PTSD: what evidence wins at the Board

For ptsd 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 PTSD (n = 22,554)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record76% (2,050/2,700)46% (3,870/8,430)+30 pts22% (754/3,473)
Private physician opinion, letter or DBQEvidence in the record71% (2,290/3,228)46% (3,630/7,902)+25 pts25% (1,057/4,307)
Disability Benefits Questionnaire in the recordEvidence in the record69% (843/1,220)51% (5,077/9,910)+18 pts39% (798/2,022)
Third-party lay statements (spouse, buddy, employer)Evidence in the record56% (748/1,343)53% (5,172/9,787)+3 pts30% (588/1,937)
Service treatment records document the condition or injuryEvidence in the record45% (1,190/2,638)56% (4,730/8,492)-11 pts33% (1,292/3,958)
Service treatment records silent for the conditionEvidence in the record32% (1,231/3,836)64% (4,689/7,294)-32 pts17% (791/4,666)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued31% (481/1,536)57% (5,439/9,594)-25 pts22% (442/2,000)
Board hearing held or testimony takenProcedure53% (2,593/4,897)53% (3,327/6,233)-0 pts43% (3,889/9,114)
Social Security records in the fileEvidence in the record29% (137/477)54% (5,783/10,653)-26 pts48% (439/921)
Vocational expert or assessmentEvidence in the record19% (11/58)53% (5,909/11,072)-34 pts22% (17/76)
Medical literature or treatise citedEvidence in the record64% (1,198/1,871)51% (4,722/9,259)+13 pts44% (1,453/3,332)
Functional loss / DeLuca factors argued (rating cases)Theory argued47% (84/177)53% (5,836/10,953)-6 pts39% (117/299)
Presumptive service connection discussedTheory argued32% (717/2,258)59% (5,203/8,872)-27 pts26% (799/3,086)
Secondary service connection (38 CFR 3.310) in playTheory argued55% (2,404/4,395)52% (3,516/6,735)+2 pts44% (3,661/8,275)
Combat service / 1154(b) in playTheory argued46% (2,384/5,229)60% (3,536/5,901)-14 pts21% (1,376/6,666)
Military sexual trauma / personal assault claimTheory argued59% (1,317/2,217)52% (4,603/8,913)+8 pts39% (1,446/3,709)
A medical source gave a negative nexus opinionEvidence in the record57% (2,789/4,928)50% (3,131/6,202)+6 pts40% (3,367/8,325)
No nexus opinion of recordEvidence in the record14% (59/412)55% (5,861/10,718)-40 pts29% (170/585)
VA examination or VA medical opinion obtainedEvidence in the record52% (4,890/9,322)57% (1,030/1,808)-5 pts47% (8,461/17,934)
Board found a VA exam or opinion inadequateHow the Board read the record58% (1,499/2,582)52% (4,421/8,548)+6 pts62% (4,329/6,929)
Board found the VA exam or opinion adequateHow the Board read the record50% (275/548)53% (5,645/10,582)-3 pts8% (48/600)
Board found the veteran's statements credibleHow the Board read the record79% (1,346/1,705)49% (4,574/9,425)+30 pts7% (133/1,845)
Board found the veteran's statements not credible or inconsistentHow the Board read the record8% (43/538)55% (5,877/10,592)-47 pts8% (45/584)
PTSD stressor corroborated, verified or concededHow the Board read the record73% (574/788)52% (5,346/10,342)+21 pts24% (243/1,033)
PTSD stressor not corroboratedHow the Board read the record20% (209/1,032)57% (5,711/10,098)-36 pts16% (205/1,243)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record95% (2,845/2,994)38% (3,075/8,136)+57 pts2% (46/3,053)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record6% (226/3,915)79% (5,694/7,215)-73 pts0% (11/3,947)
Duty-to-assist error foundHow the Board read the record67% (159/238)53% (5,761/10,892)+14 pts90% (2,223/2,479)
Board ordered a new exam or addendum opinionProcedure32% (233/736)55% (5,687/10,394)-23 pts92% (8,135/8,888)
