Secondary service connection
Kidney disease secondary to diabetes: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided kidney disease claimed as secondary to diabetes in 907 decisions. It granted the issue in 26.5% of them, above the 17.6% grant rate for all kidney disease issues, denied it in 24.1%, and remanded it in 48.7%. Counting only decisions on the merits, 52.3% were granted.
Decisions
907
2017–2026
Granted
26.5%
All kidney disease: 17.6%
Granted on the merits
52.3%
Granted ÷ (granted + denied)
Remanded
48.7%
Denied: 24.1%
See all kidney disease decisions, direct and secondary.
Kidney disease secondary to diabetes: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2017 | 67 | 16.4% | 35.8% | 47.8% |
| 2018 | 87 | 27.6% | 25.3% | 47.1% |
| 2019 | 125 | 25.6% | 24.0% | 49.6% |
| 2020 | 114 | 16.7% | 27.2% | 55.3% |
| 2021 | 118 | 16.9% | 22.9% | 58.5% |
| 2022 | 104 | 26.0% | 24.0% | 50.0% |
| 2023 | 105 | 37.1% | 22.9% | 40.0% |
| 2024 | 89 | 41.6% | 21.3% | 37.1% |
| 2025 | 70 | 31.4% | 14.3% | 51.4% |
| 2026 | 28 | 32.1% | 25.0% | 42.9% |
Evidence in granted and denied kidney disease decisions
For each kind of supporting evidence: how often the Board granted the kidney disease 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 | 193 | 86.3% | 36.4% | +49.9 pts |
| Favorable VA exam | 150 | 73.8% | 44.5% | +29.3 pts |
| Treating physician opinion | 67 | 75.5% | 49.5% | +26.0 pts |
| Private medical opinion | 327 | 60.5% | 45.1% | +15.4 pts |
| Combat service | 56 | 65.6% | 51.3% | +14.3 pts |
| Lay statement | 630 | 45.6% | 71.4% | −25.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 68.3% of the decisions that granted kidney disease.
- The Board found the veteran's statements credible in 26.7% of grants and 9.6% 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 kidney disease 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 | 435 | 47.7% | 57.1% | −9.5 pts |
| Unfavorable VA exam | 598 | 49.2% | 59.6% | −10.3 pts |
Why the Board granted or denied kidney disease
Most common reasons in grants
- Caused by the service-connected disability51
- Current diagnosis established41
- Service connection established26
- Criteria for service connection met4
- Aggravated by the service-connected disability4
- Service connection granted on a secondary basis3
- Veteran diagnosed with chronic kidney disease3
- New and relevant evidence submitted after prior denial2
Most common reasons in denials
- No current diagnosis26
- Preponderance of the evidence against the claim23
- Service records negative or silent18
- No in-service complaints, treatment or diagnosis15
- Service connection established7
- Service connection for diabetes mellitus denied6
- Caused by the service-connected disability6
- VA examiner: less likely than not related to service6
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 kidney disease decisions
Granted
Multiple opinions relate kidney disease to DMII and hypertension.; November 2023, June 2024, and August 2025 VA examiners opined kidney disease is secondary to DMII.; January 2026 VA examination noted hypertension and renal disease are complications of DMII.
Current diagnosis of nephropathy established; Conflicting medical evidence on nexus to diabetes; Evidence in equipoise regarding causation by diabetes; Benefit of the doubt applied for grant
Diagnosis of diabetic nephropathy; Secondary to service-connected diabetes mellitus type 2
Denied
Service connection for primary condition (diabetes mellitus) denied; Cannot establish secondary condition without primary condition service connection
No current diagnosis of kidney disorder; STRs silent for kidney complaints; Veteran denied kidney trouble at separation
Service treatment records negative for kidney disorder.; Post-service diagnosis in 2001, outside presumptive period.; VA opinions found no nexus to service or hypertension.
Rules that apply to secondary kidney disease 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 kidney disease 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 kidney disease issue claimed as secondary to diabetes, 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.