The Peripheral Nerves of the Low Back and Legs

Topics:

The Nerve Rating System
The Peripheral Nerves of the Low Back and Legs
Other Nervous Conditions
DBQs for Peripheral Nervous Conditions
Principles that Apply

The Nervous System is divided over multiple pages: the Peripheral Nerves of the Upper Back and Arms, the Peripheral Nerves of the Low Back and Legs (this page), the Cranial Nerves, and Traumatic Brain Injury (TBI). Finally, all other nervous conditions can be found on The Central Nervous System page.

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

Additional compensation is given by the VA for loss of use of the arms, legs and a few other body systems. If your nerve condition is severe enough that the affected body part is unable to function at all, you probably qualify. See the Special Monthly Compensation page to see if your particular condition qualifies.

The nervous system connects the brain to the rest of the body. Impulses travel up the nerves and spinal cord to the brain, and the brain then turns these impulses into ideas like pain, heat, etc. Similarly, the brain can send signals through the nerves to various parts of the body, telling it to raise the arm, point the toes, open and close the lungs to breathe, etc.

The nervous system is divided into two parts: the central nervous system, and the peripheral nervous system. The central nervous system consists of the brain, the spinal cord, and the cranial nerves. The peripheral nervous system is made up of all the nerves that travel from the spinal cord to the rest of the body.

The majority of nervous system conditions are rated on the symptoms they create. These symptoms could include mental illness (hallucinations and the like), trouble speaking, hearing, seeing, the inability to properly move the body, tremors, and more. For the VA, every symptom will be ratable, but for the DoD, since they only rate conditions that make a service member Unfit for Duty, they will only rate the symptoms that also make him unfit. Not every symptom a nerve condition causes will always be ratable for DoD Disability. If each symptom is not unfitting by itself, but the overall condition is, then only the worst symptom can be rated.

Note: There are a few times for these conditions that the VASRD uses vague terms like “severe.” The exact definition of terms like this is up to the opinion of the Rating Authorities, so unfortunately, we can’t really give you a more concrete definition than this. It may mean one thing to one person and something entirely different to someone else. What they are supposed to be keeping in mind when deciding ratings, however, is how much that condition affects your overall health and ability to work. If that is severely affected, then the Rating Authorities should consider it a “severe” condition. Hope that helps.

 


The Nerve Rating System

This rating system is used for rating both the Cranial Nerves and the Peripheral Nerves (the nerves of the Upper Back and Low Back).

There are a few basic rules/principles to follow when rating a cranial or peripheral nerve condition.

First, all nerve conditions are rated based on the loss of function of the affected body part. There are three different categories a nerve condition can be rated under: paralysis, neuritis, and neuralgia. The condition must satisfy certain terms to be rated under one of these categories. These terms are discussed below. Once it is determined which of the three categories the nerve condition falls under, it can then be rated either under that category or under limited motion, whichever gives the higher rating. It is important to note that if the nerve condition is causing the limited motion, then only one rating can be given either under a nerve code or under limited motion. If, however, the limited motion is NOT caused by the nerve condition, then it can be rated in addition to a nerve rating.

Second, when deciding which of the three categories a condition fits in, it is important to keep in mind that the actual loss of function of the body part is the main defining criteria. In other words, if the nerve leading to a muscle in the shoulder is completely paralyzed, it is not necessarily rated as completely paralyzed. If the shoulder can no longer move the arm or function at all, then it can be rated as completely paralyzed. In most cases, however, the muscles in the shoulder and arm that are not affected by the paralyzed nerve will often compensate for the loss of function, and moving the arm will still be possible. This is especially the case since the nerves rarely work alone, meaning that more than one nerve often works a single muscle. Because of this, some movements are controlled by numerous nerves and may still be able to take place if one is damaged. In cases like this, the nerve cannot be rated as completely paralyzed. We’ll work an example in a bit to help clarify this rule.

