Secondary service connection
Hip impairment secondary to a back condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided hip impairment claimed as secondary to a back condition in 2,040 decisions. It granted the issue in 14.0% of them, close to the 15.8% grant rate for all hip impairment issues, denied it in 19.6%, and remanded it in 65.7%. Counting only decisions on the merits, 41.7% were granted.
Decisions
2,040
2017–2026
Granted
14.0%
All hip impairment: 15.8%
Granted on the merits
41.7%
Granted ÷ (granted + denied)
Remanded
65.7%
Denied: 19.6%
See all hip impairment decisions, direct and secondary.
Hip impairment secondary to a back condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 170 | 7.1% | 31.8% | 58.8% | 2.4% |
| 2018 | 244 | 6.1% | 23.0% | 68.9% | 2.0% |
| 2019 | 252 | 11.1% | 21.0% | 66.7% | 1.2% |
| 2020 | 317 | 12.3% | 23.7% | 62.8% | 1.3% |
| 2021 | 353 | 11.3% | 18.4% | 69.7% | 0.6% |
| 2022 | 318 | 14.5% | 16.7% | 68.2% | 0.6% |
| 2023 | 352 | 13.4% | 15.9% | 70.7% | 0.0% |
| 2024 | 321 | 16.5% | 17.8% | 65.7% | 0.0% |
| 2025 | 287 | 23.3% | 16.4% | 59.9% | 0.3% |
| 2026 | 127 | 33.9% | 13.4% | 52.8% | 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 Other: dismissed, withdrawn or no clear outcome.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 | 371 | 84.7% | 19.3% | +65.4 pts |
| Favorable VA exam | 225 | 79.7% | 33.4% | +46.3 pts |
| Private medical opinion | 658 | 55.6% | 31.1% | +24.5 pts |
| Treating physician opinion | 106 | 60.0% | 40.3% | +19.7 pts |
| Lay statement | 1,699 | 37.1% | 67.0% | −29.9 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 74.1% of the decisions that granted hip impairment.
- The Board found the veteran's statements credible in 25.2% of grants and 16.0% 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 |
|---|---|---|---|---|
| Unfavorable VA exam | 1,681 | 40.9% | 47.6% | −6.7 pts |
| Negative nexus opinion | 1,374 | 37.8% | 53.9% | −16.1 pts |
How these claims are argued
A secondary claim says a back 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)
6.1%
granted, of 1,122 issues (40.9% of all)
Causation only
caused by the disability, 3.310(a)
19.8%
granted, of 1,619 issues (59.1% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “Altered gait mechanics due to service-connected right knee and lumbar spine disabilities” A26004978 (2026) Denied “No medical literature supports lumbar osteoarthritis causing hip strain or gait alteration leading to hip strain..” 26003006 (2026) | 302 | 29.5% |
Nerve involvement Granted “Service connection for bilateral hip pain was granted as secondary to the Veteran's service-connected lumbar degenerative disc disease, left knee disabilities, and lower extremity radiculopathy.” A25022064 (2025) Denied “Post-service records indicated hip pain starting in 2017, attributed by the VA examiner to radiculopathy and the general aging process, not service connection or aggravation by the lumbar spine disability.” A26008744 (2026) | 211 | 11.4% |
Weight gain or obesity Granted “Obesity as intermediate step.” 26003891 (2026) Denied “VA examination found hip condition due to wear and tear and obesity, not lumbar spine disease.” A24018639 (2024) | 73 | 8.2% |
Chronic pain Granted “Pain results in functional impairment of earned capacity.” 24004981 (2024) Denied “No functional impairment in earning capacity due to left hip pain” A24030468 (2024) | 37 | 37.8% |
Stress Granted “A private medical expert linked the condition to gait dysfunction resulting from lumbar spinal disease, which caused compensatory stress on the hip.” A25102172 (2025) Denied “Examiner noted primary osteoarthritis likely related to aging/stress, not back condition..” 19102667 (2019) | 26 | 38.5% |
Reduced activity or mobility Granted “Lumbar immobility causing hip disability.” A24047555 (2024) Denied “The Board found that the Veteran's reported hip pain and mobility issues were not caused by or aggravated by the lumbar spine condition, but rather were manifestations of separately service-connected lumbar radiculopathies.” 21019334 (2021) | 10 | 30.0% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 21.2% of the 2,741 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 disability72
- Current diagnosis established40
- Service connection established34
- Aggravated by the service-connected disability18
- Secondary service connection granted4
- Service records negative or silent4
- VA examiner: less likely than not related to service4
- Resolving all doubt in veteran's favor3
Most common reasons in denials
- VA examiner: less likely than not related to service76
- No in-service complaints, treatment or diagnosis70
- Preponderance of the evidence against the claim55
- Service records negative or silent37
- No current diagnosis35
- Aggravated by the service-connected disability31
- Current diagnosis established10
- No continuity of symptomatology10
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 medical opinion provided favorable nexus; Equipoise resolved in Veteran's favor; Secondary to service-connected lumbar spine disability
Favorable finding of hip condition from AOJ; VA opinion inadequate (unsupported by rationale, conclusory); Competent and credible private opinion linked hip disability to back disability (hip-spine syndrome)
Service-connected lumbar spine disability.; Private opinion found bursitis proximately due to lumbar spine disability.; Benefit of the doubt afforded.
Denied
Favorable AOJ finding for diagnosis of myofascial syndrome.; Negative nexus opinions from VA examiners (Feb 2023, Sep 2024).; Private opinion less persuasive due to lack of baseline severity analysis.
Lack of service treatment records for hip condition; Hip condition likely due to post-service factors; No service connection for primary low back condition
No current diagnosis of left hip disability found in VA or private treatment records.; Subjective left hip pain reported by Veteran, but no evidence of functional impairment of earning capacity.; Evidence weighs against the claim, making benefit-of-the-doubt rule inapplicable.
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.
- A back condition is already service connected.
- Medical evidence linking them (a nexus opinion): hip 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
- 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 a back condition354 decisions · 6.2% granted
Hip impairment secondary to other conditions
See all conditions secondary to a back 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 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.