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Nerve damage in arms or legs (neuropathy)

Peripheral neuropathy and nerve damage (arms and legs)

What it is

Peripheral neuropathy means nerves in your arms, hands, legs, or feet are damaged, causing numbness, tingling, burning, pain, or weakness.

VA's code numbers for this: 8510-8519 (upper), 8520-8530 (lower), plus 86xx neuritis and 87xx neuralgia; common: 8515 median, 8516 ulnar, 8513 all radicular groups, 8520 sciatic, 8521 common peroneal, 8524 tibial, 8526 femoral

What the examiner will do

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

  • A VA or contract doctor, NP, or PA. Often 20-40 minutes.
  • They test feeling, vibration, reflexes, strength, and look for muscle wasting. They may order or review an EMG.
  • Questions: Where is the numbness or pain? How long? Is it constant? Any weakness, falls, or trouble with hand tasks? Which hand do you write with?

Tests, in plain words

Monofilament test
A thin nylon thread is pressed on your foot or hand. You say when you feel it.
Vibration test
A buzzing tuning fork is placed on a bone. You say when the buzzing stops.
Reflexes and strength
Tapping your knee and ankle; pushing and pulling against the examiner. Strength is graded 0 (no movement) to 5 (normal).
Muscle wasting (atrophy) and skin changes
Shrunken muscles, shiny skin, or hair loss can show more serious nerve damage.
EMG / nerve conduction study
Small shocks and a thin needle measure how well nerves send signals. Not always required.
Bilateral factor
If both arms or both legs are affected, VA adds a small extra amount when combining the ratings.

The examiner fills out a form called a DBQ. You can read it ahead of time: Diabetic Peripheral Neuropathy DBQ, or Peripheral Nerves DBQ (opens VA's site).

The rating levels, in plain words

VA picks the level that best matches how often and how badly the condition affects you.

  • 10%

    Each nerve, in each arm or leg, gets its own rating: mild, moderate, severe, or complete. Example - sciatic nerve (back of leg): mild 10%, moderate 20%, moderately severe 40%, severe with muscle wasting 60%, complete (foot drops, no movement below the knee) 80%.

    VA's exact words

    8520 Paralysis of: Complete ... 80; Incomplete: Severe, with marked muscular atrophy 60; Moderately severe 40; Moderate 20; Mild 10

    Rule: 38 CFR 4.124a, Diseases of the Peripheral Nerves, DC 8520

  • 10%

    Example - common peroneal nerve (outside of lower leg; foot lift): mild 10%, moderate 20%, severe 30%, complete (foot drop) 40%. Tibial nerve: same steps (10/20/30/40).

    VA's exact words

    8521 Paralysis of: Complete; foot drop ... 40; Incomplete: Severe 30; Moderate 20; Mild 10

    Rule: 38 CFR 4.124a, Diseases of the Peripheral Nerves, DC 8521, 8524

  • 10%

    Arm nerves pay more for your dominant ('major') hand. Example - median nerve (carpal tunnel): mild 10% either hand; moderate 30% major / 20% minor; severe 50% / 40%; complete 70% / 60%.

    VA's exact words

    8515 Paralysis of: Complete ... 70 [major] 60 [minor]; Incomplete: Severe 50 40; Moderate 30 20; Mild 10 10

    Rule: 38 CFR 4.124a, Diseases of the Peripheral Nerves, DC 8515; 38 CFR 4.69 (major vs minor)

  • 20%

    If your problem is ONLY feeling (numbness, tingling, burning) with no weakness, the rating is usually mild, or at most moderate.

    VA's exact words

    When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree.

    Rule: 38 CFR 4.124a, Diseases of the Peripheral Nerves (introductory note)

What to track before your exam

What to write down: Numbness, tingling, burning, pain, weakness, falls, dropping things, trouble with buttons, stairs, or feeling the gas pedal.

How: For 30 days, log symptoms by body part (right hand, left foot, etc.). Note what you can't do. Ask family what they see (tripping, dropping cups).

Your log: what to write each time

  1. Date
  2. Body part (R/L hand, arm, foot, leg)
  3. Numb / tingling / burning / pain (0-10)
  4. Weakness?
  5. Dropped things or tripped/fell?
  6. Trouble with buttons, writing, walking, stairs, driving?
  7. Woke me at night?

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

Honest exam rules

  • Tell the whole truth. Don't add to it. Don't shrink it.
  • Describe a normal day AND your worst days. Say how often the worst days happen.
  • Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
  • It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
  • Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
  • If something hurts or makes you worse during the exam, say so right then.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.

Common mistakes

  • Only one limb gets rated when symptoms are in all four. Each nerve and each limb should be checked.

    Where this comes from: 38 CFR 4.124a, Diseases of the Peripheral Nerves; Diabetic Peripheral Neuropathy DBQ lists each extremity

  • Not mentioning weakness, so it's rated as 'wholly sensory' (max moderate).

    Where this comes from: 38 CFR 4.124a, Diseases of the Peripheral Nerves introductory note

  • Not knowing 'mild/moderate/severe' isn't defined in the rule. VA must explain the level based on all the evidence - so your examples matter.

    Where this comes from: 38 CFR 4.2, 4.6

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. Where do you feel numbness, tingling, or burning - both hands, both feet?
  2. Do you drop things or have trouble with buttons or writing?
  3. Do you trip, catch your toes, or fall?
  4. Do the symptoms wake you up at night?
  5. Which hand do you write with?

Rule changes you may hear about

Today's rules (above) are what VA uses unless a change is final.

  • Proposed, not law yet

    VA proposed replacing 'mild / moderate / severe' with muscle-strength grades (0-5). Example for sciatic nerve: grade 4 strength = 10%, grade 3 = 20%, grade 2+ = 40%, grade 2 = 60%. It also proposes new rules for sensory-only nerve problems.

    Where it stands: Proposed Nov 12, 2024. Not final as of Oct 30, 2026.

    89 FR 88917, RIN 2900-AQ73

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.