Third, each nerve is paired, meaning that there are 2 of every nerve, one for each side of the body. The sciatic nerves exit the lumbar spine on both sides and travel down each leg. The bilateral factor (discussed in detail on the VA Math page) is an extra percentage given to ratings if both sides of the body are affected. For example, if there is a back problem that causes problems with both of the sciatic nerves, then the additional bilateral factor would be added since both legs are affected. Same thing for hands, elbows, arms, knees, hips, etc. If both sides are affected, both are each rated separately and then given the additional bilateral factor.

Fourth, each nerve has three different possible codes under which it could be rated:

– Paralysis of the nerve—the nerve itself, not the affected body part, cannot function at all. This can be complete paralysis or partial paralysis.
– Neuritis of the nerve—the nerve still functions, but it is swollen, irritated, and very painful. All cases of neuritis will have at least one of the following:

1.) a decreased ability to sense
2.) muscle atrophy
3.) loss of reflexes

– Neuralgia of the nerve—the nerve causes occasional or constant pain. There can also be tingling, numbness, etc.

For a condition to qualify for the next highest category, it must satisfy all the criteria. For example, a condition with severe pain but no other symptoms would still have to be considered neuralgia since the other symptoms, like muscle atrophy, that are required to call a condition neuritis aren’t present.

Fifth, each of these codes is rated based on a degree of severity.

Paralysis

Complete: This is defined for each nerve a little differently, but basically, it means that the nerve is completely paralyzed and the body part cannot function at all, like if it had been amputated.
Incomplete, severe: If the nerve is not completely paralyzed, and there are symptoms, like poor blood circulation and muscle atrophy, that seriously limit the body part’s ability to function, then it is rated as severe. The condition must be very severe to be rated here.
Incomplete, moderate: If the nerve is not completely paralyzed, and there is tingling, numbness, moderate pain, or other symptoms that definitely and significantly interfere with the ability of the body part to fully function, it is rated as moderate.
Incomplete, mild: If the nerve is not completely paralyzed, and there is only tingling or mild pain in the affected body part, it is rated as mild. There could also be slight or very mild limitations in the movement of the body part, but these limitations would not really affect the overall functioning.

Neuritis

Severe: If there are all three of the main symptoms (loss of reflexes, muscle atrophy, and loss of sensation), and they seriously limit the body part’s ability to function, then it is rated as severe. The condition must be very severe to be rated here.
Moderate: If there are one or more of the main symptoms that definitely and significantly interfere with the ability of the body part to fully function, it is rated as moderate.
Mild: If there are one or more of the main symptoms, but they are mild and do not interfere significantly with the ability of the body part to function, it is rated as mild.

Neuralgia

Moderate: If there is tingling, numbness, moderate to severe pain, or other symptoms that definitely and significantly interfere with the ability of the body part to function fully, it is rated as moderate.
Mild: If there is only tingling or mild pain in the affected body part, it is rated as mild. There could also be slight or very mild limitations in the movement of the body part, but these limitations would not really affect the overall functioning.

That’s basically the entire nervous rating system. Each nerve has its own percentages for the various degrees of severity. They will all be addressed in the discussion of each cranial and peripheral nerve.

Example. A service member has damage to the sciatic nerve in his right leg. The leg can move forward from the hip, but only to 20°. There is constant, mild pain and tingling down his leg and into his foot. Tests show that the sciatic nerve is completely paralyzed and unable to function at all. (Disclaimer: It’s rare for a nerve to be completely paralyzed with such mild symptoms, but let’s go with it for the sake of demonstrating the principles involved.) How is his condition rated?

First, we need to determine in which of the three categories the condition fits: paralysis, neuritis, or neuralgia. The tests say that the nerve is paralyzed, so that one’s easy.

Next, we need to determine the severity of the paralysis. We know that it cannot be rated as completely paralyzed even though the nerve is completely paralyzed, since the leg can still move. This means that the other nerves that affect the same muscles as the sciatic nerve are compensating for the damage. The definition of severe for paralysis requires severe symptoms like muscle atrophy which are clearly not seen in this case. Similarly, the definition of mild paralysis is too mild for this case since the range of motion is fairly limited. So, the best category for our condition would be moderate paralysis: “the nerve is not completely paralyzed, and there is tingling, numbness, moderate pain, or other symptoms that definitely and significantly interfere with the ability of the body part to fully function.” Yep.

