On this page
- VA neuropathy rating chart (38 CFR § 4.124a)
- Bilateral peripheral neuropathy and the bilateral factor
- Proposed changes to VA neuropathy ratings
- The peripheral neuropathy C&P exam and nerve DBQ
- Neuritis and neuralgia rating limits
- How to prove peripheral neuropathy is service connected
- Why VA denies peripheral neuropathy claims
- Questions veterans ask about peripheral neuropathy
- What is the VA rating for peripheral neuropathy?
- Is peripheral neuropathy a presumptive condition for VA?
- How does VA rate bilateral peripheral neuropathy?
- What is the VA rating for diabetic neuropathy?
- Can numbness and tingling alone get a VA rating?
- Will the proposed VA neuropathy rating changes affect my rating?
- Your next step
- Sources and limits
Peripheral neuropathy VA ratings depend on the affected nerve, the side involved, and the degree of impairment under 38 CFR § 4.124a. There is no single percentage for every neuropathy diagnosis. A record that identifies the nerve and describes the actual findings is more useful than a general statement that your hands or feet hurt.
Separate two questions: whether the condition is connected to service, and how VA should evaluate the resulting impairment. A diagnosis, a proposed secondary relationship, and a severity grade answer different parts of the claim.
This page covers the VA neuropathy rating chart, the bilateral factor, the 2024 proposal to change nerve ratings, the peripheral nerves C&P exam, how to prove service connection (diabetes, Agent Orange, and the spine), and why VA denies neuropathy claims.
VA neuropathy rating chart (38 CFR § 4.124a)
The schedule contains different codes for named nerves and nerve groups. It distinguishes incomplete paralysis from the particular findings describing complete paralysis for each nerve. Incomplete paralysis means impaired function less than that complete-paralysis description; it does not mean you must be unable to move the limb to have a compensable nerve disability.
The chart below shows the percentages for the main leg and arm nerves, including the codes that come up most in Board rating appeals. Each rating is for one side. For arm nerves, the first figure is for the major (dominant) side and the second for the minor side; under 38 CFR § 4.69, only one hand is dominant.
| Nerve (code) | Mild | Moderate | Moderately severe | Severe | Complete |
|---|---|---|---|---|---|
| Sciatic (DC 8520) | 10% | 20% | 40% | 60% (with marked muscle atrophy) | 80% |
| Common peroneal (DC 8521) | 10% | 20% | Not listed | 30% | 40% |
| Tibial (DC 8524) | 10% | 20% | Not listed | 30% | 40% |
| Femoral (DC 8526) | 10% | 20% | Not listed | 30% | 40% |
| All radicular groups, arm (DC 8513) | 20% / 20% | 40% / 30% | Not listed | 70% / 60% | 90% / 80% |
| Radial (DC 8514) | 20% / 20% | 30% / 20% | Not listed | 50% / 40% | 70% / 60% |
| Median (DC 8515) | 10% / 10% | 30% / 20% | Not listed | 50% / 40% | 70% / 60% |
| Ulnar (DC 8516) | 10% / 10% | 30% / 20% | Not listed | 40% / 30% | 60% / 50% |
Each complete-paralysis rating comes with a description of what the nerve can no longer do. Several disabilities may require separate evaluations, but it is not correct to assume every named nerve automatically receives an additional rating. The schedule says combined nerve injuries should be rated by reference to the major involvement, or by a radicular group rating if the involvement is extensive, and § 4.14 prevents paying twice for the same manifestation under different diagnoses.
Sciatic nerve (DC 8520)
The sciatic nerve is the only nerve in the chart with a "moderately severe" level. Its complete-paralysis description includes a foot that dangles and drops, no active movement of the muscles below the knee, and weakened or (very rarely) lost knee flexion. A symptom word alone does not establish that category. Read DC 8520 and the examiner's actual findings together. Sciatica and lumbar radiculopathy in the legs are often rated under this code; see sciatica and radiculopathy.
When the symptoms are only sensory
When involvement is wholly sensory, § 4.124a directs evaluation at the mild or, at most, moderate degree. For the sciatic nerve, that means 10 or 20 percent on each side. Findings beyond sensory symptoms do not automatically establish a particular higher grade. VA still has to assess the whole disability under the applicable code.
Bilateral peripheral neuropathy and the bilateral factor
The peripheral nerve ratings are for one side. When both sides are involved, § 4.124a says to combine them with the bilateral factor under § 4.26. The bilateral factor applies only when each of the paired arms or legs has a compensable rating. VA combines the ratings for both sides and then adds 10 percent of that combined value.
It does not mean an extra ten percentage points on the final combined rating. Mild sciatic neuropathy rated 10 percent on each leg combines to 19, the bilateral factor adds 1.9 for 20.9, and the result counts as 21 for further combining, a combined 20 percent if those are your only ratings. When all four limbs are involved, § 4.26(b) combines all four ratings and applies the bilateral factor once.
