Hand Wrist: what evidence wins at the Board

For hand wrist appeals, how often the Board granted the issue when the record held each kind of evidence, and how often when it did not. Measured from the decisions themselves; every number carries its fraction.

What this is computed from: evidence types detected in the full text of 1,907,778 public Board of Veterans' Appeals decisions (va.gov/vetapp), joined to the issue-level outcome. The tables use only single-issue decisions with a clean parse in complete crawl years (1993–2025) — 852,152 decisions — so each evidence flag attaches to exactly one decided issue. A split is shown only when both sides have at least 30 decisions. Data build: 2026-09-02.

Service connection for Hand Wrist (n = 4,508)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record59% (220/371)32% (883/2,721)+27 pts14% (63/436)
Private physician opinion, letter or DBQEvidence in the record41% (209/516)35% (894/2,576)+6 pts12% (72/598)
Disability Benefits Questionnaire in the recordEvidence in the record36% (42/117)36% (1,061/2,975)+0 pts38% (73/191)
Third-party lay statements (spouse, buddy, employer)Evidence in the record38% (89/232)35% (1,014/2,860)+3 pts13% (35/271)
Service treatment records document the condition or injuryEvidence in the record33% (552/1,664)39% (551/1,428)-5 pts13% (264/1,960)
Service treatment records silent for the conditionEvidence in the record22% (272/1,223)44% (831/1,869)-22 pts8% (114/1,357)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued30% (383/1,268)39% (720/1,824)-9 pts7% (91/1,365)
Board hearing held or testimony takenProcedure37% (581/1,552)34% (522/1,540)+4 pts21% (450/2,096)
Social Security records in the fileEvidence in the record25% (28/113)36% (1,075/2,979)-11 pts11% (14/131)
Medical literature or treatise citedEvidence in the record29% (93/321)36% (1,010/2,771)-7 pts33% (158/479)
Functional loss / DeLuca factors argued (rating cases)Theory argued33% (132/403)36% (971/2,689)-3 pts18% (87/496)
Presumptive service connection discussedTheory argued26% (357/1,391)44% (746/1,701)-18 pts7% (105/1,507)
Secondary service connection (38 CFR 3.310) in playTheory argued31% (332/1,056)38% (771/2,036)-6 pts24% (340/1,431)
Combat service / 1154(b) in playTheory argued35% (101/286)36% (1,002/2,806)-0 pts14% (50/345)
A medical source gave a negative nexus opinionEvidence in the record34% (469/1,362)37% (634/1,730)-2 pts27% (517/1,888)
No nexus opinion of recordEvidence in the record11% (25/220)38% (1,078/2,872)-26 pts6% (13/234)
VA examination or VA medical opinion obtainedEvidence in the record35% (929/2,676)42% (174/416)-7 pts26% (982/3,724)
Board found a VA exam or opinion inadequateHow the Board read the record42% (283/667)34% (820/2,425)+9 pts45% (564/1,247)
Board found the VA exam or opinion adequateHow the Board read the record10% (24/238)38% (1,079/2,854)-28 pts2% (5/244)
Board found the veteran's statements credibleHow the Board read the record68% (248/363)31% (855/2,729)+37 pts5% (21/385)
Board found the veteran's statements not credible or inconsistentHow the Board read the record3% (4/125)37% (1,099/2,967)-34 pts3% (4/129)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record88% (484/550)24% (619/2,542)+64 pts1% (8/559)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record3% (37/1,337)61% (1,066/1,755)-58 pts0% (3/1,343)
Duty-to-assist error foundHow the Board read the record42% (17/40)36% (1,086/3,052)+7 pts84% (221/264)
Board ordered a new exam or addendum opinionProcedure36% (177/494)36% (926/2,598)+0 pts65% (978/1,509)
AMA favorable finding acknowledgedProcedure61% (62/102)35% (1,041/2,990)+26 pts41% (71/173)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

Increased rating for Hand Wrist (n = 3,047)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record18% (8/44)15% (353/2,328)+3 pts10% (5/51)
Private physician opinion, letter or DBQEvidence in the record18% (29/162)15% (332/2,210)+3 pts7% (12/177)
Disability Benefits Questionnaire in the recordEvidence in the record17% (13/76)15% (348/2,296)+2 pts44% (60/136)
Third-party lay statements (spouse, buddy, employer)Evidence in the record14% (7/51)15% (354/2,321)-2 pts8% (5/60)
Service treatment records document the condition or injuryEvidence in the record14% (85/615)16% (276/1,757)-2 pts2% (15/642)
Service treatment records silent for the conditionEvidence in the record10% (8/80)15% (353/2,292)-5 pts3% (3/88)
Board hearing held or testimony takenProcedure16% (166/1,012)14% (195/1,360)+2 pts18% (228/1,289)
Social Security records in the fileEvidence in the record12% (9/75)15% (352/2,297)-3 pts7% (6/84)
Functional loss / DeLuca factors argued (rating cases)Theory argued14% (275/1,938)20% (86/434)-6 pts14% (307/2,252)
Presumptive service connection discussedTheory argued9% (3/33)15% (358/2,339)-6 pts5% (2/41)
Secondary service connection (38 CFR 3.310) in playTheory argued14% (78/543)15% (283/1,829)-1 pts7% (42/603)
Combat service / 1154(b) in playTheory argued20% (9/46)15% (352/2,326)+4 pts9% (5/57)
A medical source gave a negative nexus opinionEvidence in the record10% (18/181)16% (343/2,191)-6 pts11% (24/213)
VA examination or VA medical opinion obtainedEvidence in the record15% (348/2,254)11% (13/118)+4 pts17% (464/2,753)
Board found a VA exam or opinion inadequateHow the Board read the record12% (31/258)16% (330/2,114)-4 pts39% (170/434)
Board found the VA exam or opinion adequateHow the Board read the record12% (30/248)16% (331/2,124)-3 pts0% (0/248)
Board found the veteran's statements credibleHow the Board read the record23% (17/75)15% (344/2,297)+8 pts7% (6/82)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record59% (86/145)12% (275/2,227)+47 pts2% (3/149)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record5% (62/1,350)29% (299/1,022)-25 pts0% (0/1,356)
Board ordered a new exam or addendum opinionProcedure14% (38/270)15% (323/2,102)-1 pts59% (430/727)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

