{"page":"https://casescribe.ai/explorer/secondary/knee-impairment-secondary-to-back","generated_at":"2026-10-03T18:34:23.328Z","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":"Knee conditions secondary to a back condition","secondary_condition":"Knee conditions","service_connected_disability":"a back condition","decisions":2251,"years":"2017-2026","granted_pct":12.3,"denied_pct":20.3,"remanded_pct":66.6,"granted_on_merits_pct":37.8,"by_year":[{"year":2017,"issues":220,"granted_pct":11.8,"denied_pct":27.3,"remanded_pct":58.6},{"year":2018,"issues":279,"granted_pct":8.6,"denied_pct":29.7,"remanded_pct":58.4},{"year":2019,"issues":299,"granted_pct":9.4,"denied_pct":18.1,"remanded_pct":72.6},{"year":2020,"issues":368,"granted_pct":11.7,"denied_pct":20.4,"remanded_pct":65.5},{"year":2021,"issues":376,"granted_pct":6.4,"denied_pct":29.5,"remanded_pct":63.8},{"year":2022,"issues":388,"granted_pct":10.1,"denied_pct":12.6,"remanded_pct":75.8},{"year":2023,"issues":388,"granted_pct":13.7,"denied_pct":18,"remanded_pct":67},{"year":2024,"issues":353,"granted_pct":14.7,"denied_pct":13.6,"remanded_pct":71.4},{"year":2025,"issues":274,"granted_pct":21.5,"denied_pct":19.7,"remanded_pct":58},{"year":2026,"issues":140,"granted_pct":22.1,"denied_pct":10,"remanded_pct":67.1}],"benefit_of_doubt_in_grants_pct":78.3,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":221,"granted_pct_with":74.3,"granted_pct_without":31.1},{"evidence":"va_exam_unfavorable","decisions_with":1857,"granted_pct_with":35.1,"granted_pct_without":56.4},{"evidence":"nexus_positive","decisions_with":422,"granted_pct_with":83.5,"granted_pct_without":15.9},{"evidence":"nexus_negative","decisions_with":1567,"granted_pct_with":33.4,"granted_pct_without":54.2},{"evidence":"private_opinion","decisions_with":713,"granted_pct_with":55.7,"granted_pct_without":22.9},{"evidence":"treating_physician","decisions_with":116,"granted_pct_with":61.7,"granted_pct_without":35.7},{"evidence":"lay_statement","decisions_with":1870,"granted_pct_with":33.4,"granted_pct_without":67.7},{"evidence":"buddy_statement","decisions_with":77,"granted_pct_with":43.5,"granted_pct_without":37.6},{"evidence":"combat_service","decisions_with":69,"granted_pct_with":15.4,"granted_pct_without":38.2}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":66},{"reason":"current diagnosis established","decisions":28},{"reason":"service connection established","decisions":20},{"reason":"aggravated by the service-connected disability","decisions":15},{"reason":"continuity of symptomatology since service","decisions":5},{"reason":"criteria for service connection met","decisions":5}],"denied":[{"reason":"no in-service complaints, treatment or diagnosis","decisions":88},{"reason":"va examiner: less likely than not related to service","decisions":86},{"reason":"service records negative or silent","decisions":45},{"reason":"preponderance of the evidence against the claim","decisions":40},{"reason":"aggravated by the service-connected disability","decisions":38},{"reason":"no current diagnosis","decisions":26}]},"recent_examples":{"granted":[{"case_id":"A26040917","year":2026,"judge":"YVETTE R. WHITE","rationale":"Private medical opinion provided favorable nexus; Equipoise resolved in Veteran's favor; Secondary to service-connected lumbar spine disability"},{"case_id":"A26037731","year":2026,"judge":"MELANIE J. MANN","rationale":"Favorable finding by RO adopted by Board; Secondary to service-connected lumbar spine disability"},{"case_id":"A26032828","year":2026,"judge":"H.M. WALKER","rationale":"Private medical opinion found right knee osteoarthritis secondary to altered biomechanics from service-connected lumbar spine, left knee, and bilateral plantar fasciitis.; Opinion cited medical literature