Check the assigned nerves, sides, individual evaluations, and combined calculation in the decision. Use the VA disability calculator for an estimate based on those entries, then compare it with the actual award.
Proposed changes to VA neuropathy ratings
On November 12, 2024, VA proposed rewriting the neurological part of the rating schedule ("Schedule for Rating Disabilities: Neurological Conditions and Convulsive Disorders," 89 FR 88917, RIN 2900-AQ73). For peripheral nerves, the proposal would do the following.
- Muscle strength grades instead of mild, moderate and severe. Motor impairment would be rated on the Medical Research Council muscle strength scale: grade 4 in place of mild, grade 3 for moderate, grade 2+ for moderately severe (sciatic only), grade 2 for severe, and grade 0 or 1 for complete paralysis.
- A separate sensory standard. Sensation that is impaired but not absent, or numbness, tingling or other abnormal sensations, would be incomplete sensory neuropathy and, for most nerves, rate like the mild level; absent sensation would rate like the moderate level.
- No separate neuritis and neuralgia codes. The 8600 (neuritis) and 8700 (neuralgia) series would be removed, and §§ 4.123 and 4.124, which hold their rating caps, would be rewritten.
Status. Comments closed January 13, 2025. As of early October 2026 VA has not published a final rule, so the current § 4.124a chart on this page is the rule VA and the Board apply.
Existing ratings. Under 38 CFR § 3.951(a), a change to the rating schedule is not grounds to reduce a rating already in effect unless the condition has actually improved.
The peripheral neuropathy C&P exam and nerve DBQ
Claim Raven's Peripheral Nerves DBQ guide explains the form and what to prepare before discussing it with your clinician.
VA publishes separate Peripheral Nerves and Diabetic Peripheral Neuropathy questionnaires. A healthcare provider completes the clinical findings. You can use the relevant form to understand the topics and prepare an accurate history.
The peripheral-nerves form reviewed September 8, 2026 includes diagnosis and history, symptom location, muscle strength, reflexes, sensation, skin or other trophic changes, gait, affected nerves, and functional impact. The June 1, 2026 version explicitly separates sides and nerves.
Do not fill in muscle strength, reflex findings, or a medical severity grade yourself. Your role is to describe what you experience and identify relevant records. The clinician's role is to examine, interpret, and document findings.
Build a symptom and record map for the exam
| Topic | What you can prepare |
|---|---|
| Location | Which hand, fingers, foot, or other area is affected; whether the sides differ |
| Experience | Your actual pain, numbness, tingling, weakness, or other symptoms, without guessing a nerve name |
| Timing | When you first noticed the problem, its course, and any uncertainty |
| Activities | Specific effects on walking, standing, gripping, buttons, tools, or another activity you actually do |
| Treatment and tests | Relevant notes, medications, prescribed aids, and completed testing with dates |
| Changes and limits | Better periods, worse periods, treatment response, and what you cannot recall |
Fictional example: a veteran reports dropping a tool with the right hand and numbness in part of the left foot. A useful note separates the two locations, identifies when each occurs, and points to relevant treatment records. It does not assume the same nerve or severity in both areas.
Testing such as EMG or nerve-conduction studies may be part of an evaluation when clinically appropriate. Do not assume every claim requires every test or obtain a test solely to complete a checklist. Follow your clinician's assessment. Claim Raven's C&P exam preparation tool can help organize what you want to remember.
Neuritis and neuralgia rating limits
Section 4.123 generally caps neuritis at severe incomplete paralysis of the affected nerve. For neuritis without the organic changes described in that section, the maximum is generally moderate, with a moderately-severe exception for sciatic nerve involvement.
Section 4.124 generally caps peripheral neuralgia at moderate incomplete paralysis. These rules depend on the diagnosis and findings. Renaming symptoms does not establish a different condition or bypass a rating limit.
How to prove peripheral neuropathy is service connected
Every claim needs a current diagnosis that identifies the affected nerves, a service event, exposure or service-connected condition, and medical evidence linking them. Most neuropathy claims run through one of three routes.
Peripheral neuropathy secondary to diabetes
For diabetic neuropathy, the medical record should identify the diagnosis and relationship to diabetes. If diabetes is service connected, secondary service connection may be relevant. Do not assume every nerve symptom in a person with diabetes is caused by diabetes.
VA usually handles diabetic peripheral neuropathy as a complication of service-connected diabetes, not as a stand-alone contest between medical opinions. Note (1) to Diagnostic Code 7913, the diabetes code in § 4.119, says to "evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100-percent evaluation," and that "noncompensable complications are considered part of the diabetic process." In practice, neuropathy findings that reach a compensable grade under § 4.124a get their own evaluation for each affected nerve and side, and milder findings are treated as part of the diabetes rating.
