Seeking VA disability benefits for nerve conditions can feel complex, especially when dealing with the lower extremities. The tibial nerve, historically referred to as the internal popliteal nerve, is a major branch of the sciatic nerve that powers key movements in the lower leg and foot.
The VA evaluates tibial nerve paralysis (also known as tibial neuropathy or tarsal tunnel syndrome) under Diagnostic Code (DC) 8524.
Understanding the Tibial Nerve and Paralysis
The tibial nerve is critical for movement and sensation below the knee. Understanding the functions it controls is essential for documenting functional loss in your claim.
What the Tibial Nerve Controls:
- Plantar flexion: Pointing the foot and toes downward (like pressing a gas pedal).
- Flexion and separation of the toes.
Paralysis can reflect a temporary or permanent loss of motor and/or sensory function. Evaluations focus on severity and functional loss, with the evidence in your medical record guiding the percentage assigned.
The Three Categories the VA Uses for Tibial Nerve Impairment:
| Category | Diagnostic Code | Primary Manifestation | Maximum Rating Level |
| Paralysis | DC 8524 | Loss of nerve function (motor and/or sensory). | 40% (Complete) |
| Neuritis | DC 8624 | Constant pain, sensory changes, diminished reflexes, and possible muscle atrophy (38 C.F.R. § 4.123). | Severe, Incomplete Paralysis (30%) |
| Neuralgia | DC 8724 | Usually dull, intermittent pain with sensory symptoms like tingling or numbness (38 C.F.R. § 4.124). | Moderate, Incomplete Paralysis (20%)
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Note: Under 38 C.F.R. § 4.123 and § 4.124a, neuritis and neuralgia are generally evaluated as incomplete paralysis and typically do not exceed the severe or moderate level, respectively.
VA Disability Rating Levels for Tibial Nerve (DC 8524)
The VA evaluates tibial nerve paralysis based on motor and sensory impairment, using objective findings to determine the severity level (38 C.F.R. § 4.124a).
| Rating | Classification | Criteria |
| 40% | Complete Paralysis | Plantar flexion lost; frank adduction of the foot impossible; flexion and separation of toes abolished; no muscle in the sole can move. In lesions high in the popliteal fossa, plantar flexion of the foot is lost. |
| 30% | Incomplete Paralysis (Severe) | Significant functional limitation, often with marked muscular atrophy, constant pain (consistent with neuritis), and pronounced weakness or reflex changes. |
| 20% | Incomplete Paralysis (Moderate) | Noticeable interference with function, including numbness, tingling, moderate pain (consistent with neuralgia), and/or measurable weakness. |
| 10% | Incomplete Paralysis (Mild) | Mild pain or sensory changes (tingling, decreased sensation) with minimal functional impact. |
How VA Interprets Evidence for Each Level
VA decisions weigh objective findings (like muscle atrophy and strength loss) alongside reported subjective symptoms (like pain and numbness) to assign a rating.
Complete Paralysis (40%)
The VA generally assigns the maximum 40% when evidence clearly shows the specific findings listed in § 4.124a for DC 8524. For example, the total loss of plantar flexion and the inability to flex or separate the toes. This is an objective, measurable loss of function.
Incomplete Paralysis (30%, 20%, 10%)
- When symptoms are wholly sensory (pain, numbness, tingling) without objective motor weakness, atrophy, or reflex loss, evaluations are often limited to the moderate (20%) range under $\S 4.124a$.
- Neuritis (DC 8624) may be evaluated at the severe (30%) level if symptoms are characterized by constant, debilitating pain and objective signs like muscle atrophy.
- Records that document strength testing (0/5–5/5), reflex findings, muscle atrophy, trophic changes, and functional impact are critical for differentiating between mild, moderate, and severe levels.
Building a Strong Medical Evidence File for Your Rating
Medical evidence for Tibial Nerve Paralysis includes detailed medical documentation beyond subjective complaints. Your file should consist of a current diagnosis and, for secondary claims, a Medical Nexus Letter linking the condition to your service-connected disability. Objective findings of functional loss are crucial.
Those seeking a Severe (30%) or Complete (40%) rating should include documentation of muscle atrophy, specific patterns of sensory loss (such as numbness in the foot), and a record of pain severity and frequency.
What the C&P Exam and DBQ Typically Capture
The Compensation & Pension (C&P) exam often uses a Disability Benefits Questionnaire (DBQ) to document:
- Strength testing (0/5–5/5) for plantar flexion and toe flexion.
- Reflexes and sensory findings.
- Trophic changes (muscle atrophy, skin/nail changes, circulation).
It is beneficial when your ongoing treatment records clearly reflect these same objective findings and detail functional limitations such as difficulty pressing pedals, pushing off during gait, or toe movement.
Avoiding Pyramiding and Combining Evaluations
The VA avoids rating the same manifestations twice. When limited motion and nerve impairment arise from the same underlying manifestation (e.g., a lumbar spine condition), the VA generally assigns a single evaluation that best reflects the overall disability picture (the higher of the two possible ratings).
- Bilateral Factor: The bilateral factor may apply when both lower extremities are affected and compensable.
Ready to Take the Next Step?
If you’re ready to pursue the benefits you are medically, legally, and ethically eligible for, or if you have questions about building your medical evidence, schedule a free consultation with our team. There’s no upfront cost, and you remain in complete control of your benefits journey.
Compliance Disclaimer: We do not prepare, present, or prosecute VA claims. We focus on supporting you with accurate and complete medical evidence. We do not provide legal advice. Medical professionals and legal advocates serve separate and distinct roles.Top of Form
