Secondary service connection

Shoulder impairment secondary to a back condition: BVA grant rates and what wins

From 2017 to 2026, the Board of Veterans' Appeals decided shoulder impairment claimed as secondary to a back condition in 661 decisions. It granted the issue in 7.1% of them, below the 15.2% grant rate for all shoulder impairment issues, denied it in 21.8%, and remanded it in 70.8%. Counting only decisions on the merits, 24.6% were granted.

Decisions

661

2017–2026

Granted

7.1%

All shoulder impairment: 15.2%

Granted on the merits

24.6%

Granted ÷ (granted + denied)

Remanded

70.8%

Denied: 21.8%

See all shoulder impairment decisions, direct and secondary.

Shoulder impairment secondary to a back condition: outcomes by year

YearDecisionsGrantedDeniedRemanded
2017
44
4.5%34.1%59.1%
2018
52
3.8%28.8%67.3%
2019
52
0.0%17.3%82.7%
2020
86
7.0%22.1%70.9%
2021
79
1.3%21.5%77.2%
2022
89
12.4%14.6%73.0%
2023
96
9.4%21.9%67.7%
2024
81
9.9%19.8%70.4%
2025
71
9.9%22.5%67.6%

Evidence in granted and denied shoulder impairment decisions

For each kind of supporting evidence: how often the Board granted the shoulder impairment 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 opinion6375.0%16.0%+59.0 pts
Favorable VA exam5176.2%18.2%+58.0 pts
Private medical opinion15939.7%17.2%+22.5 pts
Lay statement53522.2%41.7%−19.5 pts
  • The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 76.6% of the decisions that granted shoulder impairment.
  • The Board found the veteran's statements credible in 42.6% of grants and 13.2% 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 shoulder impairment was still granted when the record contained the negative item, not that the item helped.

In the recordDecisionsGranted when presentWhen absentDifference
Negative nexus opinion44421.1%36.4%−15.3 pts
Unfavorable VA exam53321.6%45.8%−24.3 pts

Why the Board granted or denied shoulder impairment

Most common reasons in grants

  1. Caused by the service-connected disability6
  2. Current diagnosis established5
  3. Service connection established5
  4. Aggravated by the service-connected disability3
  5. Favorable finding of current left shoulder disability3
  6. VA opinion inadequate for failing to address lay statements, conflicting evidence, aggravation, and rationale2
  7. VA examiner: less likely than not related to service2

Most common reasons in denials

  1. No in-service complaints, treatment or diagnosis37
  2. VA examiner: less likely than not related to service25
  3. Service records negative or silent16
  4. Preponderance of the evidence against the claim14
  5. No current diagnosis12
  6. Aggravated by the service-connected disability12
  7. Current diagnosis established6
  8. Continuity of symptomatology since service3

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 shoulder impairment decisions

Granted

Citation Nr. 26000561Ryan T. Kessel · 2026

Aggravated by service-connected lumbar spine and lower extremity conditions; Use of a cane necessitated by service-connected conditions; Service connection granted

Citation Nr. A25107163Gayle Strommen · 2025

Current left shoulder disability diagnosed as degenerative arthritis with impingement syndrome.; Aggravated by service-connected lumbar disability due to sleeping position.; VA examiner's opinion inadequate for failing to address aggravation.

Citation Nr. A25101754T. Raymond · 2025

Favorable finding of current right shoulder disability.; Favorable finding of service-connected lumbosacral strain.; VA examiner opined disability was at least as likely as not related to service-connected lumbosacral strain.; Benefit of the doubt resolved in Veteran's favor.

Denied

Citation Nr. 26004509Eric S. Leboff · 2026

No in-service complaints or diagnoses for left shoulder disability.; No medical opinion linking current disability to service or service-connected lumbosacral strain.; Veteran's lay statement regarding onset outweighed by lack of medical evidence.

Citation Nr. 26004050H. Seesel · 2026

Claim for left shoulder condition is secondary to claimed back disability.; Service connection for back disability was denied.; No primary disability exists to support secondary service connection.

Citation Nr. 26000715Laura E. Collins · 2026

No competent or probative nexus evidence; No approximate balance of evidence; Claim denied

Rules that apply to secondary shoulder impairment claims

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How these numbers are calculated

  • Counts decisions in which the Board decided a shoulder impairment 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.