You usually do not need a separate formal claim to raise it. 38 CFR § 3.155(d)(2) directs VA to consider complications of a claimed condition, including those its rating criteria identify, as part of the claim. In Board decision A25005541 (January 22, 2025), the Board treated neuropathy in both arms as part of the veteran's appeal of his diabetes rating and granted it as secondary to diabetes, because VA examiners had attributed it to diabetes and no evidence pointed elsewhere.
The exam route runs through two questionnaires. VA's Diabetes Mellitus DBQ lists diabetic peripheral neuropathy as a recognized complication and tells the examiner to complete the matching questionnaire for each complication checked. For neuropathy, that is the Diabetic Peripheral Neuropathy questionnaire linked above, which records symptoms, the neurologic exam, severity by nerve, and functional impact. The same Board decision gave no weight to a private diabetes questionnaire that listed other complications without completing the separate body-system questionnaires the form calls for. If your diabetes exam notes numbness or tingling but no neuropathy questionnaire was completed, ask why. Claim Raven's Diabetic Peripheral Neuropathy DBQ guide explains that form.
The evidence that helps a diabetic neuropathy complication claim is below.
| Record | Why it helps |
|---|---|
| The decision service-connecting diabetes, and any later decisions on its complications | Shows the primary condition and what VA has already evaluated |
| Diabetes care notes, including annual foot exams and any monofilament, vibration, or reflex findings | Shows the course of the disease and early nerve findings |
| Your own record of when symptoms started in each hand and foot, kept separate by side | Supports a separate evaluation for each affected extremity |
| Nerve-conduction or EMG reports, if a clinician ordered them | Adds objective findings; not every claim requires them |
| Records bearing on other causes, such as spine disease, B12, thyroid or kidney problems, alcohol, or medicines | The examiner has to weigh them, and leaving them out does not remove them |
A separate medical opinion is worth the effort in two situations. The first is when VA attributes the nerve findings to something other than diabetes, such as a spine condition or alcohol. The second is when neuropathy began before diabetes and the question is whether diabetes made it worse. VA's diabetes questionnaire defines that kind of aggravation in "but for" terms: an increase in severity "that would not have occurred but for the Diabetes Mellitus, or where the nonservice-connected condition would have been less severe but for the Diabetes Mellitus."
Agent Orange and early-onset peripheral neuropathy
Early-onset peripheral neuropathy is on VA's Agent Orange presumptive list in 38 CFR § 3.309(e). Under § 3.307(a)(6)(ii), it must have become manifest to a degree of 10 percent or more within a year after the last date you were exposed to an herbicide agent in service. That timing rule is strict: neuropathy that first appeared years after you left Vietnam or another qualifying location does not fit the presumption, even if you were exposed. Qualifying service and the onset history still need evidence. See the Agent Orange guide for the service categories, and the presumptive conditions tool for the other lists.
If a presumption does not fit, another supported theory may still be available. Neuropathy from type 2 diabetes, which is itself on the Agent Orange list, runs through the diabetes route above, and a direct claim with a medical opinion is still possible. A general article cannot determine the medical cause of your symptoms.
Neuropathy and back or neck conditions
After diabetes, the conditions most often named as the cause of neuropathy in Board appeals are lumbar and cervical spine disorders. The spine rating formula in 38 CFR § 4.71a tells VA to evaluate associated objective neurologic abnormalities separately under an appropriate diagnostic code, so nerve involvement from a service-connected back or neck condition is rated on its own under the nerve chart above. The medical question is whether the findings come from a nerve root in the spine or from a peripheral neuropathy with another cause, and the opinion should say which.
Why VA denies peripheral neuropathy claims
Board appeals on nerve conditions are most often sent back for more development. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 38,304 decided Board rulings on peripheral neuropathy from 2021 to 2026, 26.1% were granted, 30.5% denied and 43.4% remanded. That grant rate is 1.4 points above the Board-wide 24.7 percent. These are outcomes in already-disputed appeals, summarized with the Board-wide figures on the VA disability statistics page. They describe patterns, not your odds.
In the Board's 2021 to 2026 service connection rulings, neuropathy claimed as secondary to another condition, most often diabetes, was granted more often than neuropathy claimed directly; the Board section below shows both, and lists the secondary conditions with their counts and grant rates.
When the Board denied neuropathy service connection, the most common reason was that it found no link to service, followed by no in-service event or exposure and then no current diagnosis. The patterns behind those denials repeat.
No medical link. The neuropathy appeared years after service, and no opinion explains why it is related to service or to a service-connected condition.
Onset outside the Agent Orange window. The veteran was exposed, but the neuropathy did not reach 10 percent within a year after the last exposure, so the presumption does not apply and nothing else carries the claim.
