How the Board ruled on bladder and urinary claims, 2021–2025

Bladder / urinary condition (direct service connection)

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

29.4% granted of 398 decided cases (margin of error 25.1–34.1%). 117 granted, 281 denied, 665 sent back to VA (remanded, not decided), 123 dismissed.

What convinced the Board in granted cases

• The Board granted when a negative VA opinion missed in-service records of urinary symptoms, ignored the veteran's statements, or contradicted itself, while a favorable opinion rested on an accurate history and clear reasoning. (5 of 9 decisions read; e.g. A25018787, 21015114, 23000406)
• Service records showing urinary problems, or credible statements from the veteran and spouse that symptoms began in service (for example after hernia surgery) and continued, supported the claim. (4 of 9 decisions read; e.g. A21005089, 23000406, A24011174)
• For bladder cancer, grants followed once herbicide exposure was found through credible testimony, with the Board noting the later addition of bladder cancer to the herbicide list as evidence of a link. (2 of 9 decisions read, few decisions; e.g. 21033948, A24020451)

Common reasons in denied cases

• The Board denied when a VA opinion gave clear reasons against a link, covering both cause and worsening or pointing to other causes like smoking, and any supporting opinion lacked a rationale. (5 of 11 decisions read; e.g. 21032680, A21009016, 21031960)
• The only link offered was the veteran's own belief about the cause of the urinary symptoms, which the Board did not accept as competent medical evidence. (5 of 11 decisions read; e.g. A25009259, 21032680, A23017593)
• Other claims failed because there was no current bladder or urinary diagnosis, or no event, injury, or symptoms in service. (5 of 11 decisions read; e.g. A25035157, A25006637, 21054732)

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Bladder / urinary condition secondary to any service-connected condition

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

48.5% granted of 194 decided cases (margin of error 41.5–55.4%). 94 granted, 100 denied, 248 sent back to VA (remanded, not decided), 7 dismissed.

What convinced the Board in granted cases

• The Board gave more weight to a private opinion with a complete rationale, an accurate history and, at times, cited medical literature than to VA opinions that gave little or no explanation. (3 of 12 decisions read; e.g. 22017014, 21077350, A24011557)
• The Board granted when a medical opinion, VA or private, explained how a service-connected condition such as diabetes, spinal injury, MS or Parkinson's caused the bladder problem, often through nerve damage, with no contrary opinion. (6 of 12 decisions read; e.g. 22023374, 21044706, 23010145)

Common reasons in denied cases

• The Board denied when no medical opinion linked the bladder condition to the service-connected condition and only the veteran's own statements did, which it found not competent on this medical question. (4 of 9 decisions read; e.g. A24022044, A22016582, 21041044)
• The Board denied when a thorough VA opinion that reviewed the record and literature found no link, sometimes pointing to another cause such as an enlarged prostate, and nothing rebutted it. (2 of 9 decisions read, few decisions; e.g. A25017855, 21041044)
• The Board denied when there was no diagnosed current urinary disability, or when the underlying condition the claim depended on was not itself service-connected. (3 of 9 decisions read; e.g. A25011089, A24017531, A23010830)

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Bladder / urinary condition secondary to low back (lumbar spine)

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

40% granted of 50 decided cases (margin of error 27.6–53.8%). 20 granted, 30 denied, 57 sent back to VA (remanded, not decided), 2 dismissed.

What convinced the Board in granted cases

• The Board granted on a private opinion with a thorough rationale, often explaining that nerve damage from the back condition affects bladder control, based on examining the veteran and reviewing the history. (9 of 12 decisions read; e.g. A24051052, 21077350, 23036042)
• Negative VA opinions lost weight when they did not discuss the service-connected back condition, predated the favorable evidence, or blamed a cause that came after the bladder symptoms began. (4 of 12 decisions read; e.g. A21006963, 22048411, 21000143)
• Some grants rested on an explained nerve mechanism with no negative opinion of record, or on credible lay reports of incontinence during back flare-ups. (2 of 12 decisions read, few decisions; e.g. 23010145, 21071986)

Common reasons in denied cases

• The Board denied when a thorough VA opinion, sometimes citing literature, found no nerve involvement from the back and no contrary opinion was offered. (5 of 13 decisions read; e.g. 23051680, 21041044, 21022549)
• There was no current diagnosed bladder or urinary disability, or the symptoms belonged to another condition such as an enlarged prostate. (4 of 13 decisions read; e.g. A24021210, A24021037, A25038766)
• The veteran's own belief that the back caused the bladder problem was not competent medical evidence; one veteran also missed the VA exam. (4 of 13 decisions read; e.g. 21074719, 21041044, A22020067)

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Bladder / urinary condition secondary to prostate cancer

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

Small sample: 23 decided cases, too few for a reliable percentage. 13 granted, 10 denied, 15 sent back to VA (remanded, not decided), 0 dismissed.

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Bladder / urinary condition secondary to diabetes

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

Small sample: 17 decided cases, too few for a reliable percentage. 11 granted, 6 denied, 15 sent back to VA (remanded, not decided), 0 dismissed.

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Bladder / urinary condition secondary to sleep apnea

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

Small sample: 11 decided cases, too few for a reliable percentage. 8 granted, 3 denied, 7 sent back to VA (remanded, not decided), 1 dismissed.

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Bladder / urinary condition secondary to hypertension

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

Small sample: 10 decided cases, too few for a reliable percentage. 4 granted, 6 denied, 10 sent back to VA (remanded, not decided), 0 dismissed.

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