Radial Nerve (Musculospiral Nerve)
The radial nerve (also called the musculospiral nerve) is one of the major nerves of the upper extremity. It controls wrist extension, finger extension, elbow flexion, turning the forearm, and wrist side-to-side movement. Damage can cause wrist drop (inability to extend the hand at the wrist) and difficulty gripping. The VA rates this nerve separately from the radicular groups. Ratings differ for the dominant vs. non-dominant arm. Each arm can receive its own rating, and the bilateral factor applies. Only one nerve evaluation per arm is allowed - the veteran receives whichever gives the highest evaluation.
VA Rating Levels
Incomplete paralysis - mild. Both dominant and non-dominant receive 20%.
Incomplete paralysis - moderate. Dominant arm receives 30%, non-dominant receives 20%.
Incomplete paralysis - severe. Dominant arm receives 50%, non-dominant receives 40%.
Complete paralysis. Wrist and fingers perpetually flexed (drop of hand and fingers), thumb adducted, cannot extend hand at wrist or fingers, supination and elbow flexion weakened. Dominant arm receives 70%, non-dominant receives 60%.
Exam Tips & Key Evidence
- →This is one of the higher-rated individual upper extremity nerves, with a potential 70% rating for complete paralysis of the dominant arm.
- →Only ONE nerve evaluation per arm is allowed, regardless of how many individual nerves or groups are impaired. The VA assigns whichever yields the highest rating.
- →If the veteran is ambidextrous, whichever side is affected will be considered the dominant arm.
- →Each arm can receive its own rating, and the bilateral factor applies.
- →Neuritis (DC 8614): 20% mild, 20-30% moderate (non-dom/dom), 40-50% severe. Neuralgia (DC 8714): 20% mild, 20-30% moderate.
- →This is a presumptive condition if diagnosed within one year of separation and the severity warranted at least 10% within that time.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.124a, DC 8514/8614/8714