Secondary service connection
Ankle impairment secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided ankle impairment claimed as secondary to a back condition in 370 decisions. It granted the issue in 11.9% of them, below the 17.8% grant rate for all ankle impairment issues, denied it in 20.8%, and remanded it in 66.5%. Counting only decisions on the merits, 36.4% were granted.
Decisions
370
2017–2026
Granted
11.9%
All ankle impairment: 17.8%
Granted on the merits
36.4%
Granted ÷ (granted + denied)
Remanded
66.5%
Denied: 20.8%
See all ankle impairment decisions, direct and secondary.
Ankle impairment secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 26 | 0.0% | 19.2% | 80.8% | 0.0% |
| 2018 | 28 | 3.6% | 21.4% | 75.0% | 0.0% |
| 2019 | 46 | 4.3% | 28.3% | 67.4% | 0.0% |
| 2020 | 66 | 6.1% | 28.8% | 60.6% | 4.5% |
| 2021 | 56 | 5.4% | 25.0% | 69.6% | 0.0% |
| 2022 | 59 | 13.6% | 18.6% | 62.7% | 5.1% |
| 2023 | 64 | 14.1% | 23.4% | 62.5% | 0.0% |
| 2024 | 69 | 13.0% | 8.7% | 78.3% | 0.0% |
| 2025 | 65 | 13.8% | 21.5% | 64.6% | 0.0% |
Each row counts issues (each condition the Board decided), so the shares add up to 100%. Other: dismissed, withdrawn or no clear outcome. Years with fewer than 20 issues are left out.
Evidence in granted and denied ankle impairment decisions
For each kind of supporting evidence: how often the Board granted the ankle impairment issue on the merits when the decision mentioned it, compared with decisions that did not. These are associations, not causes, and evidence is recorded per decision, not per issue.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Positive nexus opinion | 65 | 83.3% | 16.5% | +66.9 pts |
| Private medical opinion | 107 | 66.0% | 17.6% | +48.4 pts |
| Lay statement | 305 | 30.0% | 66.7% | −36.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 75.0% of the decisions that granted ankle impairment.
- The Board found the veteran's statements credible in 18.2% of grants and 7.8% of denials.
Negative evidence in the record
An unfavorable exam or a negative nexus opinion often sits in the same record as favorable evidence, and the Board weighs them against each other. So these rows show how often ankle impairment was still granted when the record contained the negative item, not that the item helped.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Unfavorable VA exam | 298 | 35.6% | 41.2% | −5.6 pts |
| Negative nexus opinion | 246 | 29.9% | 52.9% | −23.1 pts |
How these claims are argued
A secondary claim says a back condition caused ankle impairment or made it worse, and names how. Below: whether the Board's decision discussed aggravation, and the medical link each decision names, with how often those issues were granted.
Aggravation discussed
made worse by the disability, 3.310(b)
7.9%
granted, of 190 issues (38.2% of all)
Causation only
caused by the disability, 3.310(a)
13.6%
granted, of 308 issues (61.8% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “Favorable VA examiner opinion linking right ankle to lumbar spine via gait changes” A26013883 (2026) Denied “Examiners attributed ankle disorder to compensation for abnormal gait from right hip surgery, not service..” 22007180 (2022) | 62 | 30.6% |
Nerve involvement Granted “Service connection granted based on secondary to service-connected radiculopathy” 25015204 (2025) Denied “No evidence linking ankle disability to service-connected low back or radiculopathy.” A25092155 (2025) | 45 | 11.1% |
Weight gain or obesity Granted “Obesity as intermediate step.” 26003891 (2026) Denied “Multiple VA examiners opined DJD is multifactorial (age, obesity, genetics)” 22042674 (2022) | 18 | 27.8% |
Chronic pain Granted “Service connection for left ankle 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 persistent lumbar pain and imbalanced...” A26005954 (2026) Denied “The Board found the veteran's lay statements attributing ongoing pain to the in-service fall less credible due to a lack of contemporaneous medical evidence and normal separation examination findings.” 21057758 (2021) | 15 | 13.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 26.1% of the 498 issues name at least one medical link; the rest only say “secondary to” the disability. One issue can name several links. Granted is the share of those issues granted (remands count as not granted). A link named in a denial was often the argument the Board rejected.