AMA favorable finding acknowledgedProcedure79% (1,167/1,479)49% (4,753/9,651)+30 pts36% (834/2,327)

"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 PTSD (n = 8,224)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record47% (45/95)35% (1,737/4,947)+12 pts10% (11/111)
Private physician opinion, letter or DBQEvidence in the record42% (354/834)34% (1,428/4,208)+9 pts9% (88/936)
Disability Benefits Questionnaire in the recordEvidence in the record39% (254/644)35% (1,528/4,398)+5 pts25% (213/862)
Third-party lay statements (spouse, buddy, employer)Evidence in the record42% (150/361)35% (1,632/4,681)+7 pts10% (39/402)
Service treatment records document the condition or injuryEvidence in the record47% (77/165)35% (1,705/4,877)+12 pts22% (51/227)
Service treatment records silent for the conditionEvidence in the record43% (52/121)35% (1,730/4,921)+8 pts9% (13/148)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued53% (40/75)35% (1,742/4,967)+18 pts13% (12/95)
Board hearing held or testimony takenProcedure38% (592/1,573)34% (1,190/3,469)+3 pts27% (688/2,513)
Social Security records in the fileEvidence in the record31% (70/226)36% (1,712/4,816)-5 pts28% (87/315)
Vocational expert or assessmentEvidence in the record33% (51/153)35% (1,731/4,889)-2 pts15% (28/183)
Medical literature or treatise citedEvidence in the record47% (34/72)35% (1,748/4,970)+12 pts29% (32/112)
Functional loss / DeLuca factors argued (rating cases)Theory argued49% (105/213)35% (1,677/4,829)+15 pts35% (116/336)
Presumptive service connection discussedTheory argued55% (56/101)35% (1,726/4,941)+21 pts18% (25/136)
Secondary service connection (38 CFR 3.310) in playTheory argued40% (219/548)35% (1,563/4,494)+5 pts17% (122/707)
Combat service / 1154(b) in playTheory argued35% (357/1,027)35% (1,425/4,015)-1 pts10% (126/1,201)
Military sexual trauma / personal assault claimTheory argued42% (59/141)35% (1,723/4,901)+7 pts14% (24/175)
A medical source gave a negative nexus opinionEvidence in the record44% (94/214)35% (1,688/4,828)+9 pts22% (63/290)
VA examination or VA medical opinion obtainedEvidence in the record35% (1,631/4,681)42% (151/361)-7 pts25% (1,586/6,335)
Board found a VA exam or opinion inadequateHow the Board read the record38% (140/364)35% (1,642/4,678)+3 pts43% (282/650)
Board found the VA exam or opinion adequateHow the Board read the record23% (50/213)36% (1,732/4,829)-12 pts1% (3/217)
Board found the veteran's statements credibleHow the Board read the record55% (131/239)34% (1,651/4,803)+20 pts1% (3/246)
Board found the veteran's statements not credible or inconsistentHow the Board read the record13% (7/53)36% (1,775/4,989)-22 pts7% (4/58)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record87% (514/590)28% (1,268/4,452)+59 pts1% (6/605)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record18% (419/2,367)51% (1,363/2,675)-33 pts0% (0/2,389)
Duty-to-assist error foundHow the Board read the record36% (27/74)35% (1,755/4,968)+1 pts75% (226/303)
Board ordered a new exam or addendum opinionProcedure28% (53/186)36% (1,729/4,856)-7 pts88% (1,374/1,569)
AMA favorable finding acknowledgedProcedure48% (28/58)35% (1,754/4,984)+13 pts13% (9/68)

"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 PTSD issues, every benefit type (n = 39,884)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record73% (2,273/3,117)47% (9,212/19,625)+26 pts20% (797/3,948)
Private physician opinion, letter or DBQEvidence in the record66% (3,235/4,924)46% (8,250/17,818)+19 pts20% (1,214/6,209)
