Secondary service connection
Cervical spine limitation of motion secondary to a knee condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided cervical spine limitation of motion claimed as secondary to a knee condition in 397 decisions. It granted the issue in 10.6% of them, below the 13.3% grant rate for all cervical spine limitation of motion issues, denied it in 17.9%, and remanded it in 70.3%. Counting only decisions on the merits, 37.2% were granted.
Decisions
397
2017–2026
Granted
10.6%
All cervical spine limitation of motion: 13.3%
Granted on the merits
37.2%
Granted ÷ (granted + denied)
Remanded
70.3%
Denied: 17.9%
See all cervical spine limitation of motion decisions, direct and secondary.
Cervical spine limitation of motion secondary to a knee condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 24 | 0.0% | 20.8% | 70.8% | 8.3% |
| 2018 | 48 | 14.6% | 20.8% | 64.6% | 0.0% |
| 2019 | 57 | 12.3% | 15.8% | 71.9% | 0.0% |
| 2020 | 31 | 3.2% | 22.6% | 74.2% | 0.0% |
| 2021 | 57 | 10.5% | 15.8% | 73.7% | 0.0% |
| 2022 | 55 | 5.5% | 21.8% | 70.9% | 1.8% |
| 2023 | 50 | 6.0% | 24.0% | 68.0% | 2.0% |
| 2024 | 35 | 8.6% | 8.6% | 80.0% | 2.9% |
| 2025 | 30 | 26.7% | 10.0% | 63.3% | 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 Other: dismissed, withdrawn or no clear outcome.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 cervical spine limitation of motion decisions
For each kind of supporting evidence: how often the Board granted the cervical spine limitation of motion 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 | 79 | 65.9% | 20.8% | +45.0 pts |
| Private medical opinion | 135 | 50.0% | 27.0% | +23.0 pts |
| Favorable VA exam | 43 | 51.9% | 32.6% | +19.3 pts |
| Lay statement | 310 | 34.1% | 50.0% | −15.9 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 76.2% of the decisions that granted cervical spine limitation of motion.
- The Board found the veteran's statements credible in 40.5% of grants and 8.5% 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 cervical spine limitation of motion 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 | 311 | 31.2% | 65.0% | −33.8 pts |
| Negative nexus opinion | 274 | 29.1% | 63.0% | −33.9 pts |
How these claims are argued
A secondary claim says a knee condition caused cervical spine limitation of motion 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)
7.1%
granted, of 196 issues (49.4% of all)
Causation only
caused by the disability, 3.310(a)
13.9%
granted, of 201 issues (50.6% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “A private nurse practitioner opined that the neck condition was as likely as not aggravated by these service-connected conditions due to altered gait.” A26023906 (2026) Denied “Private medical opinion from 2013 lacked probative value due to absence of supporting diagnostic imaging and chronic gait abnormality.” 22051118 (2022) | 57 | 12.3% |
Nerve involvement Granted “Service connection for a cervical spine condition is granted on a secondary basis, found to be proximately caused by the service-connected right knee condition and right lower extremity radiculopathy.” 26001303 (2026) Denied “The Board found a current diagnosis of arthritis of C5-6 with radiculopathy but denied direct service connection due to lack of in-service onset or complaints.” 19134793 (2019) | 18 | 33.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 19.9% of the 397 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 cervical spine limitation of motion
Most common reasons in grants
- Caused by the service-connected disability10
- Current diagnosis established5
- Service connection established5
- Aggravated by the service-connected disability2
Most common reasons in denials
- Preponderance of the evidence against the claim14
- Aggravated by the service-connected disability9
- VA examiner: less likely than not related to service8
- Service records negative or silent5
- No in-service complaints, treatment or diagnosis5
- Evidence persuasively weighs against service connection4
- No continuity of symptomatology4
- 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 cervical spine limitation of motion decisions
Granted
Private medical opinion found neck disorder aggravated by service-connected lower extremity disabilities; Opinion based on Veteran's medical history and current medical understanding; No contrary opinion of record
New and relevant evidence received; Buddy statement corroborated in-service injury; Veteran's accounts inherently plausible and consistent; Benefit of the doubt applied
Evidence supports secondary service connection; Conflicting VA examiner opinions ultimately favored positive nexus; Medical literature supports link between lower extremity impairment and cervical spine issues
Denied
No current diagnosis at time of initial decision; Subsequent records received after appeal period; Veteran not competent to provide nexus opinion
Cervical spine disability not caused by service-connected knee; Cervical spine disability not aggravated by service-connected knee; Evidence weighs against secondary connection
No medical nexus opinion linking cervical spine to service or knee disabilities; Veteran missed scheduled VA examination; Evidence persuasively weighs against service connection
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 cervical spine limitation of motion.
- A knee condition is already service connected.
- Medical evidence linking them (a nexus opinion): cervical spine limitation of motion was caused by a knee 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 knee condition
- Major depressive disorder secondary to a knee condition512 decisions · 49.4% granted
- Sleep apnea secondary to a knee condition983 decisions · 46.2% granted
- Osteoarthritis secondary to a knee condition535 decisions · 34.2% granted
- Degenerative arthritis of the spine secondary to a knee condition2,449 decisions · 24.1% granted
- Intervertebral disc syndrome secondary to a knee condition1,760 decisions · 19.7% granted
- Hip impairment secondary to a knee condition2,665 decisions · 19.0% granted
- Ankle impairment secondary to a knee condition952 decisions · 15.2% granted
- Shoulder impairment secondary to a knee condition426 decisions · 15.0% granted
- Thoracolumbar or lumbar spine limitation of motion secondary to a knee condition636 decisions · 8.6% granted
- Foot impairment secondary to a knee condition445 decisions · 8.3% granted
Cervical spine limitation of motion secondary to other conditions
See all conditions secondary to a knee condition or neck conditions as a primary or secondary condition.
Rules that apply to secondary cervical spine limitation of motion 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 cervical spine limitation of motion 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 cervical spine limitation of motion issue claimed as secondary to a knee 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.