Secondary service connection

Erectile dysfunction secondary to PTSD: BVA grant rates and what wins

From 2018 to 2026, the Board of Veterans' Appeals decided erectile dysfunction claimed as secondary to PTSD in 1,551 decisions. It granted the issue in 30.9% of them, above the 17.5% grant rate for all erectile dysfunction issues, denied it in 14.4%, and remanded it in 53.8%. Counting only decisions on the merits, 68.1% were granted.

Decisions

1,551

2018–2026

Granted

30.9%

All erectile dysfunction: 17.5%

Granted on the merits

68.1%

Granted ÷ (granted + denied)

Remanded

53.8%

Denied: 14.4%

See all erectile dysfunction decisions, direct and secondary.

Erectile dysfunction secondary to PTSD: outcomes by year

YearDecisionsGrantedDeniedRemanded
2018
142
25.4%19.7%52.8%
2019
191
20.9%19.4%59.2%
2020
183
28.4%15.8%55.2%
2021
122
28.7%13.9%56.6%
2022
162
32.7%11.1%54.9%
2023
161
31.1%11.2%57.8%
2024
227
32.6%12.3%54.6%
2025
268
36.9%13.1%49.3%
2026
95
42.1%14.7%40.0%

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 recordDecisionsGranted when presentWhen absentDifference
Positive nexus opinion37392.5%50.5%+42.1 pts
Treating physician opinion8391.8%66.4%+25.5 pts
Favorable VA exam24386.7%61.8%+24.9 pts
Private medical opinion46479.6%60.3%+19.4 pts
Buddy statement4280.0%67.8%+12.2 pts
Combat service20473.0%67.2%+5.7 pts
Lay statement1,14664.9%79.0%−14.1 pts
  • The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 77.9% of the decisions that granted erectile dysfunction.
  • The Board found the veteran's statements credible in 23.8% of grants and 11.6% 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 recordDecisionsGranted when presentWhen absentDifference
Negative nexus opinion1,00967.7%69.2%−1.5 pts
Unfavorable VA exam1,24866.4%77.6%−11.1 pts

Why the Board granted or denied erectile dysfunction

Most common reasons in grants

  1. Current diagnosis established77
  2. Caused by the service-connected disability61
  3. Service connection established49
  4. Aggravated by the service-connected disability12
  5. Secondary to PTSD9
  6. VA examiner: less likely than not related to service8
  7. Criteria for service connection met6
  8. Veteran diagnosed with erectile dysfunction6

Most common reasons in denials

  1. VA examiner: less likely than not related to service38
  2. No in-service complaints, treatment or diagnosis30
  3. No current diagnosis26
  4. Preponderance of the evidence against the claim19
  5. Service records negative or silent16
  6. Current diagnosis established12
  7. Service connection established5
  8. Continuity of symptomatology since service4

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

Citation Nr. A26040875Mariah N. Sim · 2026

Veteran has current diagnosis of erectile dysfunction.; VA examiner opined erectile dysfunction is secondary to PTSD.; Examiner's opinion considered claims file and medical principles.; Negative nexus opinion for TERAs does not preclude secondary service connection for PTSD.

Citation Nr. A26039734Steven D. Reiss · 2026

Veteran competent and credible to report symptoms; VA examiner's opinion unclear regarding nexus to PTSD; Board found but/for relationship met for secondary SC

Citation Nr. A26039659Michael J. Skaltsounis · 2026

Private medical opinion linked erectile dysfunction to PTSD and treatment.; Nexus established that it is at least as likely as not a result of PTSD.; Benefit of the doubt applied.

Denied

Citation Nr. A26035835Thomas H. O'Shay · 2026

No current diagnosis of ED established; Veteran confirmed no formal diagnosis at hearing; Private opinion assumed diagnosis without confirmation

Citation Nr. A26025951R. Bisignani · 2026

Evidence persuasively weighs against finding of erectile dysfunction with onset during service or relation to PTSD.; Criteria for service connection for erectile dysfunction not met.

Citation Nr. A26023670Bethany L. Buck · 2026

No current diagnosis of erectile dysfunction reflected in VA or service treatment records.; VA examiner did not diagnose erectile dysfunction.; Veteran is competent to describe symptoms but not diagnose complex conditions.

Rules that apply to secondary erectile dysfunction claims

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How these numbers are calculated

  • Counts decisions in which the Board decided a erectile dysfunction issue claimed as secondary to PTSD, 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.