Why the Board granted or denied ankle impairment
Most common reasons in grants
- Caused by the service-connected disability10
- Service connection established5
- Aggravated by the service-connected disability5
- Current diagnosis established4
Most common reasons in denials
- No in-service complaints, treatment or diagnosis12
- VA examiner: less likely than not related to service12
- No current diagnosis10
- Preponderance of the evidence against the claim10
- Service records negative or silent8
- Aggravated by the service-connected disability7
- Current diagnosis established5
- Caused by the service-connected disability3
Numbers are decisions that gave the reason. Reasons are short phrases extracted by AI from each decision; common wordings of the same reason are grouped. Benefit of the doubt is reported above.
Recent ankle impairment decisions
Granted
Service-connected bilateral knee and low back disabilities established.; Private and VA opinions found bilateral ankle disability aggravated by service-connected knee/back conditions.; Opinions cited biomechanical relationship and overcompensation.
Treating physician opined injuries secondary to back condition; Record in relative equipoise; Benefit of the doubt resolved in Veteran's favor
Resolving doubt in Veteran's favor; Related to service-connected back disability; Obesity as intermediate step
Denied
No chronicity of right ankle disorder shown in service or within one year of separation.; VA examiners consistently found no nexus between current right ankle disorder and service.; Right ankle disorder not caused or aggravated by service-connected back condition.
No in-service injury, disease, or event reported for left ankle.; No chronic or continuous symptoms since service.; VA medical opinions found less likely than not related to service or aggravated by service-connected lumbosacral disability.; Condition attributed to normal aging process.
Not causally related to service; Not aggravated by service-connected disability; No in-service evidence or continuity of symptoms; Denied secondary to lumbar spine disorder (not service-connected)
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of ankle impairment.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): ankle impairment was caused by a back condition (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
Other conditions secondary to a back condition
- Paralysis of sciatic nerve secondary to a back condition325 decisions · 57.8% granted
- Radiculopathy secondary to a back condition1,181 decisions · 49.9% granted
- Major depressive disorder secondary to a back condition770 decisions · 47.4% granted
- Paralysis of sciatic nerve or external popliteal nerve secondary to a back condition2,436 decisions · 38.7% granted
- Sleep apnea secondary to a back condition1,166 decisions · 38.2% granted
- Ulnar nerve paralysis secondary to a back condition628 decisions · 34.6% granted
- Peripheral nerve conditions secondary to a back condition307 decisions · 32.2% granted
- Peripheral nerve disorders secondary to a back condition1,204 decisions · 27.8% granted
- Erectile dysfunction secondary to a back condition619 decisions · 27.6% granted
- Degenerative arthritis of the spine secondary to a back condition679 decisions · 23.7% granted
- Urinary incontinence secondary to a back condition408 decisions · 22.8% granted
- Hypertension secondary to a back condition330 decisions · 20.0% granted
- Migraine secondary to a back condition347 decisions · 18.7% granted
- Hip impairment secondary to a back condition1,856 decisions · 13.6% granted
- Knee conditions secondary to a back condition2,083 decisions · 12.3% granted
- Cervical spine limitation of motion secondary to a back condition1,553 decisions · 8.8% granted
- Shoulder impairment secondary to a back condition647 decisions · 7.3% granted
- Foot impairment secondary to a back condition354 decisions · 6.2% granted
Ankle impairment secondary to other conditions
See all conditions secondary to a back condition or ankle conditions as a primary or secondary condition.
Rules that apply to secondary ankle impairment claims
- 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - M21-1 V.ii.2.D
Secondary service connection and aggravation of non-service-connected disabilities
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer
Research your ankle impairment case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.
How these numbers are calculated
- Counts decisions in which the Board decided a ankle impairment issue claimed as secondary to a back condition, by the outcome of that issue.
- The primary disability is read from the decision text ("secondary to …") and grouped by name, so spellings such as "PTSD" and "posttraumatic stress disorder" count together.
- Secondary claims also include aggravation of a non-service-connected condition by a service-connected one (38 CFR 3.310(b)).
- The data comes from CaseScribe's AI extraction of public BVA decisions (2017–2026) and can contain errors. It is updated automatically as new decisions are added.