Now that we have determined the severity of paralysis, we can find the proper rating under the sciatic nerve section below. The code for this condition is 8520, and the rating under moderate paralysis is 20%.

Alright, so we know that the nerve rating for this condition under code 8520 is 20%. Now we need to determine what his condition would rate for limited motion of the hip. Underneath each of the ratings for the individual nerves is a section that gives the codes of the various limited motions for that nerve. We know that the hip cannot bend forward (flexion) more than 20°, so code 5252 would be the correct code. Under that code, if the hip cannot move the leg forward more than 20°, it is rated 30%.

Since 30% under limited motion is more than the 20% given under the nerve code, this condition would be rated on limited motion. The final code would look like this: 8520-5252. The first four-digit code defines the condition as a paralyzed sciatic nerve. The second four-digit code tells us that the condition was rated under limited motion of the hip.

That’s it. Just remember to figure out which nerve category and severity the condition best fits and then find the rating for limited motion. Choose the highest rating.

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The Peripheral Nerves of the Low Back and Legs

The peripheral nerves travel from the spinal cord to the rest of the body. Nerves from the upper back and neck travel to the shoulders and arms. The nerves in the lower back travel to the legs and feet.

Here is a list of the nerves in the low back that can be rated:

The Sciatic Nerve
The Tibial Nerve
The Posterior Tibial Nerve (tarsal tunnel)
The Common Peroneal Nerve
The Deep Peroneal Nerve
The Superficial Peroneal Nerve
The Ilioinguinal Nerve
The Obturator Nerve
The Femoral Nerve
The Internal Saphenous Nerve
The Lateral Femoral Cutaneous Nerve

The nerves in the low back and legs can be a bit complicated. This is because the larger nerves split into smaller nerves as they travel down the leg. The sciatic nerve, the largest and longest nerve in the body, alone splits into five nerves that have their own codes and ratings. If the sciatic nerve is damaged in a location before it splits, then all of the nerves it divides into will not properly function. In this case, only one rating can be given under the sciatic nerve code. None of the other nerves that split from the sciatic nerve can be rated as well. If, however, the nerve is damaged below a split, then only the damaged branch of the nerve can be rated.

Here are two illustrations of the ratable nerves in the legs (there are many more nerves, but these are the only ones ratable). Note carefully where they branch in order to ensure a proper rating.

the nerves of the low back and legs        the nerves of the low back and legs

The sciatic nerve divides just above the knee into the tibial nerve and the common peroneal nerve. The tibial nerve turns into the posterior tibial nerve when it circles around the back of the ankle and enters the inner foot through the tarsal tunnel. The common peroneal nerve splits just below the knee into the deep peroneal nerve and the superficial peroneal nerve. The lateral femoral cutaneous nerve technically splits, but the branches do not have their own separate codes. The ilioinguinal nerve and obturator nerve also stand alone and do not split as far as rating is concerned. The femoral nerve splits about mid-thigh. One of its branches is the internal saphenous nerve.

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The Sciatic Nerve (a.k.a. ischiadic nerve or ischiatic nerve) begins in the lower back and runs through the buttocks down each leg. It controls the following movements: kicking the leg backwards from the hip, bending the knee, kicking the leg inward across the other leg, pointing and flexing the foot, turning your feet so you stand on the outward edge, and turning the feet outward.

muscle motion controlled by the sciatic nerve         muscle motion controlled by the sciatic nerve                     muscle motion controlled by the sciatic nerve

muscle motion controlled by the sciatic nerve                muscle motion controlled by the sciatic nerve                       muscle motion controlled by the sciatic nerve            

A condition of the sciatic nerve is rated under one of the following codes with the corresponding ratings.

