Secondary service connection
Degenerative arthritis of the spine secondary to flat feet: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided degenerative arthritis of the spine claimed as secondary to flat feet in 419 decisions. It granted the issue in 23.4% of them, above the 21.2% grant rate for all degenerative arthritis of the spine issues, denied it in 22.4%, and remanded it in 53.0%. Counting only decisions on the merits, 51.0% were granted.
From Board of Veterans' Appeals decisions: appeals, not VA's first decisions. About these numbers
Decisions
419
2017–2026
Granted
23.4%
All degenerative arthritis of the spine: 21.2%
Granted on the merits
51.0%
Granted ÷ (granted + denied)
Remanded
53.0%
Denied: 22.4%
At a glance
- Most often argued link: altered gait or overuse, named in 81 issues, 46.9% granted. Details
- Causation only: 30.1% granted; when the decision discussed aggravation: 17.0%. Details
- Positive nexus opinion: 82.2% granted on the merits when in the record, 23.5% without. Details
- Private medical opinion: 66.1% granted on the merits when in the record, 31.3% without. Details
- Issues granted: 25.0% in 2019, 28.3% in 2023. Details
How these claims are argued
A secondary claim says flat feet caused degenerative arthritis of the spine 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)
17.0%
granted, of 206 issues (47.7% of all)
Causation only
caused by the disability, 3.310(a)
30.1%
granted, of 226 issues (52.3% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “linked altered gait from feet disabilities to lumbar spine issues.” A26000420 (2026) Denied “No medical literature supports link between foot conditions and back pain without gait abnormalities.” A25039041 (2025) | 81 | 46.9% |
Weight gain or obesity Granted “Obesity as intermediate step” 23011877 (2023) Denied “Alternative factors cited: post-service occupation, aging, obesity..” 24027914 (2024) | 15 | 6.7% |
Nerve involvement Granted “Service connection for a back disability, diagnosed as lumbosacral spine degenerative arthritis and lumbar spine disc disease with left lower extremity radiculopathy, is granted on a secondary basis.” 23011877 (2023) Denied “No in-service injury, disease, event, or chronic symptoms of back arthritis with radiculopathy.” A24062272 (2024) | 11 | 27.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 26.6% of the 432 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.
Evidence in granted and denied degenerative arthritis of the spine decisions
For each kind of supporting evidence: how often the Board granted the degenerative arthritis of the spine 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 | 130 | 82.2% | 23.5% | +58.7 pts |
| Private medical opinion | 181 | 66.1% | 31.3% | +34.7 pts |
| Favorable VA exam | 59 | 70.3% | 46.5% | +23.8 pts |
| Lay statement | 339 | 43.8% | 87.5% | −43.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 81.6% of the decisions that granted degenerative arthritis of the spine.
- The Board found the veteran's statements credible in 20.4% of grants and 6.4% 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 degenerative arthritis of the spine 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 | 357 | 48.6% | 73.7% | −25.1 pts |
| Negative nexus opinion | 322 | 47.0% | 75.0% | −28.0 pts |
Recent degenerative arthritis of the spine decisions
Granted
Grant based on Veteran's lay statements and private medical opinion; Resolving reasonable doubt in Veteran's favor; VA opinions found inadequate for failing to consider all evidence
Current diagnosis of lumbar degenerative arthritis of the spine, spinal fusion, spinal stenosis, and DDD established.; Service-connected pes planus established.; Treating neurosurgeon's opinion linked foot condition to worsening back problems.; VA examiner's negative opinion for secondary connection used incorrect causation standard.; Benefit of the doubt applied due to approximate balance of evidence.
Dr. M.T. found back condition as likely as not related to service-connected pes planus and shin splints.; Functional limitations found to constitute disabling impairment.; Veteran entered service without back issues.
Denied
August 2020 VA examination found lumbar disability less likely than not related to service or service-connected conditions.; Lack of supporting medical evidence and normal aging process cited.; Service treatment records showed only an isolated sciatica complaint with no further lumbar issues noted.
No evidence of in-service event, injury, or disease for low back.; Service records silent regarding low back condition.; Pes planus not service-connected, thus secondary claim denied.
