Depression or anxiety secondary to ankle conditions

In the Board decisions we have indexed since 2019, depression or anxiety appeared as secondary to ankle conditions in 74 issues. The Board granted 17, denied 12, and sent 40 back for more work. Of the ones it decided, it granted 59 percent.

Every decision counted here is an appeal. The regional office decided the claim first, the veteran disagreed, and the Board is the next step after that. These are not the odds on a first claim.

Since 2019

1 were reopened for a fresh look, which is not a grant and is not counted as one. 4 were dismissed or withdrawn.

Across every year we have indexed, that is 253 issues, 50 percent granted of the ones decided, and 53 percent sent back for more work.

The argument behind these claims

The argument in these claims is that long-term pain wears on your mood and sleep. The counts above show how the Board answered, one claim at a time. Whether the link is true for you is a question for your doctor.

What a secondary claim needs

In a secondary claim, the Board reads for three things. A diagnosis of the second condition. A first condition that is already service connected. And a medical opinion that says the first condition led to the second, or made it worse, and explains why. The rule itself is shorter than that. Here is the part that matters.

… disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.

38 CFR 3.310(a), from the middle of its first sentence

Proximately due to means the first condition led to the second. The other route is aggravation, where the first condition made the second worse. The rule for that route is in the next paragraph of the same section, and it says increase in severity.

Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.

38 CFR 3.310(b), first sentence

That paragraph goes on to say the VA will not concede aggravation without a baseline. A baseline is medical evidence of how bad the second condition was before the first one started making it worse, or the earliest record after that and before the evidence of how bad it is now. If you claim aggravation, find the earliest record you have of the second condition, from either window. Without a baseline from one of them, the VA will not concede aggravation. The other route, that the first condition led to the second, does not need a baseline.

A remand is not a yes or a no. The Board sends the claim back to the regional office for more work, such as a new exam or a record that was not in the file. The claim is decided again later, and that later decision is a separate document.

Recent decisions on these claims

• December 22, 2025Granted

  Entitlement to service connection for adjustment disorder with mixed anxiety and depressed mood secondary to service-connected right and left knee disabilities, right and left ankle disabilities, and…

  Read the decision at VA.gov
• November 18, 2025Granted

  Entitlement to service connection for major depressive disorder, as secondary to the Veteran's right ankle sprain

  Read the decision at VA.gov
• February 7, 2024Granted

  Entitlement to service connection for an acquired psychiatric disorder, diagnosed as an adjustment disorder and a depressive disorder, as secondary to the service-connected asthma, right ankle…

  Read the decision at VA.gov
• February 2, 2024Denied

  Entitlement to an acquired psychiatric disorder, as secondary to service-connected osteoarthritis of the left ankle with deformity of the distal tibia post-traumatic and chronic medical malleolar…

  Read the decision at VA.gov
• June 14, 2021Denied

  Entitlement to service connection for an acquired psychiatric disability, to include as secondary to a left ankle disability

  Read the decision at VA.gov