Secondary service connection
Hip impairment secondary to a knee condition: BVA grant rates and what wins
From 2018 to 2026, the Board of Veterans' Appeals decided hip impairment claimed as secondary to a knee condition in 2,484 decisions. It granted the issue in 19.4% of them, above the 16.2% grant rate for all hip impairment issues, denied it in 17.0%, and remanded it in 63.6%. Counting only decisions on the merits, 53.4% were granted.
Decisions
2,484
2018–2026
Granted
19.4%
All hip impairment: 16.2%
Granted on the merits
53.4%
Granted ÷ (granted + denied)
Remanded
63.6%
Denied: 17.0%
See all hip impairment decisions, direct and secondary.
Hip impairment secondary to a knee condition: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2018 | 263 | 11.4% | 27.0% | 60.8% |
| 2019 | 285 | 13.3% | 22.5% | 64.2% |
| 2020 | 290 | 11.4% | 25.2% | 64.1% |
| 2021 | 298 | 17.4% | 15.8% | 67.1% |
| 2022 | 292 | 18.5% | 14.0% | 66.8% |
| 2023 | 309 | 15.5% | 14.2% | 70.2% |
| 2024 | 334 | 26.0% | 9.9% | 64.4% |
| 2025 | 291 | 33.0% | 10.7% | 56.4% |
| 2026 | 122 | 36.9% | 14.8% | 49.2% |
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 | 591 | 87.1% | 24.1% | +63.0 pts |
| Private medical opinion | 943 | 71.5% | 30.1% | +41.5 pts |
| Treating physician opinion | 152 | 79.4% | 50.2% | +29.1 pts |
| Favorable VA exam | 263 | 75.1% | 48.4% | +26.8 pts |
| Lay statement | 2,020 | 49.0% | 74.4% | −25.4 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 78.1% of the decisions that granted hip impairment.
- The Board found the veteran's statements credible in 24.6% of grants and 8.8% 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 | 2,065 | 52.2% | 62.3% | −10.1 pts |
| Negative nexus opinion | 1,753 | 51.1% | 61.4% | −10.3 pts |
Why the Board granted or denied hip impairment
Most common reasons in grants
- Caused by the service-connected disability98
- Current diagnosis established62
- Service connection established57
- Aggravated by the service-connected disability21
- VA examiner: less likely than not related to service7
- Secondary service connection granted6
- Conflicting medical opinions regarding nexus4
- VA opinion inadequate3
Most common reasons in denials
- VA examiner: less likely than not related to service81
- No in-service complaints, treatment or diagnosis66
- Preponderance of the evidence against the claim61
- Service records negative or silent44
- No current diagnosis28
- Aggravated by the service-connected disability23
- Current diagnosis established14
- No continuity of symptomatology14
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
Secondary to service-connected right knee disability; Caused or aggravated by service-connected right knee disability; Resolved doubt in Veteran's favor
Private opinion found hip osteoarthritis at least as likely as not due to service-connected knee residuals.; Private opinion cited "knee-hip-spine syndrome" and multi-causal links.; VA opinion found inadequate due to internal inconsistency and failure to address aggravation.
Private medical opinion found left hip secondary to service-connected back and bilateral knee conditions; Satisfied elements for secondary service connection; Benefit of the doubt resolved in veteran's favor
Denied
No in-service onset; No continuity of symptoms; Not proximately due to service-connected disability; Hip pain attributed to radiculopathy
No objective findings of functional impairment; Insufficient evidence to support diagnosis; Symptoms only subjectively reported
No evidence of current disability for right hip; Lack of service treatment records or post-service medical records; Veteran's statements insufficient to trigger duty to assist
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 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.