Secondary service connection
Osteoarthritis secondary to a knee condition: BVA grant rates and what wins
From 2018 to 2026, the Board of Veterans' Appeals decided osteoarthritis claimed as secondary to a knee condition in 494 decisions. It granted the issue in 34.6% of them, above the 19.8% grant rate for all osteoarthritis issues, denied it in 22.1%, and remanded it in 43.7%. Counting only decisions on the merits, 61.1% were granted.
Decisions
494
2018–2026
Granted
34.6%
All osteoarthritis: 19.8%
Granted on the merits
61.1%
Granted ÷ (granted + denied)
Remanded
43.7%
Denied: 22.1%
See all osteoarthritis decisions, direct and secondary.
Osteoarthritis secondary to a knee condition: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2018 | 57 | 36.8% | 33.3% | 31.6% |
| 2019 | 49 | 30.6% | 18.4% | 55.1% |
| 2020 | 67 | 37.3% | 29.9% | 34.3% |
| 2021 | 63 | 27.0% | 30.2% | 42.9% |
| 2022 | 59 | 32.2% | 13.6% | 54.2% |
| 2023 | 52 | 32.7% | 13.5% | 51.9% |
| 2024 | 70 | 38.6% | 15.7% | 47.1% |
| 2025 | 58 | 37.9% | 22.4% | 36.2% |
Evidence in granted and denied osteoarthritis decisions
For each kind of supporting evidence: how often the Board granted the osteoarthritis 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 | 146 | 92.6% | 37.1% | +55.5 pts |
| Private medical opinion | 183 | 79.3% | 44.1% | +35.1 pts |
| Favorable VA exam | 71 | 86.9% | 53.9% | +33.0 pts |
| Treating physician opinion | 51 | 82.9% | 57.3% | +25.6 pts |
| Lay statement | 404 | 56.3% | 88.1% | −31.8 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 79.5% of the decisions that granted osteoarthritis.
- The Board found the veteran's statements credible in 29.2% of grants and 7.3% 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 osteoarthritis 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 | 439 | 60.5% | 68.4% | −7.9 pts |
| Negative nexus opinion | 376 | 59.0% | 71.7% | −12.8 pts |
Why the Board granted or denied osteoarthritis
Most common reasons in grants
- Caused by the service-connected disability35
- Current diagnosis established18
- Service connection established15
- VA examiner: less likely than not related to service4
- Aggravated by the service-connected disability3
- New and relevant evidence submitted after prior denial2
- Secondary service connection warranted2
- Continuity of symptomatology since service2
Most common reasons in denials
- VA examiner: less likely than not related to service27
- No in-service complaints, treatment or diagnosis18
- Preponderance of the evidence against the claim16
- Service records negative or silent15
- Aggravated by the service-connected disability6
- Continuity of symptomatology since service2
- Current diagnosis established2
- No continuity of symptomatology2
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 osteoarthritis decisions
Granted
Current diagnosis of left hip osteoarthritis.; Service-connected disabilities of bilateral knees and lumbar spine.; Private opinion from Dr. J.M. links hip pain to gait changes from knee/back conditions and service.; Opinion is probative and uncontradicted.
Evidence in approximate balance; Hip disability related to service-connected knee; Benefit of the doubt resolved in veteran's favor
Treating physician opined right knee degeneration likely secondary to overuse from left knee impairment.; Board found opinion persuasive, establishing nexus for right knee claim.; Service-connected left knee disability contributed to and accelerated right knee degeneration.
Denied
Service treatment records negative for left knee complaints/diagnosis; No specific in-service injury described for left knee; VA examiners opined left knee disability less likely than not related to service-connected conditions
No in-service complaints or documentation of bilateral hip issues in STRs.; Lay statements did not reference in-service hip problems.; VA clinician provided negative nexus opinion for secondary connection to knees.
No presumptive service connection for left knee arthritis.; In-service injury from jeep accident found, but no nexus to current arthritis.; March 2023 VA examiner opinion found highly probative, stating less likely than not related to service or aggravated by right knee disability.; Veteran's own statements indicated gradual onset of left knee pain post-service and secondary claim to right knee.
Rules that apply to secondary osteoarthritis 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 osteoarthritis 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 osteoarthritis 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.