{"page":"https://casescribe.ai/explorer/secondary/osteoarthritis-secondary-to-knee","generated_at":"2026-10-03T18:34:26.277Z","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":"Osteoarthritis secondary to a knee condition","secondary_condition":"Osteoarthritis","service_connected_disability":"a knee condition","decisions":538,"years":"2017-2026","granted_pct":34.2,"denied_pct":23.2,"remanded_pct":42.9,"granted_on_merits_pct":59.5,"by_year":[{"year":2017,"issues":48,"granted_pct":29.2,"denied_pct":39.6,"remanded_pct":31.3},{"year":2018,"issues":67,"granted_pct":35.8,"denied_pct":31.3,"remanded_pct":32.8},{"year":2019,"issues":53,"granted_pct":30.2,"denied_pct":17,"remanded_pct":52.8},{"year":2020,"issues":83,"granted_pct":32.5,"denied_pct":26.5,"remanded_pct":41},{"year":2021,"issues":74,"granted_pct":27,"denied_pct":28.4,"remanded_pct":44.6},{"year":2022,"issues":68,"granted_pct":32.4,"denied_pct":11.8,"remanded_pct":55.9},{"year":2023,"issues":57,"granted_pct":31.6,"denied_pct":14,"remanded_pct":50.9},{"year":2024,"issues":79,"granted_pct":39.2,"denied_pct":15.2,"remanded_pct":44.3},{"year":2025,"issues":66,"granted_pct":36.4,"denied_pct":25.8,"remanded_pct":34.8},{"year":2026,"issues":24,"granted_pct":37.5,"denied_pct":16.7,"remanded_pct":45.8}],"benefit_of_doubt_in_grants_pct":80.4,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":75,"granted_pct_with":87.7,"granted_pct_without":52},{"evidence":"va_exam_unfavorable","decisions_with":476,"granted_pct_with":58.8,"granted_pct_without":70},{"evidence":"nexus_positive","decisions_with":157,"granted_pct_with":93.2,"granted_pct_without":34.5},{"evidence":"nexus_negative","decisions_with":411,"granted_pct_with":56.9,"granted_pct_without":73.5},{"evidence":"private_opinion","decisions_with":197,"granted_pct_with":77.9,"granted_pct_without":42.5},{"evidence":"treating_physician","decisions_with":53,"granted_pct_with":83.7,"granted_pct_without":55.6},{"evidence":"lay_statement","decisions_with":445,"granted_pct_with":55.3,"granted_pct_without":86}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":37},{"reason":"current diagnosis established","decisions":20},{"reason":"service connection established","decisions":16},{"reason":"va examiner: less likely than not related to service","decisions":4},{"reason":"aggravated by the service-connected disability","decisions":3},{"reason":"favorable private medical opinion","decisions":2}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":32},{"reason":"no in-service complaints, treatment or diagnosis","decisions":23},{"reason":"preponderance of the evidence against the claim","decisions":16},{"reason":"service records negative or silent","decisions":15},{"reason":"aggravated by the service-connected disability","decisions":7},{"reason":"caused by the service-connected disability","decisions":3}]},"recent_examples":{"granted":[{"case_id":"A26035267","year":2026,"judge":"D. SMART","rationale":"Current diagnosis of left hip osteoarthritis.; Service-connected disabilities of bilateral knees and lumbar spine.; Private opinion from Dr. J.M. links hip pain to gait changes from knee/back conditions and service.; Opinion is probative and uncontradicted."},{"case_id":"A26033309","year":2026,"judge":"E. I. VELEZ","rationale":"Evidence in approximate balance; Hip disability related to service-connected knee; Benefit of the doubt resolved in veteran's favor"},{"case_id":"A26032222","year":2026,"judge":"T. MAINELLI","rationale":"Treating physician opined right knee degeneration likely secondary to overuse from left knee impairment.; Board found opinion persuasive, establishing nexus for right knee claim.; Service-connected left knee disability contributed to and accelerated right knee degeneration."}],"denied":[{"case_id":"A26036867","year":2026,"judge":"L. B. CRYAN","rationale":"Service treatment records negative for left knee complaints/diagnosis; No specific in-service injury described for left knee; VA examiners opined left knee disability less likely than not related to service-connected conditions"},{"case_id":"A26035366","year":2026,"judge":"BETHANY L. BUCK","rationale":"No in-service complaints or documentation of bilateral hip issues in STRs.; Lay statements did not reference in-service hip problems.; VA clinician provided negative nexus opinion for secondary connection to knees."},{"case_id":"26000034","year":2026,"judge":"JENNA BRANT","rationale":"No presumptive service connection for left knee arthritis.; In-service injury from jeep accident found, but no nexus to current arthritis.; March 2023 VA examiner opinion found highly probative, stating less likely than not related to service or aggravated by right knee disability.; Veteran's own st… [truncated, 98 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":619,"aggravation_discussed":{"issues":270,"granted_pct":14.8},"causation_only":{"issues":349,"granted_pct":47.3},"issues_naming_a_pathway_pct":31.5,"pathways":[{"pathway":"Altered gait or overuse","issues":159,"granted_pct":56.6,"examples":[{"case_id":"A26008890","year":2026,"outcome":"GRANTED","quote":"The Veteran asserted that the left knee disability caused altered gait and biomechanics, leading to the right knee condition."},{"case_id":"26000034","year":2026,"outcome":"DENIED","quote":"The examiner also found it less likely than not that the left knee disability was aggravated by the service-connected right knee disability due to a lack of evidence for significantly altered gait or increased treatment."}]},{"pathway":"Weight gain or obesity","issues":19,"granted_pct":10.5,"examples":[{"case_id":"22026241","year":2022,"outcome":"GRANTED","quote":"Obesity found to be intermediate step between service-connected knee/foot disabilities and ankle disabilities."},{"case_id":"24025475","year":2024,"outcome":"DENIED","quote":"Diagnosed conditions are more likely due to age, obesity, and diabetes."}]},{"pathway":"Chronic pain","issues":13,"granted_pct":69.2,"examples":[{"case_id":"A25039197","year":2025,"outcome":"GRANTED","quote":"The Veteran's altered gait due to left knee pain led to increased biomechanical strain on the right knee, causing the osteoarthritis."}]},{"pathway":"Stress","issues":11,"granted_pct":54.5,"examples":[{"case_id":"A26035267","year":2026,"outcome":"GRANTED","quote":"opined that pain in the knees and back could impact gait, leading to increased stress on the hips, and that the left hip pain was at least as likely as not related to service."},{"case_id":"A20013403","year":2020,"outcome":"DENIED","quote":"The Veteran claimed service connection for left knee osteoarthritis, asserting it was secondary to his service-connected right knee osteoarthritis following a meniscal tear, due to an altered gait and increased stress."}]},{"pathway":"Nerve involvement","issues":10,"granted_pct":40,"examples":[{"case_id":"A24030561","year":2024,"outcome":"GRANTED","quote":"This condition was found to be secondarily related to the veteran's existing service-connected right knee condition, right ankle condition, and radiculopathy associated with lumbar intervertebral disc syndrome."},{"case_id":"21065154","year":2021,"outcome":"DENIED","quote":"No evidence of significant muscle or nerve damage impacting opposite limb."}]}]},"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."}}