7 VA Secondary Conditions to Knee Pain and How to Claim Them

VA secondary conditions to knee pain can affect more than just your legs; they can also take a toll on your hips, back, feet, digestion, and mental health.  

These issues often develop slowly, making it essential to recognize how they arise from your service-connected knee injury.  

In this post, we explain seven VA secondary conditions to knee pain (and how the VA rates them). We’ll also examine why a strong Nexus Letter is important for proving secondary service connection, and how to file a secondary VA claim.

Key Takeaways

• Secondary conditions to knee pain develop when the effects of chronic knee issues contribute to additional physical or functional problems. 

• A credible Nexus Letter from a qualified medical provider is a powerful tool for proving that your secondary condition is directly caused or aggravated by your service-connected knee injury. 

• Strong medical evidence is the most critical factor in getting a secondary condition claim approved. 

Understanding VA Secondary Conditions

Secondary conditions occur when a service-connected disability, like knee pain, causes or worsens another medical issue.  

These conditions may develop gradually over time as your body compensates for pain or altered movement. 

Establishing secondary service connection requires a current medical diagnosis and strong evidence linking the secondary condition to your service-connected knee injury (e.g., a credible nexus letter). 

7 VA Secondary Conditions to Knee Pain

Hip Pain

Knee injuries or degenerative issues can cause misalignment, altered gait, and extra pressure on the hip, eventually leading to discomfort. 

How knee pain can lead to hip pain: 

• Altered Gait: Favoring one leg places extra strain on the hip over time. 

• Joint Stress and Misalignment: Knee problems disrupt lower-body alignment, which can increase hip pressure. 

• Referred Pain: Knee issues can cause hip pain as nearby joints compensate for the affected area. 

A 2023 study in Arthritis Research & Therapy found that knee and hip osteoarthritis are linked and increase the risk of falls, highlighting how connected lower-limb joints are.

VA Ratings for Hip Pain Secondary to Knee Pain:

Hip pain secondary to knee pain is rated under various diagnostic codes (DC), depending on your specific condition and the severity of your symptoms. 

Back Pain

Chronic knee pain can alter the way you walk and affect your posture, often placing extra stress on your spine.  

Over time, this altered gait can lead to back pain or aggravate existing spinal conditions. 

A 2017 study of adults aged 50–79 found that those with knee pain were far more likely to develop pain in other joints, including the back, compared to those without knee pain.

VA Ratings for Back Pain Secondary to Knee Pain:

VA ratings for back pain secondary to knee pain depend on the severity and impact on function, ranging from 0% to 100% under various diagnostic codes. Many conditions involving painful motion or limited mobility start at a 10% rating. 

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain among veterans and can often be caused or aggravated by service-connected knee pain.  

When knee pain alters the way you walk, it places additional strain on the plantar fascia, the thick band of tissue that runs along the bottom of your foot and connects your heel bone to your toes. 

Common symptoms of Plantar Fasciitis include: 

• Sharp heel pain (especially after standing, walking, or running) 

• Painful or limited motion 

• Tenderness and swelling around the heel 

• Stiffness after rest 

VA Ratings for Plantar Fasciitis Secondary to Knee Pain:

The VA rates plantar fasciitis secondary to knee pain under DC 5269, with ratings ranging from 10% to 40%.

Note: A 40% VA rating is only given if there is actual loss of use of the foot. 

>>View Our Main Guide on Plantar Fasciitis VA Ratings 

Arthritis

Arthritis is characterized by the swelling and tenderness of one or more joints, most often causing pain and stiffness that worsens with age. 

The two most common types are osteoarthritis (degenerative) and rheumatoid arthritis. 

For veterans, knee pain and arthritis often go hand in hand. Knee pain can contribute to the development of arthritis, and existing arthritis can worsen knee pain, making it possible to claim arthritis as a secondary condition to service-connected knee pain.

VA Ratings for Arthritis Secondary to Knee Pain:

Degenerative arthritis is prevalent among veterans and is rated under DC 5003, with potential VA ratings of 10% or 20%. 

GERD

Gastroesophageal reflux disease (GERD) can develop as a secondary condition to service-connected knee pain, often due to the long-term use of pain medications prescribed to manage chronic knee issues.  

