Peripheral Neuropathy (Upper Extremities)
Peripheral neuropathy of the upper extremities involves the nerves originating from the cervical spine that control arm and hand function. These nerves are organized into radicular groups (upper from the 5th and 6th cervical vertebrae, middle from the 7th cervical, and lower from the 8th cervical and 1st thoracic) as well as individual nerves (radial, median, ulnar, musculocutaneous, axillary, and long thoracic). If most or all nerves in a group are affected, they are rated as a group. Otherwise, the veteran receives a single rating based on the highest-rated individual nerve. Only one nerve evaluation per arm is allowed regardless of how many groups or individual nerves are impaired. Each arm is rated independently, and ratings differ for the dominant versus non-dominant arm. If the veteran is ambidextrous, whichever side is affected is considered dominant.
VA Rating Levels
Incomplete paralysis, mild for radicular groups or the radial nerve (both dominant and non-dominant). For individual nerves like the median and ulnar, mild is 10%.
Incomplete paralysis, moderate for the dominant arm in radicular groups (30% for non-dominant). For the median nerve, moderate is 30% dominant, 20% non-dominant.
Complete paralysis of the upper radicular group, dominant arm: all shoulder and elbow movements lost or severely affected (60% non-dominant). Severe impairment for all three radicular groups combined.
Complete paralysis of all three radicular groups, dominant arm (80% non-dominant): the highest possible upper extremity nerve rating.
Exam Tips & Key Evidence
- →You can only receive one nerve evaluation per arm, regardless of how many nerves or groups are impaired. The VA should select whichever gives the highest rating.
- →The dominant arm receives a higher rating than the non-dominant arm at the same severity level. If you are ambidextrous, the affected side is treated as dominant.
- →Cervical radiculopathy (nerve compression from the neck) is commonly rated under the radicular group schedules.
- →Like lower extremity nerves, the bilateral factor applies when both arms are affected.
- →Common secondary claims include nerve damage from diabetes, cervical spine conditions, or repetitive use injuries from military service.
Commonly Related Conditions
38 CFR Reference
38 CFR $ 4.124a, Diagnostic Codes 8510-8519