Secondary service connection

Diabetes mellitus secondary to a psychiatric disorder: BVA grant rates and what wins

From 2017 to 2026, the Board of Veterans' Appeals decided diabetes claimed as secondary to a psychiatric disorder in 495 decisions. It granted the issue in 20.0% of them, close to the 20.2% grant rate for all diabetes issues, denied it in 16.6%, and remanded it in 62.8%. Counting only decisions on the merits, 54.7% were granted.

Decisions

495

2017–2026

Granted

20.0%

All diabetes: 20.2%

Granted on the merits

54.7%

Granted ÷ (granted + denied)

Remanded

62.8%

Denied: 16.6%

See all diabetes decisions, direct and secondary.

Diabetes mellitus secondary to a psychiatric disorder: outcomes by year

YearDecisionsGrantedDeniedRemanded
2018
37
2.7%37.8%56.8%
2019
39
7.7%30.8%61.5%
2020
38
7.9%18.4%73.7%
2021
59
15.3%15.3%69.5%
2022
59
15.3%11.9%72.9%
2023
55
16.4%18.2%65.5%
2024
72
23.6%8.3%68.1%
2025
87
40.2%8.0%50.6%
2026
35
34.3%14.3%48.6%

Evidence in granted and denied diabetes decisions

For each kind of supporting evidence: how often the Board granted the diabetes 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 recordDecisionsGranted when presentWhen absentDifference
Positive nexus opinion13481.7%26.1%+55.6 pts
Private medical opinion18270.5%37.2%+33.3 pts
Favorable VA exam8069.1%48.4%+20.7 pts
Lay statement38648.2%76.2%−28.0 pts
  • The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 79.8% of the decisions that granted diabetes.
  • The Board found the veteran's statements credible in 15.2% of grants and 7.3% 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 diabetes was still granted when the record contained the negative item, not that the item helped.

In the recordDecisionsGranted when presentWhen absentDifference
Negative nexus opinion31650.0%68.1%−18.1 pts
Unfavorable VA exam37051.4%69.7%−18.3 pts

Why the Board granted or denied diabetes

Most common reasons in grants

  1. Current diagnosis established15
  2. Service connection established15
  3. Caused by the service-connected disability14
  4. Obesity as intermediate step5
  5. No contrary medical opinion2
  6. Aggravated by the service-connected disability2

Most common reasons in denials

  1. VA examiner: less likely than not related to service18
  2. Preponderance of the evidence against the claim10
  3. No in-service complaints, treatment or diagnosis9
  4. Aggravated by the service-connected disability7
  5. Service records negative or silent7
  6. No current diagnosis3
  7. No continuity of symptomatology3
  8. Caused by the service-connected disability2

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 diabetes decisions

Granted

Citation Nr. A26036527L. Stepanick · 2026

AOJ favorably found diabetes related to service-connected acquired psychiatric disorder; Board bound by favorable AOJ finding; Criteria for service connection met

Citation Nr. A26036320J. T. Hutcheson · 2026

Private evaluation found diabetes at least as likely as not caused/aggravated by PTSD; PTSD causes neuroendocrine dysregulation and impaired glucose metabolism; Temporal relationship between PTSD and diabetes onset supports PTSD as etiological factor; Evidence in equipoise, doubt resolved in Veteran's favor

Citation Nr. A26033961Michael Martin · 2026

Evidence in relative equipoise regarding secondary service connection; Benefit of the doubt applied in Veteran's favor; Private medical opinion linked diabetes to stress eating from anxiety

Denied

Citation Nr. A26035680Marcus N. Fulton · 2026

Criteria for entitlement not met; Evidence persuasively weighs against service connection; No nexus to in-service immunizations

Citation Nr. 26001129M. Tenner · 2026

Evidence weighed against secondary service connection for diabetes due to psychiatric disability.; VA medical opinions found diabetes pathophysiologically different from psychiatric disability.; Diabetes diagnosed before significant obesity, making secondary link less likely.

Citation Nr. 26000995Thomas H. O'Shay · 2026

No evidence of diabetes in service treatment records.; Diagnosis of diabetes approximately 1.5 years after service.; VA examiner opined diabetes less likely than not due to service-connected adjustment disorder.; Examiner cited obesity and metabolic factors as primary cause of diabetes.; No direct pathophysiological link between adjustment disorder and diabetes.; Adjustment disorder did not aggravate diabetes.

Rules that apply to secondary diabetes claims

Research your diabetes case

Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.

What medical evidence wins diabetes secondary to a psychiatric disorder at the Board?Show granted decisions for diabetes secondary to a psychiatric disorder and the nexus opinions they relied on.Why does the Board deny diabetes secondary to a psychiatric disorder?
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How these numbers are calculated

  • Counts decisions in which the Board decided a diabetes issue claimed as secondary to a psychiatric disorder, 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.