GERD happens when stomach acid frequently flows back into the esophagus causing irritation and symptoms like persistent heartburn.

VA Ratings for GERD Secondary to Knee Pain:

The VA rates GERD under DC 7206, with potential ratings of 0%, 10%, 30%, 50% or 80%. 

>> Learn More About GERD VA Ratings 

IBS

Irritable bowel syndrome (IBS) can be claimed as a secondary condition to service-connected knee pain, often due to side effects of long-term pain medications.  

IBS typically causes abdominal pain, bloating, and changes in bowel habits, ranging from diarrhea to constipation, or both.

VA Ratings for IBS Secondary to Knee Pain:

The VA rates IBS under DC 7319, with potential ratings of 10%, 20%, or 30%. 

Depression and Anxiety

Chronic knee pain can disrupt work, social life, and physical activity, which may trigger or worsen depression and anxiety.  

If you experience these symptoms, you may find everyday tasks overwhelming, struggle to leave the house, or feel persistent sadness and loss of interest in activities you once enjoyed. 

Over time, the mental and emotional impact of chronic knee pain can significantly affect relationships, job performance, and overall quality of life.

VA Ratings for Anxiety or Depression Secondary to Knee Pain:

The VA rates depression and anxiety secondary to knee pain under the General Rating Formula for Mental Disorders, with potential ratings of 0%, 10%, 30%, 50%, 70%, or 100%. 

>>Explore Secondary Conditions to Depression and Anxiety 

Proving Secondary Service Connection

To establish a secondary service connection, you’ll need two vital elements:  

1. A current diagnosis – Medical documentation of your secondary condition from a qualified provider.  

2. A medical nexus – Evidence showing that your secondary condition was caused or aggravated by your service-connected knee pain.  

Did you know? A detailed nexus letter from an independent medical provider is often the most effective way to demonstrate the link between a primary service-connected condition and secondary conditions.

Why Get a Nexus Letter for Secondary Conditions?

A nexus letter is highly recommended when filing for secondary service connection.  

To prove a secondary disability, you must show it is “proximately due to” or “aggravated by” your service-connected knee pain. 

A credible nexus letter provides the VA with a detailed medical opinion from a qualified provider that explains the link between your secondary condition and your knee pain. While not required, it can be the difference between an approval and a denial. 

A nexus letter for VA secondary conditions to knee pain: 

• Establishes causation: Clearly explains how your knee pain caused or worsened your secondary condition. 

• Adds credibility: Carries significant weight when written by a medical expert. 

• Strengthens your VA claim: Provides the missing connection if the link between conditions isn’t apparent.

How to File a VA Claim for Secondary Conditions

To be eligible for a VA rating for secondary conditions to knee pain, you must file a VA claim. 

You can file a VA claim: 

• Online 

• By mail    

• Via fax  

• In person at a VA regional office 

If you don’t file online, you must download and complete VA Form 21-526EZ to submit your claim. 

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied? 

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims! 

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim.

FAQs | Frequently Asked Questions

What conditions are secondary to knee pain?

Common secondary conditions include hip pain, back pain, plantar fasciitis, arthritis, IBS, GERD, depression, and anxiety. 

What is the VA rating for knee pain?

The VA rating for knee pain ranges from 10% to 60%, depending on severity, range of motion, instability, and ankylosis. Temporary 100% ratings may apply after surgeries, such as knee replacements. 

Is plantar fasciitis secondary to knee pain?

Yes, it can be. Altered walking from knee pain may put extra stress on your feet, causing plantar fasciitis. You’ll need a current diagnosis and medical evidence showing the connection for VA approval. 

Do I need a separate VA claim for the secondary condition?

Yes. Even if the primary condition is already service-connected, you must file a separate claim for each secondary condition. 

Can secondary conditions appear years after my knee injury?

Yes. Many secondary issues, like arthritis or chronic back pain, develop over time. You can still file a claim if you can prove the connection between your service-connected knee injury and a secondary condition. 

Can VA secondary conditions to knee pain increase my overall disability rating?

Yes. Each approved secondary condition receives its own rating. When combined with your primary knee rating, it may increase your total VA disability percentage.