Secondary service connection
Urinary incontinence secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided urinary incontinence claimed as secondary to a back condition in 411 decisions. It granted the issue in 22.6% of them, above the 20.4% grant rate for all urinary incontinence issues, denied it in 24.1%, and remanded it in 52.3%. Counting only decisions on the merits, 48.4% were granted.
Decisions
411
2017–2026
Granted
22.6%
All urinary incontinence: 20.4%
Granted on the merits
48.4%
Granted ÷ (granted + denied)
Remanded
52.3%
Denied: 24.1%
See all urinary incontinence decisions, direct and secondary.
Urinary incontinence secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 33 | 15.2% | 39.4% | 45.5% | 0.0% |
| 2018 | 45 | 22.2% | 42.2% | 33.3% | 2.2% |
| 2019 | 58 | 24.1% | 25.9% | 48.3% | 1.7% |
| 2020 | 46 | 10.9% | 23.9% | 63.0% | 2.2% |
| 2021 | 48 | 16.7% | 27.1% | 56.3% | 0.0% |
| 2022 | 42 | 16.7% | 23.8% | 59.5% | 0.0% |
| 2023 | 40 | 35.0% | 10.0% | 55.0% | 0.0% |
| 2024 | 50 | 22.0% | 14.0% | 62.0% | 2.0% |
| 2025 | 53 | 37.7% | 17.0% | 45.3% | 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 Other: dismissed, withdrawn or no clear outcome.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 urinary incontinence decisions
For each kind of supporting evidence: how often the Board granted the urinary incontinence 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 | 79 | 76.7% | 35.6% | +41.1 pts |
| Favorable VA exam | 64 | 63.8% | 43.4% | +20.4 pts |
| Private medical opinion | 132 | 57.6% | 41.1% | +16.5 pts |
| Lay statement | 319 | 46.0% | 61.3% | −15.3 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 79.6% of the decisions that granted urinary incontinence.
- The Board found the veteran's statements credible in 25.8% of grants and 18.2% 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 urinary incontinence 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 | 244 | 41.9% | 60.3% | −18.4 pts |
| Unfavorable VA exam | 330 | 45.3% | 64.5% | −19.2 pts |
How these claims are argued
A secondary claim says a back condition caused urinary incontinence 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)
6.5%
granted, of 123 issues (29.1% of all)
Causation only
caused by the disability, 3.310(a)
29.0%
granted, of 300 issues (70.9% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Medical opinions attributed the incontinence to disruption of nerve signals from the spinal cord injury.” 25014740 (2025) Denied “The veteran claims entitlement to service connection for urinary incontinence (UI) as secondary to his service-connected left lower extremity radiculopathy and/or degenerative arthritis of the lumbar spine.” A26003964 (2026) | 65 | 20.0% |
Stress Granted “Competent evidence shows lumbar radiculopathy caused stress urinary incontinence.” A25005816 (2025) Denied “VA examinations indicated normal MRIs and EMG studies, suggesting the condition was more consistent with age-related pelvic floor weakness or stress urinary incontinence, rather than the service-connected back disability.” 21002713 (2021) | 13 | 23.1% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 18.9% of the 423 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 urinary incontinence
Most common reasons in grants
- Caused by the service-connected disability17
- Service connection established8
- Current diagnosis established4
- Criteria for secondary service connection met3
- Secondary to lumbar spine disability2
Most common reasons in denials
- VA examiner: less likely than not related to service20
- Preponderance of the evidence against the claim11
- No in-service complaints, treatment or diagnosis8
- Caused by the service-connected disability8
- Service records negative or silent7
- No current diagnosis6
- Aggravated by the service-connected disability4
- Current diagnosis established3
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 urinary incontinence decisions
Granted
Evidence in approximate balance for requiring absorbent materials changed less than 2 times per day; Weight of evidence against higher rating; Criteria for 20% rating met
Evidence in approximate balance; Resolved reasonable doubt in veteran's favor; VA opinions lacked specific rationale; Incontinence can be caused by chronic medical conditions
Linked to service-connected quadriplegia; Spinal cord injury affects bladder/bowel function
Denied
VA examiner opined UI was less likely than not related to service-connected conditions.; Prostate brachytherapy identified as a more likely cause of UI.; No evidence of multi-link causal chain or inability to treat UI due to service-connected disabilities.
Incontinence more likely due to prostate cancer/tumor; No evidence of incontinence related to service-connected back/radiculopathy; VA examiners concluded cancer was the cause
No current diagnosis of bowel incontinence; No complaints of bowel incontinence in service or post-service records; March 2018 VA exam found no bowel problems
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 urinary incontinence.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): urinary incontinence 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
- 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
- Shoulder impairment secondary to a back condition647 decisions · 7.3% granted
- Foot impairment secondary to a back condition354 decisions · 6.2% granted
See all conditions secondary to a back condition.
Rules that apply to secondary urinary incontinence 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 urinary incontinence 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 urinary incontinence 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.