{"page":"https://casescribe.ai/explorer/secondary/ankle-impairment-secondary-to-knee","generated_at":"2026-10-03T18:34:25.642Z","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 knee condition","secondary_condition":"Ankle impairment","service_connected_disability":"a knee condition","decisions":955,"years":"2017-2026","granted_pct":15.2,"denied_pct":16.5,"remanded_pct":67.7,"granted_on_merits_pct":47.9,"by_year":[{"year":2017,"issues":85,"granted_pct":11.8,"denied_pct":30.6,"remanded_pct":49.4},{"year":2018,"issues":99,"granted_pct":12.1,"denied_pct":22.2,"remanded_pct":65.7},{"year":2019,"issues":140,"granted_pct":16.4,"denied_pct":16.4,"remanded_pct":64.3},{"year":2020,"issues":125,"granted_pct":7.2,"denied_pct":16,"remanded_pct":76.8},{"year":2021,"issues":146,"granted_pct":15.8,"denied_pct":15.8,"remanded_pct":67.8},{"year":2022,"issues":129,"granted_pct":11.6,"denied_pct":14,"remanded_pct":74.4},{"year":2023,"issues":170,"granted_pct":14.1,"denied_pct":11.8,"remanded_pct":74.1},{"year":2024,"issues":131,"granted_pct":13,"denied_pct":12.2,"remanded_pct":74},{"year":2025,"issues":123,"granted_pct":19.5,"denied_pct":20.3,"remanded_pct":60.2},{"year":2026,"issues":44,"granted_pct":36.4,"denied_pct":13.6,"remanded_pct":50}],"benefit_of_doubt_in_grants_pct":80.7,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":113,"granted_pct_with":76.1,"granted_pct_without":39.8},{"evidence":"va_exam_unfavorable","decisions_with":785,"granted_pct_with":45.8,"granted_pct_without":61},{"evidence":"nexus_positive","decisions_with":188,"granted_pct_with":88.2,"granted_pct_without":21.7},{"evidence":"nexus_negative","decisions_with":651,"granted_pct_with":44.3,"granted_pct_without":57.3},{"evidence":"private_opinion","decisions_with":292,"granted_pct_with":70.1,"granted_pct_without":29.5},{"evidence":"treating_physician","decisions_with":51,"granted_pct_with":76.5,"granted_pct_without":44.2},{"evidence":"lay_statement","decisions_with":797,"granted_pct_with":45.2,"granted_pct_without":65}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":35},{"reason":"current diagnosis established","decisions":22},{"reason":"service connection established","decisions":15},{"reason":"aggravated by the service-connected disability","decisions":5},{"reason":"va examiner opinion inadequate","decisions":2},{"reason":"resolving all doubt in veteran's favor","decisions":2}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":32},{"reason":"no current diagnosis","decisions":22},{"reason":"preponderance of the evidence against the claim","decisions":20},{"reason":"no in-service complaints, treatment or diagnosis","decisions":14},{"reason":"aggravated by the service-connected disability","decisions":13},{"reason":"service records negative or silent","decisions":13}]},"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":"A26037161","year":2026,"judge":"B. D. WATSON","rationale":"No direct service connection for left ankle sprain.; Secondary service connection granted based on right knee disability.; Benefit of the doubt applied to link ankle disability to knee injury."},{"case_id":"A26033063","year":2026,"judge":"MICHAEL J. SKALTSOUNIS","rationale":"Current disability conceded by AOJ; Service-connected left knee disability established; Private medical opinion found favorable nexus"}],"denied":[{"case_id":"26004344","year":2026,"judge":"MICHAEL LANE","rationale":"Evidence persuasively against service connection; Lack of nexus to service-connected knee and feet disability"},{"case_id":"A26026839","year":2026,"judge":"K.A. KENNERLY","rationale":"No current ankle disability or functional impairment.; No evidence of in-service complaints or diagnoses.; Claim of secondary ankle condition due to left knee is contradicted by evidence."},{"case_id":"A26025527","year":2026,"judge":"JOHN Z. JONES","rationale":"No evidence of current disability for right ankle; Lack of service treatment records or post-service medical records; Veteran's statements insufficient to trigger duty to assist"}]},"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":1192,"aggravation_discussed":{"issues":498,"granted_pct":5},"causation_only":{"issues":694,"granted_pct":21.3},"issues_naming_a_pathway_pct":23.2,"pathways":[{"pathway":"Altered gait or overuse","issues":217,"granted_pct":23.5,"examples":[{"case_id":"A26008103","year":2026,"outcome":"GRANTED","quote":"Opinions link left ankle condition to service-connected spinal and right knee issues and altered gait."},{"case_id":"A26026839","year":2026,"outcome":"DENIED","quote":"The claim that the ankle condition is due to the service-connected left knee is contradicted by evidence of a normal gait and lack of association between the knee and ankle pain."}]},{"pathway":"Weight gain or obesity","issues":40,"granted_pct":0,"examples":[{"case_id":"A24035001","year":2024,"outcome":"DENIED","quote":"The Veteran claimed it was secondary to his service-connected left knee disability, but the VA examiner opined it was less likely than not caused or aggravated by the left knee, attributing the ankle issues to morbid obesity."}]},{"pathway":"Chronic pain","issues":23,"granted_pct":8.7,"examples":[{"case_id":"A25077064","year":2025,"outcome":"GRANTED","quote":"The veteran's altered gait due to knee pain likely caused the left ankle defect."},{"case_id":"A25005724","year":2025,"outcome":"DENIED","quote":"Appellant did not mention pain interfering with ministry.."}]},{"pathway":"Stress","issues":10,"granted_pct":100,"examples":[{"case_id":"A26037161","year":2026,"outcome":"GRANTED","quote":"While direct service connection was denied due to lack of evidence of an in-service ankle injury, the Board found the left ankle disability to be secondary to the Veteran's service-connected right knee disability, citing medical..."}]}]},"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."}}