No qualifying exposure or event. The service records do not place the veteran where herbicide exposure is presumed, or show the injury the claim depends on.
Another cause. Common identifiable causes of peripheral neuropathy include diabetes, nerve compression or injury, alcohol use, toxins, hereditary disease, and nutritional deficiencies, and a standard first workup checks blood sugar, B12 and thyroid levels along with a blood count and a metabolic panel (Castelli, American Family Physician, 2020). An examiner who finds one of those causes, or a non-service-connected spine problem, will usually write a negative opinion.
A secondary opinion that skips aggravation. For neuropathy claimed secondary to diabetes or a spine condition, an opinion that says only "not caused by" without addressing whether the service-connected condition made the neuropathy worse is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)).
The findings don't reach the level claimed. Wholly sensory involvement is capped at the moderate level, and neuritis and neuralgia have their own caps.
When the Board sent a neuropathy claim back instead of deciding it, the most common reason was an inadequate VA exam or opinion. The Board section below shows how often each denial and remand reason came up, how the Board ruled when it relied on a favorable medical opinion, an opinion against the claim, or none, and rating appeals by diagnostic code, where the sciatic nerve code comes up most often.
Questions veterans ask about peripheral neuropathy
What is the VA rating for peripheral neuropathy?
It depends on the nerve, the side, and the severity. Under 38 CFR § 4.124a, the sciatic nerve rates 10, 20, 40, 60 or 80 percent from mild to complete paralysis, while the other leg nerves top out at 40 percent or less, and the arm nerves generally pay more on the dominant side. Each affected nerve on each side is rated separately unless the same symptoms would be counted twice.
Is peripheral neuropathy a presumptive condition for VA?
In two situations. Early-onset peripheral neuropathy is presumed service connected for veterans exposed to Agent Orange if it reached 10 percent within a year after the last exposure. Former prisoners of war held at least 30 days get a presumption for peripheral neuropathy that appears to 10 percent at any time, except where it is directly related to an infection (38 CFR § 3.309(c)).
How does VA rate bilateral peripheral neuropathy?
VA rates each side separately, combines the two, and adds 10 percent of the combined value under the bilateral factor in 38 CFR § 4.26, if both sides have compensable ratings. Two legs at 10 percent each work out to 20.9, which rounds to a combined 20 percent, not 30.
What is the VA rating for diabetic neuropathy?
VA rates diabetic neuropathy under the same nerve codes, for each affected nerve and side. Under Note (1) to Diagnostic Code 7913, compensable neuropathy is rated separately from diabetes, and neuropathy below the compensable level is treated as part of the diabetes rating.
Can numbness and tingling alone get a VA rating?
Yes. When the involvement is wholly sensory, § 4.124a rates it at the mild or, at most, moderate level of the affected nerve, which for the sciatic nerve is 10 or 20 percent on each side. Higher ratings need findings such as weakness, muscle atrophy or loss of movement.
Will the proposed VA neuropathy rating changes affect my rating?
Not yet. VA proposed new nerve criteria in November 2024, and as of early October 2026 the rule is not final. Under 38 CFR § 3.951(a), a later change to the schedule is not grounds to reduce a rating already in effect unless your condition has improved.
Your next step
Prepare the symptom-and-record map before your examination. Claim Raven's C&P exam preparation tool can help organize what you want to remember. Describe your actual experience, follow the examiner's instructions, and compare any later summary with the original report.
Sources and limits
Reviewed September 8, 2026 using VA's public nerve DBQs, its Agent Orange guidance, and §§ 4.14, 4.123, 4.124, and 4.124a in the official GPO daily eCFR Title 38 file. The section on service-connected diabetes was added September 23, 2026 using § 3.155(d)(2), Diagnostic Code 7913 in § 4.119, VA's Diabetes Mellitus DBQ (updated March 16, 2026), and the full text of Board decision A25005541, which binds only that appeal. Updated October 6, 2026: the nerve chart, the dominant-hand rule in § 4.69, the bilateral factor in § 4.26, the presumptions in §§ 3.307(a)(6) and 3.309(c) and (e), the spine formula note in § 4.71a, the rating-preservation rule in § 3.951(a), and the November 2024 proposed rule (89 FR 88917), whose status was checked in early October 2026. The list of causes is from Castelli, "Peripheral Neuropathy: Evaluation and Differential Diagnosis," American Family Physician (2020). Board figures come from Claim Raven's read of 511,036 Board decisions from 2021 to 2026, which contain 1,378,030 rulings, including 41,864 rulings on peripheral neuropathy; dismissed, withdrawn and moot rulings are excluded from the shares. The example is fictional. This guide does not diagnose nerve damage, assign a clinical severity grade, or predict an individual rating.