{"page":"https://casescribe.ai/explorer/secondary/shoulder-impairment-secondary-to-knee","generated_at":"2026-10-03T18:34:26.068Z","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":"Shoulder impairment secondary to a knee condition","secondary_condition":"Shoulder impairment","service_connected_disability":"a knee condition","decisions":428,"years":"2017-2026","granted_pct":15,"denied_pct":18.7,"remanded_pct":66.4,"granted_on_merits_pct":44.4,"by_year":[{"year":2017,"issues":34,"granted_pct":14.7,"denied_pct":38.2,"remanded_pct":41.2},{"year":2018,"issues":51,"granted_pct":11.8,"denied_pct":29.4,"remanded_pct":58.8},{"year":2019,"issues":46,"granted_pct":17.4,"denied_pct":21.7,"remanded_pct":58.7},{"year":2020,"issues":64,"granted_pct":7.8,"denied_pct":15.6,"remanded_pct":76.6},{"year":2021,"issues":69,"granted_pct":8.7,"denied_pct":27.5,"remanded_pct":63.8},{"year":2022,"issues":62,"granted_pct":19.4,"denied_pct":14.5,"remanded_pct":66.1},{"year":2023,"issues":71,"granted_pct":11.3,"denied_pct":14.1,"remanded_pct":74.6},{"year":2024,"issues":65,"granted_pct":18.5,"denied_pct":1.5,"remanded_pct":80},{"year":2025,"issues":51,"granted_pct":9.8,"denied_pct":17.6,"remanded_pct":72.5}],"benefit_of_doubt_in_grants_pct":78.1,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":42,"granted_pct_with":72,"granted_pct_without":38.7},{"evidence":"va_exam_unfavorable","decisions_with":363,"granted_pct_with":42.4,"granted_pct_without":57.9},{"evidence":"nexus_positive","decisions_with":67,"granted_pct_with":89.5,"granted_pct_without":28.3},{"evidence":"nexus_negative","decisions_with":311,"granted_pct_with":40.2,"granted_pct_without":59.4},{"evidence":"private_opinion","decisions_with":134,"granted_pct_with":64,"granted_pct_without":34},{"evidence":"lay_statement","decisions_with":370,"granted_pct_with":43.1,"granted_pct_without":71.4}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":14},{"reason":"service connection established","decisions":6},{"reason":"current diagnosis established","decisions":4},{"reason":"granted service connection","decisions":2},{"reason":"new and material evidence received","decisions":2}],"denied":[{"reason":"preponderance of the evidence against the claim","decisions":14},{"reason":"no in-service complaints, treatment or diagnosis","decisions":14},{"reason":"va examiner: less likely than not related to service","decisions":11},{"reason":"aggravated by the service-connected disability","decisions":5},{"reason":"no current diagnosis","decisions":5},{"reason":"service records negative or silent","decisions":4}]},"recent_examples":{"granted":[{"case_id":"A26034607","year":2026,"judge":"REBECCA N. POULSON","rationale":"Veteran's consistent reports of falls due to knee instability; Early statements predating claim corroborate injury theory; VA opinions inadequate for failing to address Veteran's theory"},{"case_id":"A26027919","year":2026,"judge":"K.A. KENNERLY","rationale":"Private medical opinion found shoulder disability secondary to service-connected lower extremity disabilities.; VA examination was inadequate as it failed to address lay assertions and aggravation.; Resolving doubt in veteran's favor, private opinion deemed sufficient for grant."},{"case_id":"26003004","year":2026,"judge":"THOMAS L. ENGLISH","rationale":"Veteran's lay statements of fall injuring shoulder after knee injury are competent and credible; Negative VA opinions failed to address secondary connection theory; Board applied benefit of the doubt and afforded greater probative value to lay statements"}],"denied":[{"case_id":"A26006819","year":2026,"judge":"THOMAS H. O'SHAY","rationale":"No competent medical opinion linking left shoulder disability to service or left knee disability.; Veteran's lay opinion regarding nexus is not probative.; Lack of credible continuity of symptomatology for shoulder pain.; Duty to provide VA exam not triggered."},{"case_id":"25013433","year":2025,"judge":"B. D. WATSON","rationale":"Not service connected for the primary right knee condition.; Failed to provide specifics of an in-service event related to the shoulder condition.; Did not meet McLendon test for remand."},{"case_id":"25011821","year":2025,"judge":"STEVEN D. REISS","rationale":"Service treatment records did not reflect complaints or treatment for right shoulder disability.; Veteran's statements regarding knee issues causing shoulder pain were found not credible.; June 2025 VA opinion found right shoulder disability less likely than not related to 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":531,"aggravation_discussed":{"issues":248,"granted_pct":4},"causation_only":{"issues":283,"granted_pct":22.3},"issues_naming_a_pathway_pct":11.1,"pathways":[{"pathway":"Altered gait or overuse","issues":39,"granted_pct":10.3,"examples":[{"case_id":"26001914","year":2026,"outcome":"GRANTED","quote":"A November 2023 private opinion found it at least as likely as not due to altered gait from the right knee arthritis."},{"case_id":"23030719","year":2023,"outcome":"DENIED","quote":"Shoulder impingement likely due to overuse, not falls."}]}]},"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."}}