Secondary service connection

Conditions secondary to flat feet

Veterans with service-connected flat feet often claim other conditions as caused or worsened by it. This page lists those conditions, what VA needs to grant them, and how they fared when veterans appealed to the Board of Veterans' Appeals.

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:

  1. A current diagnosis of the secondary condition.
  2. Flat feet is already service connected.
  3. Medical evidence linking them (a nexus opinion): the secondary condition 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).

Conditions claimed secondary to flat feet

Conditions the Board decided at least 300 times as secondary to this disability, highest appeal grant rate first. Open one for the evidence and reasons behind the decisions.

Positive nexus opinions track with higher flat feet grant rates

Board flat feet appeals decided on the merits were granted 68.7% of the time when a positive nexus opinion was in the record, against 32.0% without one.

Common reasons for claim denials and appeal outcomes

Across 13,017 bilateral flatfoot decisions, the Board denied 31.0%, granted 20.5% and remanded 46.9%. The top denial reason was a preponderance of evidence against the claim, cited in 349 decisions. Silent service records followed at 338, then no in-service complaints at 304. No current diagnosis appeared in 246 denials, and a negative examiner opinion in 241. Grant rates rose from 13.5% in 2017 to 25.2% in 2024.

Flatfoot Board outcomes by year
GrantedDenied

2017

13.5%
35.3%

2019

16.9%
31.0%

2021

19.4%
32.8%

2023

21.4%
24.9%

2024

25.2%
26.5%

2025

23.3%
31.3%

2026

30.2%
36.0%

Share of issues per year. 2026 is a partial year.

Aggravation of pre-existing pes planus

Aggravation shows up often in grant reasons. The presumption of aggravation applied in 49 grants. It was not rebutted by clear and unmistakable evidence in 35 more, and simply not rebutted in 25. By comparison, an established current diagnosis was cited in 216 grants.

Medical nexus letters and C&P exams

A favorable VA exam went with a 63.1% merits grant rate, versus 34.6% without. Unfavorable exams were common, in 9,613 decisions, yet those still saw 38.5% granted. Treating physician opinions matched 62.2% against 38.6%. The benefit of the doubt was applied in 71.5% of grants. The data does not show why these opinions line up with grants.

Flatfoot merits grant rate with and without each evidence type
WithWithout

Positive nexus opinion

68.7%
32.0%

Favorable VA exam

63.1%
34.6%

Treating physician opinion

62.2%
38.6%

Private opinion

51.4%
34.2%

Buddy statement

50.0%
39.3%

Lay statement

39.8%
39.1%

Board decisions on the merits for bilateral acquired flatfoot. Associations only; the data does not show cause.

Lay statements and buddy letters

Lay statements appeared in 10,996 decisions, with almost no gap: 39.8% with versus 39.1% without. Buddy statements were rarer, in 429 decisions, and matched 50.0% versus 39.3%.

Figures from the research data as of Oct 15, 2026. Every number is computed from the data, which is extracted by AI from public decisions and can contain errors.

Rules that apply to secondary claims

Research your secondary case

Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.

Which conditions secondary to flat feet does the Board grant most often, and why?What nexus opinions win claims secondary to flat feet?Why does the Board deny conditions claimed secondary to flat feet?
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Where this data comes from

  1. Claim
  2. Regional office decides
  3. Veteran appeals
  4. Board decides
  5. 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