supporting the link between gait disturbances and adjacent joint stress.; Veteran diagnosed wit… [truncated, 60 chars omitted]"}],"denied":[{"case_id":"26004881","year":2026,"judge":"A. C. MACKENZIE","rationale":"Isolated in-service treatment for left knee pain with no further documentation or diagnosis.; March 2017 VA examiner opinion found less likely than not related to service.; Examiner noted mild degenerative arthritis consistent with aging/occupation.; Examiner attributed symptoms to low back disorder… [truncated, 19 chars omitted]"},{"case_id":"A26026414","year":2026,"judge":"L. HOWELL","rationale":"No in-service complaints, treatment, or diagnosis of left knee disorder in STRs.; Separation exam showed no left knee issues; veteran denied relevant symptoms.; VA addendum opinion found osteoarthritis less likely than not due to service-connected back disability."},{"case_id":"26003526","year":2026,"judge":"DAVID H. ROBERTSON","rationale":"Service treatment records normal for left knee.; No in-service complaints or treatment for left knee.; Post-service treatment began over 40 years after service.; VA examiners opined less likely than not related to service.; Private opinions given minimal weight due to lack of in-service nexus and po… [truncated, 17 chars omitted]"}]},"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":3085,"aggravation_discussed":{"issues":1349,"granted_pct":6.7},"causation_only":{"issues":1736,"granted_pct":16.6},"issues_naming_a_pathway_pct":23.4,"pathways":[{"pathway":"Altered gait or overuse","issues":385,"granted_pct":28.1,"examples":[{"case_id":"26001978","year":2026,"outcome":"GRANTED","quote":"A VA examiner in October 2024 provided a positive nexus opinion, stating that lumbar spine issues could cause abnormal gait and strain on the ankle, establishing a pathophysiological relationship."},{"case_id":"A26001805","year":2026,"outcome":"DENIED","quote":"Inconsistent gait documentation and lack of progression evidence."}]},{"pathway":"Nerve involvement","issues":220,"granted_pct":8.6,"examples":[{"case_id":"A25022064","year":2025,"outcome":"GRANTED","quote":"Service connection for right knee instability was granted as secondary to the Veteran's service-connected lumbar degenerative disc disease, left knee disabilities, and lower extremity radiculopathy."},{"case_id":"26004881","year":2026,"outcome":"DENIED","quote":"Examiner attributed symptoms to low back disorder and radiculopathy.."}]},{"pathway":"Weight gain or obesity","issues":129,"granted_pct":12.4,"examples":[{"case_id":"26003891","year":2026,"outcome":"GRANTED","quote":"Obesity as intermediate step."},{"case_id":"A25020209","year":2025,"outcome":"DENIED","quote":"VA examiner opined current arthritis likely due to aging and obesity.."}]},{"pathway":"Chronic pain","issues":56,"granted_pct":25,"examples":[{"case_id":"A26004803","year":2026,"outcome":"GRANTED","quote":"The Veteran's lumbar spine condition caused chronic pain and aggravated the left knee, leading to DJD."},{"case_id":"A25069290","year":2025,"outcome":"DENIED","quote":"Private records also indicated flexion limited to 70 degrees due to pain."}]},{"pathway":"Stress","issues":40,"granted_pct":52.5,"examples":[{"case_id":"A26005954","year":2026,"outcome":"GRANTED","quote":"Service connection for left knee 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 imbalanced stress on joints from lumbar pain."},{"case_id":"1722866","year":2017,"outcome":"DENIED","quote":"The veteran sought service connection for a right knee disability, claiming it was directly related to in-service injuries and pain, secondarily to service-connected low back disability and right tibia stress fracture, and due to..."}]}]},"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."}}