{"page":"https://casescribe.ai/explorer/secondary/major-depressive-disorder-secondary-to-knee","generated_at":"2026-10-03T18:34:27.727Z","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":"Major depressive disorder secondary to a knee condition","secondary_condition":"Major depressive disorder","service_connected_disability":"a knee condition","decisions":516,"years":"2017-2026","granted_pct":49.4,"denied_pct":12.8,"remanded_pct":34.5,"granted_on_merits_pct":79.4,"by_year":[{"year":2017,"issues":40,"granted_pct":22.5,"denied_pct":27.5,"remanded_pct":37.5},{"year":2018,"issues":99,"granted_pct":43.4,"denied_pct":12.1,"remanded_pct":38.4},{"year":2019,"issues":78,"granted_pct":56.4,"denied_pct":10.3,"remanded_pct":29.5},{"year":2020,"issues":62,"granted_pct":43.5,"denied_pct":17.7,"remanded_pct":37.1},{"year":2021,"issues":45,"granted_pct":35.6,"denied_pct":8.9,"remanded_pct":53.3},{"year":2022,"issues":43,"granted_pct":51.2,"denied_pct":11.6,"remanded_pct":34.9},{"year":2023,"issues":43,"granted_pct":46.5,"denied_pct":11.6,"remanded_pct":39.5},{"year":2024,"issues":53,"granted_pct":62.3,"denied_pct":9.4,"remanded_pct":28.3},{"year":2025,"issues":41,"granted_pct":78,"denied_pct":9.8,"remanded_pct":12.2}],"benefit_of_doubt_in_grants_pct":76.9,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":100,"granted_pct_with":87.1,"granted_pct_without":76.7},{"evidence":"va_exam_unfavorable","decisions_with":399,"granted_pct_with":78.7,"granted_pct_without":81.9},{"evidence":"nexus_positive","decisions_with":250,"granted_pct_with":94.7,"granted_pct_without":51.8},{"evidence":"nexus_negative","decisions_with":301,"granted_pct_with":77.4,"granted_pct_without":81.9},{"evidence":"private_opinion","decisions_with":296,"granted_pct_with":86.6,"granted_pct_without":64.8},{"evidence":"lay_statement","decisions_with":408,"granted_pct_with":76.5,"granted_pct_without":90.9}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":65},{"reason":"aggravated by the service-connected disability","decisions":36},{"reason":"service connection established","decisions":26},{"reason":"current diagnosis established","decisions":26},{"reason":"new and material evidence submitted","decisions":4},{"reason":"va examiner: less likely than not related to service","decisions":4}],"denied":[{"reason":"preponderance of the evidence against the claim","decisions":10},{"reason":"va examiner: less likely than not related to service","decisions":9},{"reason":"caused by the service-connected disability","decisions":6},{"reason":"no in-service complaints, treatment or diagnosis","decisions":4},{"reason":"no current diagnosis","decisions":3},{"reason":"service records negative or silent","decisions":3}]},"recent_examples":{"granted":[{"case_id":"A26037097","year":2026,"judge":"LESLEY A. REIN","rationale":"Private medical opinion found depression secondary to knee issues; Veteran testimony corroborates depression linked to knee pain; Evidence in approximate balance, doubt resolved in Veteran's favor"},{"case_id":"A26037085","year":2026,"judge":"MARJORIE A. AUER","rationale":"Private physician opinion found condition more likely than not secondary to service-connected injuries.; Evidence found to be in equipoise regarding nexus.; Benefit of the doubt resolved in Veteran's favor."},{"case_id":"A26028339","year":2026,"judge":"JONATHAN HAGER","rationale":"Current diagnosis of depressive disorder with depressive features, melancholic features, and anxious distress.; Conflicting opinions from private psychologist (favorable nexus) and VA examiner (unfavorable nexus).; Evidence found to be at least evenly balanced."}],"denied":[{"case_id":"A26007209","year":2026,"judge":"A. P. SIMPSON","rationale":"No evidence of in-service psychiatric injury or disease.; Veteran's testimony regarding chronic psychiatric symptoms was not credible.; Private psychological evaluation was generalized and speculative."},{"case_id":"A25043023","year":2025,"judge":"B. D. WATSON","rationale":"No evidence of mental health issues during service.; Veteran's MDD claimed as secondary to service-connected back and knee pain.; VA examiner provided negative nexus opinion; private opinion found unpersuasive by Board.; Board found VA examiner more credible due to expertise and addressing veteran's… [truncated, 9 chars omitted]"},{"case_id":"A25018142","year":2025,"judge":"A. C. MACKENZIE","rationale":"No current diagnosis of depression; Lay contentions lack probative value without objective medical evidence; Absence of diagnosis suggests symptoms did not begin in service"}]},"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":521,"aggravation_discussed":{"issues":174,"granted_pct":48.3},"causation_only":{"issues":347,"granted_pct":49.9},"issues_naming_a_pathway_pct":32.2,"pathways":[{"pathway":"Chronic pain","issues":111,"granted_pct":81.1,"examples":[{"case_id":"26000344","year":2026,"outcome":"GRANTED","quote":"The Board found that while the Veteran had pre-existing anxiety and trauma related to childhood abuse, his depressive disorder was at least as likely as not due to chronic pain from his service-connected knee conditions."},{"case_id":"22062584","year":2022,"outcome":"DENIED","quote":"The veteran claimed an acquired psychiatric disorder, including depression and bipolar disorder, secondary to his service-connected left knee disability, attributing the onset to chronic pain and life limitations."}]},{"pathway":"Stress","issues":29,"granted_pct":27.6,"examples":[{"case_id":"A25061319","year":2025,"outcome":"GRANTED","quote":"The Board found a private medical opinion probative, linking the Veteran's stress, anxiety, and depressed mood to chronic pain from these service-connected conditions."},{"case_id":"22045211","year":2022,"outcome":"DENIED","quote":"The Board noted that the Veteran's psychiatric symptoms predated his knee condition and were more consistently linked to familial, financial, and social stressors."}]},{"pathway":"Sleep disruption","issues":20,"granted_pct":50,"examples":[{"case_id":"A25038858","year":2025,"outcome":"GRANTED","quote":"Service connection for a psychiatric disorder, including insomnia and major depressive disorder with anxious distress, was granted on a secondary basis."},{"case_id":"24024613","year":2024,"outcome":"DENIED","quote":"Service connection for an acquired psychiatric disorder, specifically depression and insomnia, claimed as secondary to a right knee disability, was denied."}]},{"pathway":"Reduced activity or mobility","issues":15,"granted_pct":86.7,"examples":[{"case_id":"A26017814","year":2026,"outcome":"GRANTED","quote":"The Board found that the Veteran's physical limitations from these service-connected conditions negatively impacted his mood and functioning, leading to the psychiatric conditions."}]},{"pathway":"Nerve involvement","issues":14,"granted_pct":85.7,"examples":[{"case_id":"A26017814","year":2026,"outcome":"GRANTED","quote":"The Veteran claimed entitlement to service connection for an acquired psychiatric disorder, specifically major depressive disorder and generalized anxiety disorder, as secondary to his service-connected lumbar spine, bilateral..."}]}]},"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."}}