Secondary service connection
Conditions secondary to hypertension
Veterans with service-connected hypertension often claim other conditions as caused or worsened by it. This page lists those conditions, what VA needs to grant them, and how they fared when veterans appealed to the Board of Veterans' Appeals.
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of the secondary condition.
- Hypertension is already service connected.
- Medical evidence linking them (a nexus opinion): the secondary condition was caused by hypertension (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
Conditions claimed secondary to hypertension
Conditions the Board decided at least 300 times as secondary to this disability, highest appeal grant rate first. Open one for the evidence and reasons behind the decisions.
- Kidney disease secondary to hypertension528 decisions · 37.1% granted
- Erectile dysfunction secondary to hypertension648 decisions · 36.7% granted
- Migraine secondary to hypertension346 decisions · 23.7% granted
- Sleep apnea secondary to hypertension692 decisions · 14.6% granted
- Diabetes mellitus secondary to hypertension467 decisions · 14.6% granted
Hypertension claimed secondary to other conditions
The other direction: hypertension claimed as caused or worsened by a different service-connected disability.
- Hypertension secondary to sleep apnea511 decisions · 25.4% granted
- Hypertension secondary to a psychiatric disorder1,487 decisions · 20.1% granted
- Hypertension secondary to a back condition330 decisions · 20.0% granted
- Hypertension secondary to PTSD3,194 decisions · 16.5% granted
- Hypertension secondary to diabetes2,809 decisions · 15.2% granted
All Board decisions on hypertension, direct and secondary: Hypertension grant rates.
Rules that apply to secondary 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 - 38 CFR 4.104 · DC 7101
Schedule of ratings: cardiovascular system
Read it in VA Law Explorer - M21-1 V.iii.5.3
Hypertension: definitions, blood pressure readings required, predominant blood pressure
Read it in VA Law Explorer - M21-1 V.iii.11.2.e
When hypertension is or is not a complication of diabetes
Read it in VA Law Explorer
Research your secondary case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.