Secondary service connection
Erectile dysfunction secondary to hypertension: BVA grant rates and what wins
From 2018 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to hypertension in 655 decisions. It granted the issue in 37.3% of them, above the 17.5% grant rate for all erectile dysfunction issues, denied it in 16.5%, and remanded it in 45.5%. Counting only decisions on the merits, 69.3% were granted.
Decisions
655
2018–2026
Granted
37.3%
All erectile dysfunction: 17.5%
Granted on the merits
69.3%
Granted ÷ (granted + denied)
Remanded
45.5%
Denied: 16.5%
See all erectile dysfunction decisions, direct and secondary.
Erectile dysfunction secondary to hypertension: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2018 | 65 | 23.1% | 20.0% | 53.8% |
| 2019 | 64 | 23.4% | 12.5% | 64.1% |
| 2020 | 73 | 28.8% | 30.1% | 41.1% |
| 2021 | 75 | 32.0% | 22.7% | 44.0% |
| 2022 | 66 | 33.3% | 15.2% | 51.5% |
| 2023 | 98 | 39.8% | 13.3% | 45.9% |
| 2024 | 80 | 45.0% | 16.3% | 37.5% |
| 2025 | 99 | 50.5% | 9.1% | 40.4% |
| 2026 | 35 | 62.9% | 8.6% | 28.6% |
Evidence in granted and denied erectile dysfunction decisions
For each kind of supporting evidence: how often the Board granted the erectile dysfunction 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 | 167 | 92.1% | 54.2% | +37.9 pts |
| Favorable VA exam | 110 | 91.2% | 61.7% | +29.5 pts |
| Private medical opinion | 220 | 78.1% | 63.1% | +15.0 pts |
| Lay statement | 469 | 63.5% | 84.0% | −20.5 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 71.7% of the decisions that granted erectile dysfunction.
- The Board found the veteran's statements credible in 17.6% of grants and 11.1% 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 erectile dysfunction 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 | 437 | 68.6% | 70.9% | −2.3 pts |
| Unfavorable VA exam | 524 | 67.6% | 78.6% | −11.0 pts |
Why the Board granted or denied erectile dysfunction
Most common reasons in grants
- Caused by the service-connected disability56
- Current diagnosis established48
- Service connection established33
- Erectile dysfunction diagnosed4
- Criteria for secondary service connection met4
- Service connection for hypertension granted4
- Erectile dysfunction linked to service-connected hypertension3
- Evidence evenly balanced3
Most common reasons in denials
- No in-service complaints, treatment or diagnosis15
- Hypertension not service-connected12
- VA examiner: less likely than not related to service11
- No current diagnosis7
- Preponderance of the evidence against the claim7
- Service records negative or silent5
- Current diagnosis established4
- Service connection for hypertension denied4
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 erectile dysfunction decisions
Granted
Evidence weighed in favor of claim; Private physician opinion found probative; ED caused by medication for service-connected hypertension
Current diagnosis of erectile dysfunction established by treatment records and prescription of Sildenafil.; Veteran is service-connected for hypertension.; Evidence regarding causation/aggravation by hypertension was in approximate balance, leading to benefit of the doubt grant.
Erectile dysfunction is etiologically related to hypertension; Hypertension is service-connected; Board resolves doubt in Veteran's favor to establish nexus
Denied
Lay statements suggested medication-induced connection; Treatment records lacked notation of connection; VA examiner opined no causation/aggravation from service-connected conditions or medications
Probative evidence favors finding erectile dysfunction did not begin during service.; No competent indication of in-service nexus.; Claim denied as secondary to hypertension, which was not service-connected.
No in-service complaints or diagnosis of erectile dysfunction.; VA examiner provided negative opinion for direct and secondary service connection.; Erectile dysfunction attributed to hypertension medications, which were not service-connected.; Lack of competent evidence linking erectile dysfunction to service or service-connected condition.
Rules that apply to secondary erectile dysfunction 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 erectile dysfunction 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 erectile dysfunction issue claimed as secondary to hypertension, 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 (2018–2026) and can contain errors. It is updated automatically as new decisions are added.