Disability Benefits Questionnaire in the recordEvidence in the record62% (1,512/2,436)49% (9,973/20,306)+13 pts31% (1,120/3,581)
Third-party lay statements (spouse, buddy, employer)Evidence in the record55% (1,137/2,057)50% (10,348/20,685)+5 pts24% (659/2,738)
Service treatment records document the condition or injuryEvidence in the record46% (1,459/3,171)51% (10,026/19,571)-5 pts31% (1,416/4,638)
Service treatment records silent for the conditionEvidence in the record33% (1,410/4,270)55% (10,075/18,472)-22 pts16% (836/5,173)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued34% (594/1,744)52% (10,891/20,998)-18 pts21% (477/2,259)
Board hearing held or testimony takenProcedure52% (4,479/8,585)49% (7,006/14,157)+3 pts35% (5,048/14,473)
Social Security records in the fileEvidence in the record40% (412/1,033)51% (11,073/21,709)-11 pts37% (632/1,686)
Vocational expert or assessmentEvidence in the record55% (284/512)50% (11,201/22,230)+5 pts15% (92/621)
Medical literature or treatise citedEvidence in the record63% (1,286/2,035)49% (10,199/20,707)+14 pts43% (1,534/3,591)
Functional loss / DeLuca factors argued (rating cases)Theory argued54% (304/558)50% (11,181/22,184)+4 pts35% (307/887)
Presumptive service connection discussedTheory argued34% (855/2,551)53% (10,630/20,191)-19 pts25% (861/3,469)
Secondary service connection (38 CFR 3.310) in playTheory argued54% (3,036/5,654)49% (8,449/17,088)+4 pts40% (3,972/9,932)
Combat service / 1154(b) in playTheory argued46% (3,498/7,547)53% (7,987/15,195)-6 pts17% (1,615/9,331)
Military sexual trauma / personal assault claimTheory argued58% (1,542/2,669)50% (9,943/20,073)+8 pts36% (1,530/4,269)
A medical source gave a negative nexus opinionEvidence in the record56% (3,137/5,555)49% (8,348/17,187)+8 pts39% (3,567/9,179)
No nexus opinion of recordEvidence in the record19% (89/478)51% (11,396/22,264)-33 pts27% (183/668)
VA examination or VA medical opinion obtainedEvidence in the record51% (9,514/18,681)49% (1,971/4,061)+2 pts37% (10,983/30,047)
Board found a VA exam or opinion inadequateHow the Board read the record56% (1,865/3,338)50% (9,620/19,404)+6 pts59% (4,835/8,209)
Board found the VA exam or opinion adequateHow the Board read the record44% (388/878)51% (11,097/21,864)-7 pts6% (53/938)
Board found the veteran's statements credibleHow the Board read the record76% (1,636/2,151)48% (9,849/20,591)+28 pts6% (141/2,312)
Board found the veteran's statements not credible or inconsistentHow the Board read the record10% (68/651)52% (11,417/22,091)-41 pts7% (52/709)
PTSD stressor corroborated, verified or concededHow the Board read the record72% (608/848)50% (10,877/21,894)+22 pts23% (253/1,105)
PTSD stressor not corroboratedHow the Board read the record22% (238/1,104)52% (11,247/21,638)-30 pts16% (212/1,326)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record94% (4,244/4,512)40% (7,241/18,230)+54 pts1% (59/4,624)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record15% (1,194/7,978)70% (10,291/14,764)-55 pts0% (11/8,075)
Duty-to-assist error foundHow the Board read the record44% (264/604)51% (11,221/22,138)-7 pts80% (2,565/3,209)
Board ordered a new exam or addendum opinionProcedure35% (378/1,091)51% (11,107/21,651)-17 pts90% (10,326/11,451)
AMA favorable finding acknowledgedProcedure76% (1,285/1,684)48% (10,200/21,058)+28 pts33% (853/2,564)

"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: PTSD decisions · all conditions · outcome rates.