Adams v. Collins
38 Vet. App. 273 (2025), decided July 8, 2025. Court of Appeals for Veterans Claims, No. 23-5064, Judge Pietsch; Judges Greenberg and Jaquith concurring in part and dissenting in part. Precedential. Board decision vacated in part and remanded.
The newest case on this list, and the easiest one to overread. Read the limits before the holding.
The background: a General Counsel opinion
For years VA worked from a 2017 General Counsel opinion holding that obesity is neither a "disease" nor an "injury" for purposes of 38 U.S.C. §1110, and therefore cannot be service connected — directly or secondarily. That single conclusion closed off a theory that comes up constantly, because weight gain sits between a service-connected condition and a later one often enough to matter.
The Veterans Court took the two halves apart and reached different answers.
What it holds
Obesity can be a disability. The court held the General Counsel's conclusion that obesity is not a disability under §1110 "is not a persuasive interpretation of the statute." Obesity may be a disability where it causes functional impairment of earning capacity — which is a question to be assessed individually, on a record, not answered in advance for everyone.
The bar on secondary service connection does not stand. For a secondary claim, the court held it is irrelevant whether obesity is a "disease." What matters is functional impairment and a but-for causal relationship to the service-connected condition. The General Counsel's contrary reading was "an impermissible interpretation of the statute." The Board's denial of obesity secondary to service-connected PTSD was vacated and remanded.
The bar on direct service connection was left alone. On the arguments presented, the court found the General Counsel's view that obesity is not a "disease" for §1110 purposes "a persuasive interpretation," and declined to disturb the prohibition on direct service connection for obesity. Direct connection still requires a disease or injury incurred in service.
So the case is half an opening and half a closed door, and which half applies depends entirely on the theory.
Four things it does not do
This is where the case gets misread, so these are worth stating flatly.
- It does not grant anything. A vacatur and remand sends the issue back for readjudication. It can end in another denial.
- It does not decide sleep apnea. The Board had itself remanded the OSA-secondary-to-PTSD issue, so that issue was not before the court. Adams is not an OSA case and does not hold that obesity-driven apnea is service connected.
- It does not establish a rating for obesity. It holds that obesity may be a disability where it functionally impairs earning capacity. How that would be evaluated is a separate question the case did not reach.
- It does not open direct service connection. Judge Greenberg would have gone further on that point. That was a partial dissent, not the holding.
Later history
Both sides appealed to the Federal Circuit. On May 15, 2026, that court dismissed the appeal and cross-appeal by agreement of the parties under Fed. R. App. P. 42(b), each side bearing its own costs. The order decides nothing on the merits and does not disturb the panel opinion, which stands.
The intermediate step, and how to think about it
The reason this case matters in practice is the shape of claim it unblocks: a service-connected condition, or its treatment, causes weight gain, and the weight gain causes or worsens something else. Each link in that chain is a separate medical question, and none of them is established by the links on either side of it.
That makes it a question for an opinion that addresses the chain explicitly, in the terms Atencio requires — causation and aggravation answered separately — and reasoned the way Stefl and Nieves-Rodriguez require. Two diagnoses and a weight chart establish nothing on their own. See sleep apnea and medical opinions.
Finding the opinion
The court's official PDF: AdamsMW_23-5064.pdf. Published at 38 Vet. App. 273.
Educational summary. The decision addressed the facts and issues identified above; its outcome does not predict another claim. Check its precedential status and subsequent history before relying on it.
Reviewed October 6, 2026