Secondary service connection
Shoulder impairment secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided shoulder impairment claimed as secondary to a back condition in 661 decisions. It granted the issue in 7.1% of them, below the 15.2% grant rate for all shoulder impairment issues, denied it in 21.8%, and remanded it in 70.8%. Counting only decisions on the merits, 24.6% were granted.
Decisions
661
2017–2026
Granted
7.1%
All shoulder impairment: 15.2%
Granted on the merits
24.6%
Granted ÷ (granted + denied)
Remanded
70.8%
Denied: 21.8%
See all shoulder impairment decisions, direct and secondary.
Shoulder impairment secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 52 | 3.8% | 32.7% | 61.5% | 1.9% |
| 2018 | 71 | 4.2% | 29.6% | 66.2% | 0.0% |
| 2019 | 67 | 0.0% | 16.4% | 83.6% | 0.0% |
| 2020 | 106 | 5.7% | 21.7% | 72.6% | 0.0% |
| 2021 | 98 | 2.0% | 19.4% | 78.6% | 0.0% |
| 2022 | 109 | 10.1% | 14.7% | 75.2% | 0.0% |
| 2023 | 123 | 8.1% | 20.3% | 69.9% | 1.6% |
| 2024 | 107 | 11.2% | 21.5% | 67.3% | 0.0% |
| 2025 | 101 | 8.9% | 20.8% | 70.3% | 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 Other: dismissed, withdrawn or no clear outcome.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 shoulder impairment decisions
For each kind of supporting evidence: how often the Board granted the shoulder impairment 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 | 63 | 75.0% | 16.0% | +59.0 pts |
| Favorable VA exam | 51 | 76.2% | 18.2% | +58.0 pts |
| Private medical opinion | 159 | 39.7% | 17.2% | +22.5 pts |
| Lay statement | 535 | 22.2% | 41.7% | −19.5 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 76.6% of the decisions that granted shoulder impairment.
- The Board found the veteran's statements credible in 42.6% of grants and 13.2% 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 shoulder impairment 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 | 444 | 21.1% | 36.4% | −15.3 pts |
| Unfavorable VA exam | 533 | 21.6% | 45.8% | −24.3 pts |
How these claims are argued
A secondary claim says a back condition caused shoulder impairment 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)
3.6%
granted, of 391 issues (46.2% of all)
Causation only
caused by the disability, 3.310(a)
9.2%
granted, of 456 issues (53.8% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Secondary to service-connected lumbar spine disability with radiculopathy” 25013549 (2025) Denied “Negative VA exam findings for radiculopathy.” 23015636 (2023) | 54 | 9.3% |
Altered gait or overuse Granted “VA examiner opined condition associated with overuse and likely caused by brace use” 25013549 (2025) Denied “A VA reviewer opined it was less likely than not that the service-connected back disability caused or aggravated the bilateral shoulder disability, citing anatomical and biomechanical disconnects.” 18109768 (2018) | 19 | 10.5% |
Chronic pain Granted “Veteran's lay statements regarding IED blast and persistent pain found credible.” 24018413 (2024) Denied “The Veteran claimed service connection for right shoulder strain and impingement syndrome, also referred to as chronic pain, alleging it was secondary to service-connected lumbar spondylosis.” A20017862 (2020) | 14 | 7.1% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 10.2% of the 847 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 shoulder impairment
Most common reasons in grants
- Caused by the service-connected disability6
- Current diagnosis established5
- Service connection established5
- Aggravated by the service-connected disability3
- Favorable finding of current left shoulder disability3
- VA opinion inadequate for failing to address lay statements, conflicting evidence, aggravation, and rationale2
- VA examiner: less likely than not related to service2
Most common reasons in denials
- No in-service complaints, treatment or diagnosis37
- VA examiner: less likely than not related to service25
- Service records negative or silent16
- Preponderance of the evidence against the claim14
- No current diagnosis12
- Aggravated by the service-connected disability12
- Current diagnosis established6
- Continuity of symptomatology since service3
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 shoulder impairment decisions
Granted
Aggravated by service-connected lumbar spine and lower extremity conditions; Use of a cane necessitated by service-connected conditions; Service connection granted
Current left shoulder disability diagnosed as degenerative arthritis with impingement syndrome.; Aggravated by service-connected lumbar disability due to sleeping position.; VA examiner's opinion inadequate for failing to address aggravation.
Favorable finding of current right shoulder disability.; Favorable finding of service-connected lumbosacral strain.; VA examiner opined disability was at least as likely as not related to service-connected lumbosacral strain.; Benefit of the doubt resolved in Veteran's favor.
Denied
No in-service complaints or diagnoses for left shoulder disability.; No medical opinion linking current disability to service or service-connected lumbosacral strain.; Veteran's lay statement regarding onset outweighed by lack of medical evidence.
Claim for left shoulder condition is secondary to claimed back disability.; Service connection for back disability was denied.; No primary disability exists to support secondary service connection.
No competent or probative nexus evidence; No approximate balance of evidence; Claim denied
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 shoulder impairment.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): shoulder impairment was caused by a back condition (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 back condition
- Paralysis of sciatic nerve secondary to a back condition325 decisions · 57.8% granted
- Radiculopathy secondary to a back condition1,181 decisions · 49.9% granted
- Major depressive disorder secondary to a back condition770 decisions · 47.4% granted
- Paralysis of sciatic nerve or external popliteal nerve secondary to a back condition2,436 decisions · 38.7% granted
- Sleep apnea secondary to a back condition1,166 decisions · 38.2% granted
- Ulnar nerve paralysis secondary to a back condition628 decisions · 34.6% granted
- Peripheral nerve conditions secondary to a back condition307 decisions · 32.2% granted
- Peripheral nerve disorders secondary to a back condition1,204 decisions · 27.8% granted
- Erectile dysfunction secondary to a back condition619 decisions · 27.6% granted
- Degenerative arthritis of the spine secondary to a back condition679 decisions · 23.7% granted
- Urinary incontinence secondary to a back condition408 decisions · 22.8% granted
- Hypertension secondary to a back condition330 decisions · 20.0% granted
- Migraine secondary to a back condition347 decisions · 18.7% granted
- Hip impairment secondary to a back condition1,856 decisions · 13.6% granted
- Knee conditions secondary to a back condition2,083 decisions · 12.3% granted
- Ankle impairment secondary to a back condition322 decisions · 11.2% granted
- Cervical spine limitation of motion secondary to a back condition1,553 decisions · 8.8% granted
- Foot impairment secondary to a back condition354 decisions · 6.2% granted
Shoulder impairment secondary to other conditions
See all conditions secondary to a back condition.
Rules that apply to secondary shoulder impairment 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 shoulder impairment 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 shoulder impairment issue claimed as secondary to a back condition, 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.