[VA Disability](https://research.superinsight.me/research/va) / thread # What BVA decisions deal with secondary service connection? 8/14/2026 Question What BVA decisions deal with secondary service connection? Answer #### Direct answer None of the numbered sources provided are Board of Veterans' Appeals (BVA) decisions. The sources consist exclusively of regulatory text from 38 C.F.R. Part 3 and Part 4. Accordingly, no specific BVA decisions can be identified or cited from this source set. The source that directly governs secondary service connection is **38 C.F.R. § 3.310**, which sets out the regulatory framework but is a rule, not an adjudicative decision [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310). #### Analysis The governing regulation, § 3.310, establishes two principal pathways for secondary service connection: 1. **Proximate result / causation** — "Disability which is proximately due to or the result of a service-connected disease or injury shall be service connected." When granted, "the secondary condition shall be considered a part of the original condition." [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310) 1. **Aggravation of a nonservice-connected condition** — "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." The regulation further requires establishment of a baseline severity level before VA will concede aggravation [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310). The regulation also contains specific presumptive secondary-connection provisions: - **Cardiovascular disease** following service-connected lower-extremity amputation at or above the knee (unilateral) or at or above the ankles (bilateral) [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310). - **Traumatic brain injury** — listed conditions held to be the proximate result of a service-connected TBI [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310). Other sources in the set address related service-connection doctrines but are not BVA decisions and do not specifically address secondary service connection: - § 3.303 (general principles of service connection) [\[3\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.303) - § 3.304 (direct service connection, presumption of soundness) [\[4\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.304) - § 3.306 (aggravation of preservice disability — in-service aggravation, not secondary) [\[22\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.306) - § 3.361 (38 U.S.C. 1151 claims for additional disability due to VA treatment) [\[20\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-for-special-purposes#3.361) #### Key points - The provided source set contains **no BVA decisions**; it contains only 38 C.F.R. regulatory provisions [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310)–[\[28\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.320a). - The operative regulation for secondary service connection is **38 C.F.R. § 3.310(a)** (proximate causation) and **§ 3.310(b)** (aggravation with baseline severity requirement) [\[1\]](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310). - Special presumptive secondary rules exist for cardiovascular disease after amputation [1, § 3.310(c)] and for conditions secondary to service-connected TBI [1, § 3.310(d)]. If you need actual BVA precedent decisions (e.g., citations to specific docket numbers), those would require sources beyond what is provided here. You may wish to submit a follow-up query with BVA decisions or case law included in the source list. This answer draws on the most relevant sources found. Ask a follow-up to dig deeper into any point. #### Pinned citations [1] [§ 3.310 — Disabilities that are proximately due to, or aggravated by, service-connected disease or injury](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.310) 38 C.F.R. § 3.310 [3] [§ 3.303 — Principles relating to service connection](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.303) 38 C.F.R. § 3.303 [4] [§ 3.304 — Direct service connection; wartime and peacetime](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.304) 38 C.F.R. § 3.304 [20] [§ 3.361 — Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical or surgical treatment, examination, training and rehabilitation services, or compensated work therapy program](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-for-special-purposes#3.361) 38 C.F.R. § 3.361 [22] [§ 3.306 — Aggravation of preservice disability](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.306) 38 C.F.R. § 3.306 [28] [§ 3.320a — Presumptive service connection for bladder, ureter, and related genitourinary cancers](https://lib.superinsight.me/v/2026-07-28/va/adjudication/ratings-and-evaluations-service-connection#3.320a) 38 C.F.R. § 3.320a This is a research tool for legal and medical professionals. 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