Elbow conditions secondary to shoulder conditions

In the Board decisions we have indexed since 2019, elbow conditions appeared as secondary to shoulder conditions in 69 issues. The Board granted 4, denied 19, and sent 45 back for more work. Of the ones it decided, it granted 17 percent.

Every decision counted here is an appeal. The regional office decided the claim first, the veteran disagreed, and the Board is the next step after that. These are not the odds on a first claim.

Since 2019

1 ended some other way, or we could not read the outcome.

Across every year we have indexed, that is 185 issues, 15 percent granted of the ones decided, and 58 percent sent back for more work.

What a secondary claim needs

In a secondary claim, the Board reads for three things. A diagnosis of the second condition. A first condition that is already service connected. And a medical opinion that says the first condition led to the second, or made it worse, and explains why. The rule itself is shorter than that. Here is the part that matters.

… disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.

38 CFR 3.310(a), from the middle of its first sentence

Proximately due to means the first condition led to the second. The other route is aggravation, where the first condition made the second worse. The rule for that route is in the next paragraph of the same section, and it says increase in severity.

Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.

38 CFR 3.310(b), first sentence

That paragraph goes on to say the VA will not concede aggravation without a baseline. A baseline is medical evidence of how bad the second condition was before the first one started making it worse, or the earliest record after that and before the evidence of how bad it is now. If you claim aggravation, find the earliest record you have of the second condition, from either window. Without a baseline from one of them, the VA will not concede aggravation. The other route, that the first condition led to the second, does not need a baseline.

A remand is not a yes or a no. The Board sends the claim back to the regional office for more work, such as a new exam or a record that was not in the file. The claim is decided again later, and that later decision is a separate document.

Recent decisions on these claims

• January 23, 2025Denied

  Entitlement to service connection for left elbow disability, including as secondary to service-connected left shoulder strain

  Read the decision at VA.gov
• April 26, 2024Denied

  Entitlement to service connection for a right elbow condition, to include as secondary to the Veteran's shoulder disabilities

  Read the decision at VA.gov
• February 21, 2024Granted

  Entitlement to service connection for left elbow medial epicondylitis, to include as secondary to right shoulder impingement

  Read the decision at VA.gov
• September 15, 2017Granted

  Entitlement to service connection for a neurological disability affecting the left elbow and hand, to include as secondary to his service-connected left shoulder disability.

  Read the decision at VA.gov
• March 28, 2017Granted

  Entitlement to service connection for a bilateral elbow disability, to include as secondary to the service-connected bilateral shoulder disability.

  Read the decision at VA.gov