Secondary service connection
Hip impairment secondary to an ankle condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided hip impairment claimed as secondary to an ankle condition in 766 decisions. It granted the issue in 19.8% of them, above the 15.8% grant rate for all hip impairment issues, denied it in 17.9%, and remanded it in 62.0%. Counting only decisions on the merits, 52.6% were granted.
Decisions
766
2017–2026
Granted
19.8%
All hip impairment: 15.8%
Granted on the merits
52.6%
Granted ÷ (granted + denied)
Remanded
62.0%
Denied: 17.9%
See all hip impairment decisions, direct and secondary.
Hip impairment secondary to an ankle condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 60 | 10.0% | 21.7% | 68.3% | 0.0% |
| 2018 | 105 | 7.6% | 30.5% | 60.0% | 1.9% |
| 2019 | 83 | 19.3% | 16.9% | 63.9% | 0.0% |
| 2020 | 101 | 11.9% | 22.8% | 65.3% | 0.0% |
| 2021 | 102 | 16.7% | 19.6% | 63.7% | 0.0% |
| 2022 | 120 | 15.8% | 11.7% | 71.7% | 0.8% |
| 2023 | 117 | 21.4% | 17.9% | 59.8% | 0.9% |
| 2024 | 129 | 24.0% | 7.8% | 68.2% | 0.0% |
| 2025 | 104 | 35.6% | 15.4% | 49.0% | 0.0% |
| 2026 | 40 | 50.0% | 12.5% | 37.5% | 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 Other: dismissed, withdrawn or no clear outcome.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 hip impairment decisions
For each kind of supporting evidence: how often the Board granted the hip 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 | 194 | 88.4% | 19.9% | +68.5 pts |
| Private medical opinion | 305 | 73.1% | 22.9% | +50.2 pts |
| Favorable VA exam | 69 | 88.1% | 46.6% | +41.5 pts |
| Treating physician opinion | 56 | 69.7% | 50.4% | +19.3 pts |
| Lay statement | 639 | 48.6% | 84.4% | −35.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 82.9% of the decisions that granted hip impairment.
- The Board found the veteran's statements credible in 23.7% of grants and 9.5% 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 hip 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 | 548 | 51.7% | 55.9% | −4.2 pts |
| Unfavorable VA exam | 649 | 51.7% | 60.0% | −8.3 pts |
How these claims are argued
A secondary claim says an ankle condition caused hip 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)
10.2%
granted, of 440 issues (45.8% of all)
Causation only
caused by the disability, 3.310(a)
28.0%
granted, of 521 issues (54.2% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “Veteran's VA treatment records consistently noted complaints of right hip pain attributed to compensating for right ankle condition.” A26003203 (2026) Denied “The Veteran claimed it was secondary to his service-connected lumbar spine and right ankle conditions due to altered gait.” A25007039 (2025) | 264 | 36.0% |
Weight gain or obesity Granted “Multiple VA opinions inadequate for failing to address obesity as intermediate step or aggravation.” A25048080 (2025) Denied “VA examinations in 2023 concluded that the hip disability was less likely than not related to the service-connected ankle condition, attributing it to the post-service fall and subsequent obesity.” 24029255 (2024) | 32 | 25.0% |
Nerve involvement Granted “VA opinion found no significant impact from ankle injury unless major muscle/nerve damage occurred.” A25085668 (2025) Denied “The veteran claims service connection for a left hip condition, asserting it is secondary to his service-connected right ankle disability, lower back disability, and bilateral lower extremity radiculopathy.” 25010527 (2025) | 17 | 17.6% |
Stress Granted “Medical literature supports gait alteration leading to hip stress.” A25106647 (2025) | 16 | 56.3% |
Chronic pain Granted “This rating reflects functional loss due to pain and limitation of motion, approximating extension limited to 5 degrees.” A26025560 (2026) Denied “Insufficient evidence of functional impairment due to pain” 19184831 (2019) | 12 | 25.0% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 33.1% of the 961 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 hip impairment
Most common reasons in grants
- Caused by the service-connected disability30
- Current diagnosis established15
- Service connection established12
- Aggravated by the service-connected disability7
- Conflicting medical opinions on nexus2
- VA examiner: less likely than not related to service2
- Reopened claim based on new and material evidence2
- New and material evidence received to reopen claim2
Most common reasons in denials
- VA examiner: less likely than not related to service28
- No in-service complaints, treatment or diagnosis28
- Preponderance of the evidence against the claim16
- Service records negative or silent14
- Caused by the service-connected disability9
- No current diagnosis8
- Aggravated by the service-connected disability7
- Criteria for service connection not met3
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 hip impairment decisions
Granted
Private orthopedic surgeon provided persuasive opinion linking left hip condition to service-connected knee/ankle issues.; VA examiner's negative opinion was less persuasive due to lack of thoroughness.; Benefit of the doubt resolved in veteran's favor.
Current bilateral hip joint dysfunction; Private medical opinion found secondary causation; Gait changes from lumbar strain and ankle instability
Evidence supports 10% rating for left hip extension limitation.; Pain and functional loss considered.; No evidence of ankylosis or functional equivalent found.
Denied
Right hip disability not secondary to right ankle disability; Criteria for service connection not met
No definitive diagnosis of right hip disorder in record; Service records negative for hip complaints; Appellant not competent to diagnose etiology of hip disorder; Secondary service connection denied as primary ankle claim denied; New theories raised at hearing were untimely
VA opinions found less likely than not related to service; Lack of STR evidence for hip pain; Persuasive weight of evidence against nexus
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 hip impairment.
- An ankle condition is already service connected.
- Medical evidence linking them (a nexus opinion): hip impairment was caused by an ankle 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 an ankle condition
Hip impairment secondary to other conditions
See all conditions secondary to an ankle condition.
Rules that apply to secondary hip 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 hip 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 hip impairment issue claimed as secondary to an ankle 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.