Secondary service connection
Major depressive disorder secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided major depressive disorder claimed as secondary to a back condition in 855 decisions. It granted the issue in 49.2% of them, above the 35.3% grant rate for all major depressive disorder issues, denied it in 15.9%, and remanded it in 33.1%. Counting only decisions on the merits, 75.6% were granted.
Decisions
855
2017–2026
Granted
49.2%
All major depressive disorder: 35.3%
Granted on the merits
75.6%
Granted ÷ (granted + denied)
Remanded
33.1%
Denied: 15.9%
See all major depressive disorder decisions, direct and secondary.
Major depressive disorder secondary to a back condition: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2017 | 89 | 31.5% | 30.3% | 32.6% |
| 2018 | 145 | 48.3% | 17.9% | 29.7% |
| 2019 | 132 | 51.5% | 11.4% | 34.1% |
| 2020 | 96 | 49.0% | 13.5% | 36.5% |
| 2021 | 76 | 46.1% | 18.4% | 36.8% |
| 2022 | 71 | 42.3% | 15.5% | 39.4% |
| 2023 | 75 | 56.0% | 12.0% | 33.3% |
| 2024 | 84 | 56.0% | 11.9% | 33.3% |
| 2025 | 66 | 57.6% | 16.7% | 27.3% |
| 2026 | 21 | 76.2% | 0.0% | 19.0% |
Evidence in granted and denied major depressive disorder decisions
For each kind of supporting evidence: how often the Board granted the major depressive disorder 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 | 411 | 93.1% | 45.9% | +47.2 pts |
| Private medical opinion | 488 | 84.0% | 58.5% | +25.5 pts |
| Favorable VA exam | 176 | 88.8% | 70.3% | +18.5 pts |
| Treating physician opinion | 85 | 87.0% | 74.0% | +13.0 pts |
| Lay statement | 708 | 73.6% | 88.2% | −14.6 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 74.1% of the decisions that granted major depressive disorder.
- The Board found the veteran's statements credible in 24.7% of grants and 10.3% 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 major depressive disorder 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 |
|---|---|---|---|---|
| Unfavorable VA exam | 663 | 74.4% | 80.2% | −5.7 pts |
| Negative nexus opinion | 533 | 70.8% | 83.8% | −13.0 pts |
Why the Board granted or denied major depressive disorder
Most common reasons in grants
- Caused by the service-connected disability112
- Current diagnosis established38
- Service connection established38
- Aggravated by the service-connected disability23
- Criteria for service connection met7
- New and material evidence submitted5
- VA examiner: less likely than not related to service4
- Criteria for secondary service connection met3
Most common reasons in denials
- VA examiner: less likely than not related to service16
- Preponderance of the evidence against the claim14
- Service records negative or silent11
- No current diagnosis10
- No in-service complaints, treatment or diagnosis7
- Service connection established4
- Aggravated by the service-connected disability3
- Current diagnosis established3
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 major depressive disorder decisions
Granted
Private physician opinion found condition more likely than not secondary to service-connected injuries.; Evidence found to be in equipoise regarding nexus.; Benefit of the doubt resolved in Veteran's favor.
Private psychiatric opinion found depressive disorder caused/aggravated by chronic pain from service-connected conditions.; Private opinion cited medical literature and applied it to veteran's symptoms.; VA examiners' opinions were less favorable or speculative.; Presumption of sound mind at entry to service applied due to lack of pre-service psychiatric disorders.
Secondary service connection granted; Private medical opinion found persuasive; Benefit of the doubt applied
Denied
Private opinion inadequate due to inconsistencies with VA treatment records; Lack of clear rationale or review of medical history in private opinion; Veteran's assertions on etiology deemed incompetent
No current diagnosis during appeal period; Service treatment records negative; Post-service treatment records negative
Competent medical opinions indicated multiple etiologies unrelated to low back disability.; Weight of the evidence was against service connection.; Benefit of the doubt doctrine not applicable as evidence weighed against claim.
Rules that apply to secondary major depressive disorder 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 major depressive disorder 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 major depressive disorder issue claimed as secondary to a back condition, 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.