Shoulder conditions secondary to foot conditions

In the Board decisions we have indexed since 2019, shoulder conditions appeared as secondary to foot conditions in 46 issues. The Board granted 2, denied 14, and sent 29 back for more work. Of the ones it decided, it granted 13 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1 were dismissed or withdrawn.

Across every year we have indexed, that is 159 issues, 23 percent granted of the ones decided, and 56 percent sent back for more work.

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

• October 13, 2023Denied

  Service connection for right shoulder acromioclavicular osteoarthritis and rotator cuff tear status post total replacement, including as secondary to the service-connected bilateral feet calluses

  Read the decision at VA.gov
• February 1, 2023Denied

  Entitlement to service connection for degenerative arthritis of the left shoulder, to include as secondary to the Veteran's service-connected left and right foot and ankle disabilities

  Read the decision at VA.gov
• April 9, 2019Granted

  Entitlement to service connection for multi-joint arthritis, diagnosed as arthritis of the left ankle and foot, knees, hips, shoulders/arms and back, to include as secondary to bilateral…

  Read the decision at VA.gov
• March 8, 2018Granted

  Entitlement to service connection for left shoulder disability, to include as secondary to a service-connected bilateral foot disability.

  Read the decision at VA.gov
• February 2, 2018Granted

  Entitlement to service connection for a bilateral shoulder disorder as secondary to service-connected bilateral pes cavus (claw foot).

  Read the decision at VA.gov