No in-service injury or illness related to the back.; Contemporaneous service records indicated no back pain.; Veteran's later statements about pain onset were inconsistent.; No credible medical evidence linking pes planus to lumbar condition.; VA examination found no gait impairment or marked deformity.
Degenerative arthritis of the spine secondary to flat feet: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 36 | 11.1% | 41.7% | 38.9% | 8.3% |
| 2018 | 38 | 15.8% | 31.6% | 52.6% | 0.0% |
| 2019 | 56 | 25.0% | 26.8% | 46.4% | 1.8% |
| 2020 | 59 | 20.3% | 25.4% | 54.2% | 0.0% |
| 2021 | 43 | 18.6% | 14.0% | 67.4% | 0.0% |
| 2022 | 45 | 24.4% | 20.0% | 55.6% | 0.0% |
| 2023 | 53 | 28.3% | 15.1% | 56.6% | 0.0% |
| 2024 | 44 | 31.8% | 15.9% | 52.3% | 0.0% |
| 2025 | 43 | 34.9% | 18.6% | 44.2% | 2.3% |
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.
Why the Board granted or denied degenerative arthritis of the spine
Most common reasons in grants
- Caused by the service-connected disability17
- Current diagnosis established14
- Service connection established12
- Aggravated by the service-connected disability3
- Medical literature supports correlation between pes planus and low back pain2
- VA examiner: less likely than not related to service2
- Evidence persuasively favors secondary connection2
Most common reasons in denials
- No in-service complaints, treatment or diagnosis29
- VA examiner: less likely than not related to service24
- Preponderance of the evidence against the claim11
- Service records negative or silent7
- No continuity of symptomatology6
- Aggravated by the service-connected disability4
- Current diagnosis established3
- Claimed secondary to pes planus, which was denied1
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.
Background
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 degenerative arthritis of the spine.
- Flat feet is already service connected.
- Medical evidence linking them (a nexus opinion): degenerative arthritis of the spine 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).
How VA rates degenerative arthritis of the spine
Once service connection is granted, VA assigns a disability rating from the rating schedule, 38 CFR 4.71a, diagnostic code 5242 (Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)). The rating is the same whether the condition is service connected directly or as secondary to another disability.
| Rating | Criteria |
|---|---|
| 60% | With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months |
| 40% | With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months |
| 20% | With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months |
| 10% | With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months |
| | Rating |
- Note: If traumatic paralysis does not cause loss of use of both hands or both feet, it is incomplete paralysis. Evaluate residuals of incomplete traumatic paralysis under the appropriate diagnostic code (e.g., § 4.124a, Diseases of the Peripheral Nerves).
- Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.
- Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.
Text of 38 CFR 4.71a as of Feb 27, 2026. Confirm the current text at the source before relying on it.
See all degenerative arthritis of the spine decisions, direct and secondary.
Other conditions secondary to flat feet
Degenerative arthritis of the spine secondary to other conditions
See all conditions secondary to flat feet or back conditions as a primary or secondary condition.
Rules that apply to secondary degenerative arthritis of the spine 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 - 38 CFR 4.71a · DC 5242
Schedule of ratings: musculoskeletal system
Read it in VA Law Explorer - M21-1 V.iii.1.B.3
Spine: evaluating manifestations of spine diseases and injuries
Read it in VA Law Explorer - M21-1 V.iii.1.C
Arthritis: degenerative arthritis and separately compensable joints
Read it in VA Law Explorer - M21-1 V.iii.1.A
Painful motion and functional loss (38 CFR 4.59, DeLuca, Mitchell, Correia)
Read it in VA Law Explorer
Research your degenerative arthritis of the spine 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 degenerative arthritis of the spine 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.
Where this data comes from
- Claim
- Regional office decides
- Veteran appeals
- Board decides
- Granted · Denied · Remanded: back to the regional office
Board of Veterans' Appeals decisions show how VA's highest review body applies 38 CFR and weighs evidence on contested claims.
Each one is an appeal: a regional office decided the claim first, and the veteran appealed. So these rates describe the Board, not a veteran's odds at the regional office, where most claims are decided and whose decisions are not public.
More on what Board decisions can and cannot tell you