Secondary service connection
Ankle impairment secondary to a knee condition: BVA grant rates and what wins
From 2018 to 2026, the Board of Veterans' Appeals decided ankle impairment claimed as secondary to a knee condition in 883 decisions. It granted the issue in 15.4% of them, below the 18.2% grant rate for all ankle impairment issues, denied it in 15.3%, and remanded it in 69.2%. Counting only decisions on the merits, 50.2% were granted.
Decisions
883
2018–2026
Granted
15.4%
All ankle impairment: 18.2%
Granted on the merits
50.2%
Granted ÷ (granted + denied)
Remanded
69.2%
Denied: 15.3%
See all ankle impairment decisions, direct and secondary.
Ankle impairment secondary to a knee condition: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2018 | 87 | 11.5% | 23.0% | 65.5% |
| 2019 | 115 | 17.4% | 15.7% | 64.3% |
| 2020 | 103 | 7.8% | 15.5% | 76.7% |
| 2021 | 115 | 15.7% | 15.7% | 69.6% |
| 2022 | 100 | 12.0% | 15.0% | 74.0% |
| 2023 | 131 | 15.3% | 11.5% | 73.3% |
| 2024 | 104 | 13.5% | 10.6% | 75.0% |
| 2025 | 91 | 20.9% | 19.8% | 59.3% |
| 2026 | 37 | 40.5% | 10.8% | 51.4% |
Evidence in granted and denied ankle impairment decisions
For each kind of supporting evidence: how often the Board granted the ankle 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 | 183 | 88.6% | 22.3% | +66.3 pts |
| Private medical opinion | 278 | 71.7% | 31.3% | +40.4 pts |
| Treating physician opinion | 50 | 78.8% | 46.2% | +32.6 pts |
| Favorable VA exam | 107 | 75.4% | 42.9% | +32.6 pts |
| Lay statement | 739 | 47.9% | 65.7% | −17.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 80.1% of the decisions that granted ankle impairment.
- The Board found the veteran's statements credible in 28.7% of grants and 9.6% 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 ankle 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 | 599 | 46.9% | 58.4% | −11.5 pts |
| Unfavorable VA exam | 726 | 48.3% | 61.5% | −13.3 pts |
Why the Board granted or denied ankle impairment
Most common reasons in grants
- Caused by the service-connected disability32
- Current diagnosis established21
- Service connection established15
- Aggravated by the service-connected disability4
- VA examiner: less likely than not related to service2
- VA examiner opinion inadequate2
- Resolving all doubt in veteran's favor2
- Private opinion found probative2
Most common reasons in denials
- VA examiner: less likely than not related to service26
- No current diagnosis18
- Preponderance of the evidence against the claim16
- Service records negative or silent12
- Aggravated by the service-connected disability11
- No in-service complaints, treatment or diagnosis10
- Caused by the service-connected disability7
- Current diagnosis established6
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 ankle impairment decisions
Granted
Service-connected bilateral knee and low back disabilities established.; Private and VA opinions found bilateral ankle disability aggravated by service-connected knee/back conditions.; Opinions cited biomechanical relationship and overcompensation.
No direct service connection for left ankle sprain.; Secondary service connection granted based on right knee disability.; Benefit of the doubt applied to link ankle disability to knee injury.
Current disability conceded by AOJ; Service-connected left knee disability established; Private medical opinion found favorable nexus
Denied
Evidence persuasively against service connection; Lack of nexus to service-connected knee and feet disability
No current ankle disability or functional impairment.; No evidence of in-service complaints or diagnoses.; Claim of secondary ankle condition due to left knee is contradicted by evidence.
No evidence of current disability for right ankle; Lack of service treatment records or post-service medical records; Veteran's statements insufficient to trigger duty to assist
Rules that apply to secondary ankle 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 ankle 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 ankle impairment issue claimed as secondary to a knee 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 (2018–2026) and can contain errors. It is updated automatically as new decisions are added.