{"page":"https://casescribe.ai/explorer/secondary/knee-impairment-secondary-to-flat-feet","generated_at":"2026-10-03T18:34:29.300Z","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 flat feet","secondary_condition":"Knee conditions","service_connected_disability":"flat feet","decisions":820,"years":"2017-2026","granted_pct":23.9,"denied_pct":15.5,"remanded_pct":60.5,"granted_on_merits_pct":60.7,"by_year":[{"year":2017,"issues":74,"granted_pct":12.2,"denied_pct":31.1,"remanded_pct":51.4},{"year":2018,"issues":104,"granted_pct":29.8,"denied_pct":14.4,"remanded_pct":55.8},{"year":2019,"issues":106,"granted_pct":28.3,"denied_pct":5.7,"remanded_pct":63.2},{"year":2020,"issues":150,"granted_pct":17.3,"denied_pct":16.7,"remanded_pct":66},{"year":2021,"issues":142,"granted_pct":20.4,"denied_pct":14.8,"remanded_pct":64.8},{"year":2022,"issues":156,"granted_pct":18.6,"denied_pct":17.9,"remanded_pct":63.5},{"year":2023,"issues":131,"granted_pct":23.7,"denied_pct":14.5,"remanded_pct":61.8},{"year":2024,"issues":143,"granted_pct":25.9,"denied_pct":12.6,"remanded_pct":60.1},{"year":2025,"issues":117,"granted_pct":33.3,"denied_pct":7.7,"remanded_pct":58.1},{"year":2026,"issues":44,"granted_pct":45.5,"denied_pct":13.6,"remanded_pct":40.9}],"benefit_of_doubt_in_grants_pct":82.1,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":109,"granted_pct_with":82.4,"granted_pct_without":54.9},{"evidence":"va_exam_unfavorable","decisions_with":691,"granted_pct_with":60.1,"granted_pct_without":65},{"evidence":"nexus_positive","decisions_with":217,"granted_pct_with":91,"granted_pct_without":32.3},{"evidence":"nexus_negative","decisions_with":595,"granted_pct_with":57.4,"granted_pct_without":71.6},{"evidence":"private_opinion","decisions_with":300,"granted_pct_with":78.4,"granted_pct_without":40.8},{"evidence":"treating_physician","decisions_with":52,"granted_pct_with":85.7,"granted_pct_without":57.6},{"evidence":"lay_statement","decisions_with":658,"granted_pct_with":54.8,"granted_pct_without":86.7}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":32},{"reason":"current diagnosis established","decisions":29},{"reason":"service connection established","decisions":21},{"reason":"aggravated by the service-connected disability","decisions":8},{"reason":"new and material evidence received to reopen claim","decisions":3},{"reason":"va examiner: less likely than not related to service","decisions":3}],"denied":[{"reason":"no in-service complaints, treatment or diagnosis","decisions":20},{"reason":"va examiner: less likely than not related to service","decisions":20},{"reason":"preponderance of the evidence against the claim","decisions":17},{"reason":"service records negative or silent","decisions":16},{"reason":"aggravated by the service-connected disability","decisions":8},{"reason":"no current diagnosis","decisions":7}]},"recent_examples":{"granted":[{"case_id":"A26036582","year":2026,"judge":"J. KIRBY","rationale":"Private opinion linked knee condition to altered gait from pes planus; VA opinion found less than likelihood of service connection; Evidence found evenly balanced, benefit of doubt applied"},{"case_id":"A26035549","year":2026,"judge":"TANYA SMITH","rationale":"Private opinion linked in-service injury to current conditions; Evidence in equipoise; Benefit of doubt applied in Veteran's favor"},{"case_id":"A26035117","year":2026,"judge":"M. HYLAND","rationale":"Favorable secondary opinion from February 2024 examiner.; Opinion cited change in biomechanics due to flatfoot severity causing knee disability.; No opposing secondary opinion found."}],"denied":[{"case_id":"A26039074","year":2026,"judge":"JOHN Z. JONES","rationale":"VA opinions found knee strain less likely than not related to pes planus; VA opinions attributed knee strain to obesity and natural aging; Private opinion deemed inadequate due to lack of supporting medical reasons"},{"case_id":"A26038001","year":2026,"judge":"A. J. SPECTOR","rationale":"Evidence persuasively weighs against service connection; Evidence persuasively weighs against secondary connection to pes planus"},{"case_id":"A26020564","year":2026,"judge":"A. ISHIZAWAR","rationale":"Service treatment records are silent for knee pain complaints or diagnosis.; Post-service treatment records are silent for a specific knee diagnosis.; VA examiner found bilateral knee pain less likely than not caused by service.; Private opinion did not adequately address lack of in-service treatmen… [truncated, 95 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":1167,"aggravation_discussed":{"issues":530,"granted_pct":14.9},"causation_only":{"issues":637,"granted_pct":31.7},"issues_naming_a_pathway_pct":17,"pathways":[{"pathway":"Altered gait or overuse","issues":142,"granted_pct":39.4,"examples":[{"case_id":"26000556","year":2026,"outcome":"GRANTED","quote":"Board found veteran's testimony regarding altered gait due to foot pain causing knee flare-ups to be competent and credible, establishing aggravation.."},{"case_id":"A25061405","year":2025,"outcome":"DENIED","quote":"Examiner noted no evidence that pes planus without severe limp causes knee symptoms."}]},{"pathway":"Weight gain or obesity","issues":30,"granted_pct":10,"examples":[{"case_id":"21011142","year":2021,"outcome":"GRANTED","quote":"Evidence in equipoise between private opinion linking knee to pes planus and VA opinion linking to age/obesity/post-service injury"},{"case_id":"A26039074","year":2026,"outcome":"DENIED","quote":"VA opinions attributed knee strain to obesity and natural aging"}]},{"pathway":"Chronic pain","issues":21,"granted_pct":9.5,"examples":[{"case_id":"26000556","year":2026,"outcome":"GRANTED","quote":"Board found veteran's testimony regarding altered gait due to foot pain causing knee flare-ups to be competent and credible, establishing aggravation.."}]},{"pathway":"Stress","issues":13,"granted_pct":76.9,"examples":[{"case_id":"A25076897","year":2025,"outcome":"GRANTED","quote":"Private physician opined condition related to service-connected pes planus due to excess stress."}]}]},"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."}}