Secondary service connection
Major depressive disorder secondary to a knee condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided major depressive disorder claimed as secondary to a knee condition in 516 decisions. It granted the issue in 49.4% of them, above the 35.3% grant rate for all major depressive disorder issues, denied it in 12.8%, and remanded it in 34.5%. Counting only decisions on the merits, 79.4% were granted.
Decisions
516
2017–2026
Granted
49.4%
All major depressive disorder: 35.3%
Granted on the merits
79.4%
Granted ÷ (granted + denied)
Remanded
34.5%
Denied: 12.8%
See all major depressive disorder decisions, direct and secondary.
Major depressive disorder secondary to a knee condition: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2017 | 40 | 22.5% | 27.5% | 37.5% |
| 2018 | 98 | 43.9% | 12.2% | 38.8% |
| 2019 | 78 | 56.4% | 10.3% | 29.5% |
| 2020 | 61 | 44.3% | 18.0% | 36.1% |
| 2021 | 44 | 34.1% | 9.1% | 54.5% |
| 2022 | 43 | 51.2% | 11.6% | 34.9% |
| 2023 | 42 | 47.6% | 11.9% | 40.5% |
| 2024 | 53 | 62.3% | 9.4% | 28.3% |
| 2025 | 41 | 78.0% | 9.8% | 12.2% |
Evidence in granted and denied major depressive disorder decisions
For each kind of supporting evidence: how often the Board granted the major depressive disorder 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 | 250 | 94.7% | 51.8% | +42.9 pts |
| Private medical opinion | 296 | 86.6% | 64.8% | +21.8 pts |
| Favorable VA exam | 100 | 87.1% | 76.7% | +10.4 pts |
| Lay statement | 408 | 76.5% | 90.9% | −14.4 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 76.9% of the decisions that granted major depressive disorder.
- The Board found the veteran's statements credible in 20.4% of grants and 13.6% 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 major depressive disorder 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 | 399 | 78.7% | 81.9% | −3.2 pts |
| Negative nexus opinion | 301 | 77.4% | 81.9% | −4.5 pts |
Why the Board granted or denied major depressive disorder
Most common reasons in grants
- Caused by the service-connected disability65
- Aggravated by the service-connected disability36
- Service connection established26
- Current diagnosis established26
- New and material evidence submitted4
- VA examiner: less likely than not related to service4
- Criteria for service connection met3
- Criteria for secondary service connection met3
Most common reasons in denials
- Preponderance of the evidence against the claim10
- VA examiner: less likely than not related to service9
- Caused by the service-connected disability6
- No in-service complaints, treatment or diagnosis4
- No current diagnosis3
- Service records negative or silent3
- VA examiner provided negative nexus opinion2
- Current diagnosis established2
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 major depressive disorder decisions
Granted
Private medical opinion found depression secondary to knee issues; Veteran testimony corroborates depression linked to knee pain; Evidence in approximate balance, doubt resolved in Veteran's favor
Private physician opinion found condition more likely than not secondary to service-connected injuries.; Evidence found to be in equipoise regarding nexus.; Benefit of the doubt resolved in Veteran's favor.
Current diagnosis of depressive disorder with depressive features, melancholic features, and anxious distress.; Conflicting opinions from private psychologist (favorable nexus) and VA examiner (unfavorable nexus).; Evidence found to be at least evenly balanced.
Denied
No evidence of in-service psychiatric injury or disease.; Veteran's testimony regarding chronic psychiatric symptoms was not credible.; Private psychological evaluation was generalized and speculative.
No evidence of mental health issues during service.; Veteran's MDD claimed as secondary to service-connected back and knee pain.; VA examiner provided negative nexus opinion; private opinion found unpersuasive by Board.; Board found VA examiner more credible due to expertise and addressing veteran's history.
No current diagnosis of depression; Lay contentions lack probative value without objective medical evidence; Absence of diagnosis suggests symptoms did not begin in service
Rules that apply to secondary major depressive disorder 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 major depressive disorder 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 major depressive disorder 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 (2017–2026) and can contain errors. It is updated automatically as new decisions are added.