{"page":"https://casescribe.ai/explorer/secondary/ankle-impairment-secondary-to-back","generated_at":"2026-10-03T18:34:23.399Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Ankle impairment secondary to a back condition","secondary_condition":"Ankle impairment","service_connected_disability":"a back condition","decisions":370,"years":"2017-2026","granted_pct":11.9,"denied_pct":20.8,"remanded_pct":66.5,"granted_on_merits_pct":36.4,"by_year":[{"year":2017,"issues":26,"granted_pct":0,"denied_pct":19.2,"remanded_pct":80.8},{"year":2018,"issues":28,"granted_pct":3.6,"denied_pct":21.4,"remanded_pct":75},{"year":2019,"issues":46,"granted_pct":4.3,"denied_pct":28.3,"remanded_pct":67.4},{"year":2020,"issues":66,"granted_pct":6.1,"denied_pct":28.8,"remanded_pct":60.6},{"year":2021,"issues":56,"granted_pct":5.4,"denied_pct":25,"remanded_pct":69.6},{"year":2022,"issues":59,"granted_pct":13.6,"denied_pct":18.6,"remanded_pct":62.7},{"year":2023,"issues":64,"granted_pct":14.1,"denied_pct":23.4,"remanded_pct":62.5},{"year":2024,"issues":69,"granted_pct":13,"denied_pct":8.7,"remanded_pct":78.3},{"year":2025,"issues":65,"granted_pct":13.8,"denied_pct":21.5,"remanded_pct":64.6}],"benefit_of_doubt_in_grants_pct":75,"evidence_on_merits":[{"evidence":"va_exam_unfavorable","decisions_with":298,"granted_pct_with":35.6,"granted_pct_without":41.2},{"evidence":"nexus_positive","decisions_with":65,"granted_pct_with":83.3,"granted_pct_without":16.5},{"evidence":"nexus_negative","decisions_with":246,"granted_pct_with":29.9,"granted_pct_without":52.9},{"evidence":"private_opinion","decisions_with":107,"granted_pct_with":66,"granted_pct_without":17.6},{"evidence":"lay_statement","decisions_with":305,"granted_pct_with":30,"granted_pct_without":66.7}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":10},{"reason":"service connection established","decisions":5},{"reason":"aggravated by the service-connected disability","decisions":5},{"reason":"current diagnosis established","decisions":4}],"denied":[{"reason":"no in-service complaints, treatment or diagnosis","decisions":12},{"reason":"va examiner: less likely than not related to service","decisions":12},{"reason":"no current diagnosis","decisions":10},{"reason":"preponderance of the evidence against the claim","decisions":10},{"reason":"service records negative or silent","decisions":8},{"reason":"aggravated by the service-connected disability","decisions":7}]},"recent_examples":{"granted":[{"case_id":"A26040035","year":2026,"judge":"JONATHAN B. KRAMER","rationale":"Service-connected bilateral knee and low back disabilities established.; Private and VA opinions found bilateral ankle disability aggravated by service-connected knee/back conditions.; Opinions cited biomechanical relationship and overcompensation."},{"case_id":"A26031277","year":2026,"judge":"TANYA SMITH","rationale":"Treating physician opined injuries secondary to back condition; Record in relative equipoise; Benefit of the doubt resolved in Veteran's favor"},{"case_id":"26003891","year":2026,"judge":"NATHANIEL DOAN","rationale":"Resolving doubt in Veteran's favor; Related to service-connected back disability; Obesity as intermediate step"}],"denied":[{"case_id":"26001345","year":2026,"judge":"MICHAEL A. HERMAN","rationale":"No chronicity of right ankle disorder shown in service or within one year of separation.; VA examiners consistently found no nexus between current right ankle disorder and service.; Right ankle disorder not caused or aggravated by service-connected back condition."},{"case_id":"A25103534","year":2025,"judge":"J. PARKER","rationale":"No in-service injury, disease, or event reported for left ankle.; No chronic or continuous symptoms since service.; VA medical opinions found less likely than not related to service or aggravated by service-connected lumbosacral disability.; Condition attributed to normal aging process."},{"case_id":"25014331","year":2025,"judge":"WENDY DAKNIS","rationale":"Not causally related to service; Not aggravated by service-connected disability; No in-service evidence or continuity of symptoms; Denied secondary to lumbar spine disorder (not service-connected)"}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":498,"aggravation_discussed":{"issues":190,"granted_pct":7.9},"causation_only":{"issues":308,"granted_pct":13.6},"issues_naming_a_pathway_pct":26.1,"pathways":[{"pathway":"Altered gait or overuse","issues":62,"granted_pct":30.6,"examples":[{"case_id":"A26013883","year":2026,"outcome":"GRANTED","quote":"Favorable VA examiner opinion linking right ankle to lumbar spine via gait changes"},{"case_id":"22007180","year":2022,"outcome":"DENIED","quote":"Examiners attributed ankle disorder to compensation for abnormal gait from right hip surgery, not service.."}]},{"pathway":"Nerve involvement","issues":45,"granted_pct":11.1,"examples":[{"case_id":"25015204","year":2025,"outcome":"GRANTED","quote":"Service connection granted based on secondary to service-connected radiculopathy"},{"case_id":"A25092155","year":2025,"outcome":"DENIED","quote":"No evidence linking ankle disability to service-connected low back or radiculopathy."}]},{"pathway":"Weight gain or obesity","issues":18,"granted_pct":27.8,"examples":[{"case_id":"26003891","year":2026,"outcome":"GRANTED","quote":"Obesity as intermediate step."},{"case_id":"22042674","year":2022,"outcome":"DENIED","quote":"Multiple VA examiners opined DJD is multifactorial (age, obesity, genetics)"}]},{"pathway":"Chronic pain","issues":15,"granted_pct":13.3,"examples":[{"case_id":"A26005954","year":2026,"outcome":"GRANTED","quote":"Service connection for left ankle strain was granted on a secondary basis to the service-connected lumbar spine disability, based on a private medical opinion that found the strain likely due to persistent lumbar pain and imbalanced..."},{"case_id":"21057758","year":2021,"outcome":"DENIED","quote":"The Board found the veteran's lay statements attributing ongoing pain to the in-service fall less credible due to a lack of contemporaneous medical evidence and normal separation examination findings."}]}]},"how_va_rates":null,"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}