Many Veterans suffer daily from painful, debilitating nerve conditions like sciatica and numbness in their hands or feet. Yet, filing a successful claim for Peripheral Neuropathy (PN) VA Rating is often complex because the VA requires more than just subjective pain—it demands objective medical proof of damage.
This guide breaks down exactly what the VA looks for. You will learn the difference between the three key rating levels (Neuralgia, Neuritis, and Paralysis) and the specific diagnostic tests (like EMG/NCS) you must have to prove your condition and secure the benefits you deserve.
Understanding Nerve Conditions: Radiculopathy and PN
Peripheral Neuropathy (PN) is the medical term for damage to nerves outside your brain and spinal cord. It causes pain, numbness, tingling, and muscle weakness, most often in the extremities.
A very common form of PN for Veterans is Radiculopathy, or a pinched nerve. This occurs when a nerve root, as it exits your spine, is compressed or irritated, often due to a back injury.
- Lumbar Radiculopathy is lower back compression that causes pain/weakness in the leg.
- Cervical Radiculopathy is neck compression causing symptoms in the arms and hands.
Clarifying Common Terms
Veterans often hear several different terms for their leg pain. Here is how they relate:
| Term | Definition | Relationship |
| Peripheral Neuropathy (PN) | The general category for damage to any nerve outside the brain and spine (e.g., from diabetes or a toxin). | Radiculopathy is a type of Peripheral Neuropathy. |
| Lumbar Radiculopathy | A diagnosis that means a nerve root in the lower spine is compressed. | Sciatica is a symptom of Lumbar Radiculopathy.
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| Sciatica | A common symptom where pain, tingling, and numbness travel along the sciatic nerve down the back of the leg. | It is the most common symptom used by the public and doctors to describe severe Lumbar Radiculopathy. |
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Why is Nerve Damage Common Among Veterans?
Military service, especially carrying heavy gear, repetitive motions, and experiencing traumatic injuries, puts severe strain on the spine, leading to wear and tear.
Three Pathways to Service-Connect Nerve Damage
Before you can be rated, you must prove your nerve condition is related to your time in service.
A. Direct Service Connection
A specific event or injury during service directly caused your nerve damage (e.g., a traumatic injury causing a herniated disc that leads to radiculopathy).
B. Secondary Service Connection
A condition you already have service-connected caused or aggravated your nerve condition.
- Example 1 (Radiculopathy): Your service-connected back disability (like Degenerative Disc Disease) causes nerve root compression.
- Example 2 (Diabetic Neuropathy): Your service-connected Type 2 Diabetes Mellitus causes nerve damage in your hands and feet (Diabetic Peripheral Neuropathy, or DPN).
C. Presumptive Service Connection
The VA automatically assumes the condition is service-connected if you meet exposure criteria.
- Is neuropathy a presumptive condition? Yes, early-onset peripheral neuropathy is a recognized presumptive condition for Veterans exposed to Agent Orange.
Building Objective Medical Evidence
Your claim’s success hinges on showing objective proof of functional loss. You must have medical documentation that proves the damage goes beyond just pain.
| Required Evidence Type | Purpose & Strategic Value |
| Nerve Tests (EMG/NCS) | Crucial: These tests measure electrical signals and provide objective proof of motor nerve damage (like muscle atrophy or denervation), which is required to achieve high ratings. |
| Imaging (MRI/CT) | Provides evidence of the structural cause (e.g., slipped disc) responsible for the compression/radiculopathy. |
| Neurology/Specialist Notes | Expert opinions documenting measurable loss of reflexes, strength, or sensation. |
| Nexus Letter | An expert medical opinion linking your diagnosis to your service (required for secondary/direct claims). |
VA Nerve Damage Rating Chart: Paralysis, Neuritis, Neuralgia
The VA rates all peripheral nerve conditions using the criteria found under 38 CFR §4.124a (VA Disability Ratings for Neurological Disorders). The rating is based on the severity of symptoms and the level of functional loss, categorized below.
Visual Rating Table Summary
| Rating Category | Symptoms & Functional Loss | Required Evidence for Rating | Rating Range (Varies by Nerve) |
| Neuralgia | Primarily pain and sensory symptoms (tingling, numbness). | Subjective complaints of pain; No objective findings of atrophy or weakness. | 10% (Mild) to 20% (Moderate) |
| Neuritis | Pain plus measurable objective organic changes (sensory loss, diminished reflexes, muscle atrophy). | Objective findings documented in EMG/NCS or clinical exam. | 30% to 60% |
| Paralysis | Loss of motor function (muscle movement or control). | Complete paralysis (e.g., foot drop) or severe, incomplete weakness documented by a physician. | 10% (Mild) to 80% (Complete) |
How to Prove Neuropathy to the VA (Detail)
- Neuralgia (Pain-Only): This is the lowest tier because it lacks objective physical evidence. You will be placed here if your EMG/NCS is normal or if your only evidence is subjective pain.
- Neuritis (The Key to Higher Ratings): To reach this level, you must show the physical consequences of the nerve damage, such as marked muscular atrophy (muscle wasting) or a loss of strength/reflexes, which is best confirmed by EMG/NCS results.
- Paralysis: This is reserved for the most severe cases where the Veteran has significant or total loss of the ability to move the affected limb.
Need help interpreting your EMG/NCS results? Understanding if your test results show the objective findings necessary for a Neuritis or Paralysis rating can be difficult. Our team specializes in reviewing complex medical evidence to ensure your claim accurately reflects your severity.
Understanding Your Final Rating
A. The Bilateral Factor
The VA may apply separate ratings to each affected limb. For example, if you have diabetic peripheral neuropathy (DPN) in both feet, you get a rating for the left and a separate rating for the right.
The VA bilateral factor calculator rule adds an extra 10% to your combined rating before the final calculation if the condition affects both arms or both legs.
B. Prohibition on Pyramiding (The One Rating Rule)
The VA will not assign separate ratings for a spinal condition (like a herniated disc) and the radiculopathy (pinched nerve) that the spinal condition causes in the same limb. The VA rates only the functional loss from the nerve (radiculopathy) in the limb, as this generally results in the highest rating.
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Disclaimer
This guide is intended solely for educational assistance in understanding VA-required medical documentation related to neurological conditions. It does not constitute medical or legal advice. Always consult healthcare professionals for specific advice.
