Secondary service connection
Foot impairment secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided foot impairment claimed as secondary to a back condition in 380 decisions. It granted the issue in 5.8% of them, below the 11.0% grant rate for all foot impairment issues, denied it in 20.3%, and remanded it in 73.7%. Counting only decisions on the merits, 22.2% were granted.
Decisions
380
2017–2026
Granted
5.8%
All foot impairment: 11.0%
Granted on the merits
22.2%
Granted ÷ (granted + denied)
Remanded
73.7%
Denied: 20.3%
See all foot impairment decisions, direct and secondary.
Foot impairment secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 26 | 0.0% | 42.3% | 57.7% | 0.0% |
| 2018 | 35 | 5.7% | 17.1% | 68.6% | 8.6% |
| 2019 | 53 | 5.7% | 28.3% | 66.0% | 0.0% |
| 2020 | 58 | 3.4% | 29.3% | 67.2% | 0.0% |
| 2021 | 62 | 4.8% | 22.6% | 72.6% | 0.0% |
| 2022 | 63 | 1.6% | 9.5% | 88.9% | 0.0% |
| 2023 | 60 | 5.0% | 10.0% | 85.0% | 0.0% |
| 2024 | 77 | 5.2% | 15.6% | 79.2% | 0.0% |
| 2025 | 39 | 23.1% | 15.4% | 61.5% | 0.0% |
| 2026 | 23 | 13.0% | 21.7% | 65.2% | 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 Other: dismissed, withdrawn or no clear outcome.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 foot impairment decisions
For each kind of supporting evidence: how often the Board granted the foot 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 | 49 | 58.3% | 10.7% | +47.7 pts |
| Private medical opinion | 92 | 34.4% | 16.4% | +18.0 pts |
| Lay statement | 321 | 20.5% | 36.4% | −15.9 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 68.2% of the decisions that granted foot impairment.
- The Board found the veteran's statements credible in 27.3% of grants and 9.1% 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 foot 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 | 305 | 21.8% | 25.0% | −3.2 pts |
| Negative nexus opinion | 249 | 18.4% | 34.8% | −16.4 pts |
How these claims are argued
A secondary claim says a back condition caused foot 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)
4.1%
granted, of 171 issues (34.5% of all)
Causation only
caused by the disability, 3.310(a)
7.1%
granted, of 325 issues (65.5% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Nerve involvement Granted “Medical evidence supports nexus between DDD and left lower extremity radiculopathy..” 20011363 (2020) Denied “The Board denied this claim, finding no in-service complaints for the foot and that the VA examiner attributed the foot numbness to superficial peroneal neuropathy unrelated to the back.” A26000395 (2026) | 79 | 3.8% |
Altered gait or overuse Granted “Chiropractor cited antalgic gait and weight-shifting due to lumbar spine disorder.” A26017778 (2026) Denied “Board concluded foot issues already compensated under service-connected radiculopathy.” 20080214 (2020) | 43 | 23.3% |
Weight gain or obesity Granted “Obesity as intermediate step” A25018053 (2025) Denied “Disability attributed to morbid obesity and post-service strain.” A21002205 (2021) | 14 | 14.3% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 26.8% of the 496 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 foot impairment
Most common reasons in grants
- Caused by the service-connected disability7
- Current diagnosis established2
- Service connection established2
Most common reasons in denials
- Preponderance of the evidence against the claim10
- No in-service complaints, treatment or diagnosis9
- Service records negative or silent8
- VA examiner: less likely than not related to service7
- Aggravated by the service-connected disability6
- No current diagnosis5
- Current diagnosis established2
- Lumbar spine disorder not service-connected2
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 foot impairment decisions
Granted
Prognosis favors service connection; Secondary to service-connected lumbosacral strain; More probative evidence from private/VA treatment records; Pain with functional loss constitutes a disability
Private chiropractor opined condition is more likely than not secondary to lumbar spine disorder.; Chiropractor cited antalgic gait and weight-shifting due to lumbar spine disorder.; Private opinion given great weight due to reliance on medical history and clear conclusions.
Aggravated by service-connected lumbar spine and left ankle disabilities; Private medical opinion found at least as likely as not aggravated; Benefit of the doubt applied
Denied
No current foot disability established.; No nexus to service-connected lumbar spine disability shown.
No in-service injury documented for right foot; Negative nexus opinions from VA examiners (Aug 2024, Mar 2025); No evidence of aggravation by service-connected lumbar spine condition
No evidence of in-service manifestation or relation to in-service injury; Lay statements lacked probative value due to inconsistencies; No specific treatment for foot issues during service; Failure to attend VA examinations
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 foot impairment.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): foot 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
- Ankle impairment secondary to a back condition322 decisions · 11.2% 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 other conditions
See all conditions secondary to a back condition.
Rules that apply to secondary foot 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 foot 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 foot 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.