Secondary service connection
Shoulder impairment secondary to a neck (cervical spine) condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided shoulder impairment claimed as secondary to a neck (cervical spine) condition in 425 decisions. It granted the issue in 9.9% of them, below the 15.2% grant rate for all shoulder impairment issues, denied it in 20.7%, and remanded it in 69.6%. Counting only decisions on the merits, 32.3% were granted.
Decisions
425
2017–2026
Granted
9.9%
All shoulder impairment: 15.2%
Granted on the merits
32.3%
Granted ÷ (granted + denied)
Remanded
69.6%
Denied: 20.7%
See all shoulder impairment decisions, direct and secondary.
Shoulder impairment secondary to a neck (cervical spine) condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 36 | 8.3% | 22.2% | 69.4% | 0.0% |
| 2018 | 47 | 10.6% | 29.8% | 59.6% | 0.0% |
| 2019 | 51 | 5.9% | 17.6% | 74.5% | 2.0% |
| 2020 | 63 | 7.9% | 28.6% | 63.5% | 0.0% |
| 2021 | 74 | 6.8% | 17.6% | 75.7% | 0.0% |
| 2022 | 83 | 7.2% | 18.1% | 74.7% | 0.0% |
| 2023 | 66 | 7.6% | 22.7% | 69.7% | 0.0% |
| 2024 | 55 | 16.4% | 16.4% | 67.3% | 0.0% |
| 2025 | 47 | 23.4% | 12.8% | 63.8% | 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 Other: dismissed, withdrawn or no clear outcome.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 | 69.7% | 19.6% | +50.1 pts |
| Favorable VA exam | 41 | 68.8% | 27.2% | +41.6 pts |
| Private medical opinion | 126 | 45.1% | 24.1% | +21.0 pts |
| Lay statement | 357 | 29.7% | 58.3% | −28.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 73.8% of the decisions that granted shoulder impairment.
- The Board found the veteran's statements credible in 38.1% of grants and 14.8% 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 |
|---|---|---|---|---|
| Unfavorable VA exam | 364 | 30.2% | 50.0% | −19.8 pts |
| Negative nexus opinion | 309 | 28.3% | 50.0% | −21.7 pts |
How these claims are argued
A secondary claim says a neck (cervical spine) 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)
5.2%
granted, of 213 issues (40.3% of all)
Causation only
caused by the disability, 3.310(a)
13.0%
granted, of 315 issues (59.7% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Service connection for a right shoulder disorder secondary to the veteran's service-connected cervical spine disability with bilateral radiculopathy was granted.” 25008104 (2025) Denied “Pain attributed to radiculopathy from service-connected cervical spine.” A25109807 (2025) | 79 | 12.7% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 17.2% of the 528 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 disability10
- Service connection established4
- Current diagnosis established4
- Related to service-connected cervical spine disability2
Most common reasons in denials
- No in-service complaints, treatment or diagnosis20
- VA examiner: less likely than not related to service15
- Preponderance of the evidence against the claim8
- Aggravated by the service-connected disability7
- Current diagnosis established7
- Service records negative or silent6
- No current diagnosis6
- No continuity of symptomatology2
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
Left shoulder pain caused by cervical pain disability; Evidence weighs in favor of service connection; Resolving doubt in Veteran's favor
Secondary to service-connected cervical strain; Supported by private medical opinion; No contrary medical opinions of record
Favorable finding of diagnosis from RO decision; Lay statements regarding pain during military physical training; Private chiropractic opinion linking condition to service; Benefit of the doubt applied due to approximate balance of evidence
Denied
No in-service complaints or diagnoses for right shoulder disability.; No medical opinion linking current disability to service or service-connected cervical spine strain.; Veteran's lay statement regarding onset outweighed by lack of medical evidence.
No current diagnosis of left shoulder disability.; Pain attributed to radiculopathy from service-connected cervical spine.; No evidence of functional impairment.
C&P examiner provided negative nexus opinion regarding service connection; C&P examiner provided negative nexus opinion regarding secondary connection to cervical/lumbar spine conditions; Veteran's lay statements not competent to establish medical causal relationship; Evidence weighs against finding of service connection
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 neck (cervical spine) condition is already service connected.
- Medical evidence linking them (a nexus opinion): shoulder impairment was caused by a neck (cervical spine) 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 neck (cervical spine) condition
Shoulder impairment secondary to other conditions
See all conditions secondary to a neck (cervical spine) 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 neck (cervical spine) 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.