← All secondary claims · Ratings by condition
A secondary claim is a condition caused or worsened by one the VA has already service-connected. The causation fight is already half-won — the VA agreed your a knee injury came from service; the question is only whether it caused the back pain. That's a medical question with a recognized answer.
The connection
Favoring a bad knee for years is not free — the limp shifts load to the opposite leg, the hips, and the spine. Compensation-gait injury is a well-recognized secondary theory, and it works in every direction along the kinetic chain: knee to back, knee to opposite knee, hip to spine.
How the VA rates back pain
Thoracolumbar: 40% = forward flexion ≤30° · 20% = >30° but ≤60°, OR muscle spasm/guarding severe enough to cause abnormal gait or abnormal spinal contour · 10% = >60° but ≤85°. Rated WITH OR WITHOUT pain — measured motion governs. Cervical: 30% = ≤15° · 20% = >15–30° · 10% = >30–45°.
Full criteria and evidence guide: VA rating for back or neck pain.
What the claim needs — the three legs
- The anchor: service connection for the a knee injury (see how that condition is rated). Not connected yet? File it first — a secondary claim needs something to attach to.
- A current diagnosis of back pain — the VA rates diagnosed conditions, not symptoms.
- The medical link. An opinion stating it is "at least as likely as not" that the a knee injury caused or aggravated the back pain. The VA's own C&P examiner supplies this free in most cases; your own doctor can too. A paid independent opinion is the last resort, not the first move.
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