Secondary service connection
Kidney disease secondary to hypertension: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided kidney disease claimed as secondary to hypertension in 563 decisions. It granted the issue in 37.3% of them, above the 17.6% grant rate for all kidney disease issues, denied it in 15.8%, and remanded it in 46.4%. Counting only decisions on the merits, 70.2% were granted.
Decisions
563
2017–2026
Granted
37.3%
All kidney disease: 17.6%
Granted on the merits
70.2%
Granted ÷ (granted + denied)
Remanded
46.4%
Denied: 15.8%
See all kidney disease decisions, direct and secondary.
Kidney disease secondary to hypertension: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2018 | 41 | 22.0% | 29.3% | 46.3% |
| 2019 | 49 | 22.4% | 22.4% | 55.1% |
| 2020 | 51 | 25.5% | 13.7% | 60.8% |
| 2021 | 55 | 40.0% | 10.9% | 49.1% |
| 2022 | 64 | 32.8% | 17.2% | 48.4% |
| 2023 | 78 | 42.3% | 15.4% | 41.0% |
| 2024 | 78 | 55.1% | 12.8% | 32.1% |
| 2025 | 96 | 39.6% | 14.6% | 45.8% |
| 2026 | 32 | 43.8% | 6.3% | 50.0% |
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 | 166 | 91.6% | 53.6% | +38.0 pts |
| Favorable VA exam | 93 | 90.7% | 63.4% | +27.3 pts |
| Treating physician opinion | 59 | 88.6% | 67.1% | +21.6 pts |
| Private medical opinion | 231 | 77.1% | 63.0% | +14.1 pts |
| Lay statement | 368 | 63.1% | 88.2% | −25.2 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 70.5% of the decisions that granted kidney disease.
- The Board found the veteran's statements credible in 22.4% of grants and 7.9% 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 | 339 | 66.3% | 76.8% | −10.5 pts |
| Unfavorable VA exam | 434 | 66.9% | 84.2% | −17.3 pts |
Why the Board granted or denied kidney disease
Most common reasons in grants
- Caused by the service-connected disability44
- Service connection established29
- Current diagnosis established29
- Service connection for hypertension granted6
- Chronic kidney disease diagnosed5
- Aggravated by the service-connected disability4
- Hypertension is now service-connected3
- Hypertension is service-connected2
Most common reasons in denials
- VA examiner: less likely than not related to service13
- Service records negative or silent7
- Hypertension not service-connected7
- Preponderance of the evidence against the claim7
- No current diagnosis7
- Aggravated by the service-connected disability5
- No in-service complaints, treatment or diagnosis4
- Service connection established4
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
Private cardiologist opined Fabry's disease aggravated by hypertension.; Rationale cited NIH studies supporting correlation.; Opinion found adequate and probative for secondary connection.
Secondary to hypertension; Resolved doubt in Veteran's favor; Favorable private medical opinion
Current diagnosis of chronic kidney disease established.; Service-connected hypertension established.; Medical opinion from treating nephrologist links kidney disease to hypertension.; VA examiner opinions were less probative due to speculation.; Evidence found in approximate balance, benefit of doubt applied.
Denied
No in-service diagnosis or treatment for kidney condition.; Veteran's testimony of symptoms post-service considered.; Multiple VA opinions reviewed; most afforded low probative value.; November 2025 opinion afforded high probative value, linking condition to comorbidities, not service.
Hypertension not service-connected, precluding secondary claim; No in-service complaints, treatment, or diagnosis; First evidence of condition years after service
Lack of in-service complaints or treatment for kidney disease; First diagnosis of kidney disease in 2005; VA examiner opined kidney disease less likely than not due to hypertension or TERAs; VA opinion found persuasive
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 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 (2017–2026) and can contain errors. It is updated automatically as new decisions are added.