retinopathy with macular edema in both eyes.; Diabetic retinopathy is most likely caused by diabetes.; Granted as caused by diabetes mellitus, type 2.; Benefit of the doubt resolved in Veteran's favor.
Denied
Diagnosis of diabetic retinopathy in both eyes; AOJ favorably found secondary connection to DM2; Underlying DM2 not service-connected; Secondary connection therefore not warranted
No in-service incurrence of vision disorder; No nexus to service established; Secondary claim denied as DM not service-connected
Hypermetropia/presbyopia are congenital and not ratable; No positive association between eye diseases and herbicide exposure; Evidence weighed against nexus to service or bright light exposure
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 retinal dystrophy (including retinitis pigmentosa macular degeneration).
- Diabetes is already service connected.
- Medical evidence linking them (a nexus opinion): retinal dystrophy (including retinitis pigmentosa macular degeneration) 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
- 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 retinal dystrophy (including retinitis pigmentosa macular degeneration) 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 retinal dystrophy (including retinitis pigmentosa macular degeneration) 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 retinal dystrophy (including retinitis pigmentosa macular degeneration) 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.