All Hand Wrist issues, every benefit type (n = 15,558)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record55% (254/464)30% (2,051/6,873)+25 pts19% (112/581)
Private physician opinion, letter or DBQEvidence in the record37% (325/868)31% (1,980/6,469)+7 pts23% (263/1,146)
Disability Benefits Questionnaire in the recordEvidence in the record33% (81/249)31% (2,224/7,088)+1 pts41% (171/421)
Third-party lay statements (spouse, buddy, employer)Evidence in the record36% (115/321)31% (2,190/7,016)+5 pts23% (96/426)
Service treatment records document the condition or injuryEvidence in the record31% (814/2,649)32% (1,491/4,688)-1 pts17% (540/3,240)
Service treatment records silent for the conditionEvidence in the record22% (301/1,365)34% (2,004/5,972)-12 pts12% (195/1,586)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued30% (398/1,325)32% (1,907/6,012)-2 pts8% (118/1,457)
Board hearing held or testimony takenProcedure34% (1,153/3,408)29% (1,152/3,929)+5 pts48% (3,318/6,916)
Social Security records in the fileEvidence in the record24% (60/255)32% (2,245/7,082)-8 pts51% (277/543)
Vocational expert or assessmentEvidence in the record35% (53/153)31% (2,252/7,184)+3 pts43% (117/271)
Medical literature or treatise citedEvidence in the record28% (111/397)32% (2,194/6,940)-4 pts41% (271/668)
Functional loss / DeLuca factors argued (rating cases)Theory argued28% (907/3,232)34% (1,398/4,105)-6 pts24% (1,001/4,249)
Presumptive service connection discussedTheory argued26% (376/1,462)33% (1,929/5,875)-7 pts15% (260/1,742)
Secondary service connection (38 CFR 3.310) in playTheory argued29% (579/1,981)32% (1,726/5,356)-3 pts40% (1,345/3,388)
Combat service / 1154(b) in playTheory argued34% (127/378)31% (2,178/6,959)+2 pts39% (251/650)
A medical source gave a negative nexus opinionEvidence in the record31% (549/1,745)31% (1,756/5,592)+0 pts27% (662/2,429)
No nexus opinion of recordEvidence in the record11% (30/263)32% (2,275/7,074)-21 pts16% (50/315)
VA examination or VA medical opinion obtainedEvidence in the record31% (1,992/6,462)36% (313/875)-5 pts37% (3,849/10,430)
Board found a VA exam or opinion inadequateHow the Board read the record35% (382/1,085)31% (1,923/6,252)+4 pts54% (1,316/2,425)
Board found the VA exam or opinion adequateHow the Board read the record19% (116/600)32% (2,189/6,737)-13 pts3% (18/619)
Board found the veteran's statements credibleHow the Board read the record62% (330/529)29% (1,975/6,808)+33 pts6% (34/565)
Board found the veteran's statements not credible or inconsistentHow the Board read the record4% (6/158)32% (2,299/7,179)-28 pts6% (10/168)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record84% (766/915)24% (1,539/6,422)+60 pts3% (29/946)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record6% (208/3,311)52% (2,097/4,026)-46 pts0% (12/3,334)
Duty-to-assist error foundHow the Board read the record27% (26/95)31% (2,279/7,242)-4 pts77% (327/426)
Board ordered a new exam or addendum opinionProcedure31% (289/935)31% (2,016/6,402)-1 pts77% (3,410/4,418)
AMA favorable finding acknowledgedProcedure61% (72/118)31% (2,233/7,219)+30 pts40% (78/197)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

Reading these tables honestly

Association, not cause. A positive nexus opinion appears in the records of granted appeals far more often than in denied ones. That does not mean any letter wins; it means the Board grants when the evidence supports the claim, and a nexus opinion is how that support usually reaches the file.

Appeals are not claims. Every decision here is an appealed denial. Grant rates at the Board say nothing about the share of initial claims VA grants.

Findings are outcomes in disguise. Rows under "how the Board read the record" — credibility, benefit of the doubt, an inadequate exam — describe how the judge decided, not evidence to gather. They are shown because they say which arguments the Board actually reaches for.

Detection is by text pattern. Each evidence type is found by reading the decision for finding-shaped language with negation handling; precision was read on samples before publication and is stated per feature in the method notes below. Expect a few percent of misclassified rows, not zero.

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See also: all conditions · outcome rates.