Orthopedic secondary conditions are joint and spine problems that develop because an injured foot, ankle, knee or hip changes how you walk. VA can service connect a new condition, such as hip or back pain, if a service-connected disability at least as likely as not caused or worsened it. A medical opinion explaining the link is usually the key piece of evidence.
What is the kinetic chain?
The kinetic chain is a way of describing how the body’s joints work together: foot, ankle, knee, hip and spine each affect the next. When one link is painful or limited, you tend to shift weight, shorten your stride or tilt your pelvis. Over years, that extra load on other joints may contribute to new problems. VA does not rate “the kinetic chain.” It is a medical explanation a provider can use in an opinion, and VA decides whether it is persuasive in your case.
Which orthopedic conditions are commonly claimed as secondary?
| Service-connected condition | Commonly claimed secondary condition |
|---|---|
| Right knee strain | Left knee, hip or lower back problems |
| Flat feet (pes planus) | Plantar fasciitis, knee pain |
| Ankle instability | Hip bursitis, lower back strain |
| Lower back condition | Radiculopathy (nerve pain down the legs) |
This table shows claims veterans commonly make, not conditions VA grants automatically. Each claim needs a current diagnosis and evidence in your own records.
How does one condition lead to the next?
- Feet and ankles. Collapsed arches or an unstable ankle change how force travels up the leg.
- Knees. A knee that will not fully bend or straighten can lead you to favor the other leg.
- Hips. Hip muscles and joints take on extra work when your stride changes.
- Lower back. A tilted pelvis can strain the lumbar spine, and a back problem can in turn irritate nerves.
How is each new condition rated?
Each is rated on its own schedule. For example, knee ratings depend on motion and instability, and lower back ratings depend on spine motion and other findings. When disabilities affect both legs or both arms, VA applies the bilateral factor. Our musculoskeletal conditions guide covers how VA rates joints in general.
How do you start a secondary claim?
Begin with a diagnosis from your doctor for the new condition, then ask whether they can state in writing that it is at least as likely as not caused or aggravated by your service-connected condition. Any licensed provider can write that opinion, and VA does not require a paid one. Our guide to secondary service connection explains the process. A free accredited VSO can help you file.
Woobie is not a law firm or an accredited claims agent and does not file claims. Results vary.
Frequently asked questions
Can a knee injury cause back pain that VA will service connect?
It can be claimed that way. You need a current back diagnosis and a medical opinion that the knee at least as likely as not caused or aggravated it. VA decides whether the evidence is enough.
Is the kinetic chain a VA rating term?
No. It is a medical concept a provider can use to explain a link in an opinion. VA rates each condition under its own diagnostic code.
What does antalgic gait mean?
It is a limp caused by pain. Notes from your doctor or physical therapist that describe an antalgic gait can help show the link between conditions.
Does a secondary orthopedic condition get its own rating?
Yes. Each condition is rated separately and then combined with your other ratings using VA’s combined ratings table, so percentages are not simply added.
Questions about your medical evidence? Woobie offers a free consultation to talk through your situation. Woobie is not a law firm or an accredited claims agent and does not file claims. Schedule a free consultation →