Secondary service connection
Ankle impairment secondary to flat feet: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided ankle impairment claimed as secondary to flat feet in 332 decisions. It granted the issue in 19.0% of them, close to the 17.8% grant rate for all ankle impairment issues, denied it in 14.2%, and remanded it in 66.9%. Counting only decisions on the merits, 57.3% were granted.
Decisions
332
2017–2026
Granted
19.0%
All ankle impairment: 17.8%
Granted on the merits
57.3%
Granted ÷ (granted + denied)
Remanded
66.9%
Denied: 14.2%
See all ankle impairment decisions, direct and secondary.
Ankle impairment secondary to flat feet: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 36 | 5.6% | 25.0% | 66.7% | 2.8% |
| 2018 | 40 | 17.5% | 7.5% | 72.5% | 2.5% |
| 2019 | 42 | 26.2% | 7.1% | 66.7% | 0.0% |
| 2020 | 53 | 11.3% | 28.3% | 60.4% | 0.0% |
| 2021 | 46 | 17.4% | 15.2% | 67.4% | 0.0% |
| 2022 | 48 | 25.0% | 8.3% | 62.5% | 4.2% |
| 2023 | 51 | 21.6% | 11.8% | 64.7% | 2.0% |
| 2024 | 58 | 12.1% | 12.1% | 75.9% | 0.0% |
| 2025 | 62 | 25.8% | 12.9% | 61.3% | 0.0% |
| 2026 | 23 | 30.4% | 8.7% | 60.9% | 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 Other: dismissed, withdrawn or no clear outcome.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 | 71 | 88.9% | 35.4% | +53.5 pts |
| Favorable VA exam | 40 | 83.3% | 50.0% | +33.3 pts |
| Private medical opinion | 129 | 66.7% | 44.7% | +22.0 pts |
| Lay statement | 263 | 53.8% | 73.7% | −19.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 76.2% of the decisions that granted ankle impairment.
- The Board found the veteran's statements credible in 15.9% of grants and 12.8% 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 |
|---|---|---|---|---|
| Negative nexus opinion | 228 | 56.7% | 60.0% | −3.3 pts |
| Unfavorable VA exam | 267 | 56.1% | 66.7% | −10.5 pts |
How these claims are argued
A secondary claim says flat feet 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)
10.9%
granted, of 175 issues (38.1% of all)
Causation only
caused by the disability, 3.310(a)
23.9%
granted, of 284 issues (61.9% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “linked altered gait from feet disabilities to bilateral ankle pain.” A26000420 (2026) Denied “Service connection for a right ankle condition, claimed as secondary to bilateral pes planus, was denied because the evidence persuasively favored the conclusion that it was less likely than not incurred in or caused by active service.” 23058130 (2023) | 37 | 37.8% |
Chronic pain Granted “The Board found a current disability due to pain and functional impairment from pronation.” 23065076 (2023) | 12 | 8.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 12.4% of the 459 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 disability17
- Current diagnosis established8
- Service connection established8
Most common reasons in denials
- Preponderance of the evidence against the claim8
- VA examiner: less likely than not related to service8
- No in-service complaints, treatment or diagnosis7
- No current diagnosis4
- Service records negative or silent3
- Pes planus not service-connected2
- Claim for secondary service connection denied as the primary foot condition is not service-connected1
- Delayed onset of symptoms years after service1
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
October 2025 VA examination reflects ankylosis of left ankle, degenerative arthritis of left ankle, and bilateral ankle strain.; October 2025 medical opinion provided positive nexus stating ankle disability would be less severe and result in less functional impairment if service-connected pes planus or plantar fasciitis were absent.; November 2025 VA examination and opinion were found insufficient.
Private medical opinion found pes planus contributed to ankle injury; VA exam conflicted but lacked supporting literature; Board found private opinion highly persuasive due to rationale
Current disability shown by pain causing functional impairment; November 2022 VA exam opinion links pain to service-connected conditions; Service treatment records silent, but post-service and later VA exams noted ankle issues
Denied
Evidence persuasively weighs against service connection; Evidence persuasively weighs against secondary connection to pes planus
No chronic in-service symptoms; No continuity of symptomatology after service; No etiologically related to service; Not aggravated by service-connected conditions
Service treatment records negative for ankle disorder; April 2010 medical evaluation found ankles normal; November 2022 VA exam found no current ankle disorder
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.
- Flat feet is already service connected.
- Medical evidence linking them (a nexus opinion): ankle impairment was caused by flat feet (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 flat feet
Ankle impairment secondary to other conditions
See all conditions secondary to flat feet 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 flat feet, 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.