Board Decision Lookup › Alcohol or substance use disorder

How the Board ruled on alcohol and substance use disorder claims, 2021–2025

How the Board of Veterans' Appeals ruled on alcohol and substance use disorder service-connection claims in 2021–2025, for every theory and secondary pairing we publish. Board-appealed cases only, counted per claim. Last updated October 4, 2026.

These are past Board decisions, not a prediction for any individual case, and not legal advice. The percentage is among DECIDED cases; cases sent back to VA (remanded) are counted separately.

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Alcohol or substance use disorder (direct service connection)

Direct (began in or was caused by service), or theory not stated in the Board order

23% granted of 113 decided cases (margin of error 16.2–31.6%). 26 granted, 87 denied, 108 sent back to VA (remanded, not decided), 38 dismissed.

What convinced the Board in granted cases

  • The Board gave weight to private or VA opinions that reviewed the full file, considered the veteran's account, and explained with sound medical reasoning how the drinking tied to a service-related mental health condition. (5 of 9 decisions read; e.g. A24046035, A25031367, 21052985)
  • Most grants treated alcohol or substance use disorder as part of, a progression of, or a result of service-connected PTSD, depression, anxiety, or bipolar disorder, not as a stand-alone condition. (7 of 9 decisions read; e.g. A23017779, A24046035, 21041739)
  • Negative VA opinions lost weight when they relied mainly on a lack of treatment records after service, or said the impact could not be judged without explaining why. (2 of 9 decisions read, few decisions; e.g. 21056078, 21041739)

Common reasons in denied cases

  • The Board denied when a reasoned VA opinion, based on an accurate history, found the substance use began before service and was not worsened by it, or outweighed a private opinion. (3 of 9 decisions read; e.g. A25002615, 22048040, 21044616)
  • Several claims failed because no current alcohol or substance use disorder was diagnosed, and the veteran's own view was not competent to establish one. (4 of 9 decisions read; e.g. 22020024, A23026292, 22000234)
  • Alcohol or drug abuse cannot be service connected on its own on a direct basis; claims failed when it was not shown to result from a service-connected condition. (3 of 9 decisions read; e.g. 23031213, A24069118, 21044616)

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Alcohol or substance use disorder secondary to any service-connected condition

Secondary (caused or worsened by a service-connected condition)

64% granted of 89 decided cases (margin of error 53.7–73.2%). 57 granted, 32 denied, 90 sent back to VA (remanded, not decided), 5 dismissed.

What convinced the Board in granted cases

  • The Board granted when medical evidence, including treatment records or an adequate examiner opinion, showed the drinking or drug use resulted from a service-connected condition, usually PTSD or another mental condition. (5 of 10 decisions read; e.g. 24004802, 23026674, 24016644)
  • Negative VA opinions lost weight when they addressed only direct service connection, rested on speculation, or did not separate casual youthful use from later abuse. (4 of 10 decisions read; e.g. 24004802, 21033022, 23026674)
  • The veteran's credible account of when heavy drinking began, such as after returning from Vietnam, supported the claim. (2 of 10 decisions read, few decisions; e.g. 21039271, 21033022)

Common reasons in denied cases

  • The Board denied when no medical opinion linked the substance use to a service-connected condition, or a VA opinion against it went unrebutted; the veteran's belief was not competent. (6 of 12 decisions read; e.g. 21023047, 21057595, 23019010)
  • The condition the veteran blamed, usually a psychiatric disorder, was not service-connected, so a secondary claim could not succeed. (5 of 12 decisions read; e.g. 23018585, 24030128, 21024114)
  • There was no current substance use diagnosis, or the symptoms were already compensated under service-connected PTSD. (4 of 12 decisions read; e.g. A25034219, 21019199, A24060829)

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Alcohol or substance use disorder secondary to PTSD

Secondary (caused or worsened by a service-connected condition)

81.8% granted of 44 decided cases (margin of error 68.0–90.5%). 36 granted, 8 denied, 29 sent back to VA (remanded, not decided), 1 dismissed.

What convinced the Board in granted cases

  • The Board granted when a VA examiner, VA treating clinician, or private doctor explained that the veteran drank or used drugs to self-medicate or numb PTSD symptoms. (5 of 12 decisions read; e.g. 23045836, 23003993, 21070957)
  • Negative VA opinions lost weight when they used the wrong legal standard, addressed only direct service connection and not the PTSD link, or were outweighed by a private opinion. (4 of 12 decisions read; e.g. A24013050, 24004802, 23045836)
  • Credible statements from the veteran and family that he drank to cope with PTSD supported the grant. (2 of 12 decisions read, few decisions; e.g. 23057765, 24004802)

Common reasons in denied cases

  • Most denials found no current alcohol or drug use diagnosis, or no substance problem separate from symptoms already rated under the service-connected PTSD. (5 of 6 decisions read; e.g. 21019199, A24057245, A25034219)
  • The veteran's own belief about the diagnosis or its cause was not competent medical evidence. (3 of 6 decisions read; e.g. 21019199, A21004264, 23035784)

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Alcohol or substance use disorder secondary to depression / psychiatric disorder

Secondary (caused or worsened by a service-connected condition)

48.5% granted of 33 decided cases (margin of error 32.5–64.8%). 16 granted, 17 denied, 41 sent back to VA (remanded, not decided), 2 dismissed.

What convinced the Board in granted cases

  • The Board granted when medical evidence, such as a VA examiner or VA treating clinicians, linked the alcohol or drug use to the service-connected psychiatric condition, often as a way to cope with its symptoms. (6 of 8 decisions read; e.g. A23015386, 24016644, 21025341)
  • In several grants, the psychiatric condition itself was service-connected in the same decision, and the substance use claim was then granted as secondary to it. (4 of 8 decisions read; e.g. A23015386, 21037473, A24070205)
  • Negative VA opinions lost weight when the examiner ignored the veteran's own reports or symptom history, or relied mainly on missing treatment records. (2 of 8 decisions read, few decisions; e.g. 23001991, 24018409)

Common reasons in denied cases

  • The Board denied when VA medical opinions found no link to the psychiatric condition, sometimes pointing to another cause such as drinking that began in adolescence or no evidence of self-medicating. (5 of 10 decisions read; e.g. 21052685, 22010182, 21057595)
  • The veteran's own belief that the psychiatric condition caused the drinking or drug use was not competent medical evidence, and in one case his statements were found inconsistent and not credible. (4 of 10 decisions read; e.g. 21052685, 22010182, 21057595)
  • Secondary service connection failed because the veteran was not service-connected for any psychiatric condition. (4 of 10 decisions read; e.g. 21023047, 21024114, 21066493)

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Other conditions

Percentages are shown only for combinations with at least 30 decided cases (granted + denied). Named secondary pairings with 10–29 decided cases are listed as "small sample" with counts only. "ANY service-connected condition (all combined)" pools every secondary claim for that condition. Other combinations exist, but there are too few decided cases to report. Each claim is counted by the Board's ruling on that specific claim (a decision covering several issues is split by issue). Remanded = sent back to VA for more work, not decided. "What convinced the Board" summarizes a reading of up to 25 granted and 25 denied Board decisions for each claim type, with the decision numbers shown so any point can be checked. Board-appealed cases only, not regional-office decisions. Information only, not legal advice. Flat Rate Nexus is a private medical practice, not affiliated with the VA.

Source: Board of Veterans' Appeals decisions, 2021–2025. Last updated October 4, 2026. flatratenexus.com · Privacy · Terms