Code 8520: Paralysis of the sciatic nerve. Complete paralysis: If the foot drops (it cannot be lifted by the muscles in the legs), all the muscles in the leg below the knee do not work at all, and the knee has serious trouble bending (bending the knee doesn’t have to be impossible to rate as complete paralysis of the sciatic nerve, it just has to be limited), it is rated 80%. Incomplete, severe paralysis is rated 60%. Incomplete, moderately severe paralysis is rated 40%. Incomplete, moderate paralysis is rated 20%. Incomplete, mild paralysis is rated 10%.

Code 8620: Neuritis of the sciatic nerve. If the condition causes severe symptoms, it is rated 60%. If it causes moderately severe symptoms, it is rated 40%. If it causes moderate symptoms, it is rated 20%. Mild symptoms is rated 10%.

Code 8720: Neuralgia of the sciatic nerve (“sciatica”). Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 20%. If it is mild, it is rated 10%.

Make sure to check to see if a higher rating can be given under limited motion of the hip, code 5251-5253, limited motion of the knee, code 5260, or limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8620-5251. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Tibial Nerve (a.k.a. internal popliteal nerve) breaks off the sciatic nerve just above the knee. It then travels down the back of the leg before it curves around the ankle to pass through the tarsal tunnel into the inner foot. Once the tibial nerve curves around the ankle, its name changes to the posterior tibial nerve. If the nerve is damaged before it curves around the ankle, it is rated here. If not, it is rated as the Posterior Tibial Nerve. This nerve controls the following movements: pointing and flexing the foot, turning the feet so the toes point inward, spreading and closing the toes, and curling the toes.

muscle motion controlled by the tibial nerve           muscle motion controlled by the tibial nerve          muscle motion controlled by the tibial nerve      muscle motion controlled by the tibial nerve

A condition of the tibial nerve is rated under one of the following codes with the corresponding ratings.

Code 8524: Paralysis of the tibial nerve. Complete paralysis: If the foot and toes cannot point at all, the toes cannot separate, the foot cannot turn inward, and none of the muscle on the bottom of the foot can move at all, it is rated 40%. Incomplete, severe paralysis is rated 30%. Incomplete, moderate paralysis is rated 20%. Incomplete, mild paralysis is rated 10%.

Code 8624: Neuritis of the tibial nerve. If the condition causes severe symptoms, it is rated 30%. If it causes moderate symptoms, it is rated 20%. Mild symptoms is 10%.

Code 8724: Neuralgia of the tibial nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 20%. If it is mild it is rated 10%.

Make sure to check to see if a higher rating can be given under limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8624-5271. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Posterior Tibial Nerve begins where the tibial nerve curves around the ankle. It passes through the tarsal tunnel on the inside ankle (thus is the nerve affected in tarsal tunnel syndrome) and continues into the arch of the foot. If the nerve is damaged before it curves around the ankle and passes through the tarsal tunnel, then it is not rated here—it is rated as the Tibial Nerve. This nerve controls the following movements: turning the foot so the toes point inward, pointing and flexing just the toes (not the ankle), spreading and closing the toes, and curling the toes.

muscle motion controlled by the posterior tibial nerve          muscle motion controlled by the posterior tibial nerve           muscle motion controlled by the posterior tibial nerve         muscle motion controlled by the posterior tibial nerve

A condition of the posterior tibial nerve is rated under one of the following codes with the corresponding ratings.

Code 8525: Paralysis of the posterior tibial nerve. Complete paralysis: If the toes cannot curl or separate, all the muscles on the bottom of the foot cannot move at all, the foot has trouble turning inward (but it can do it), and the foot has trouble pointing (but it can do it), it is rated 30%. Incomplete, severe paralysis is rated 20%. Incomplete, moderate paralysis is rated 10%. Incomplete, mild paralysis is rated 10%.

Code 8625: Neuritis of the posterior tibial nerve. If the condition causes severe symptoms, it is rated 20%. If it causes moderate or mild symptoms, it is 10%.

Code 8725: Neuralgia of the posterior tibial nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate or mild it is rated 10%.

Make sure to check to see if a higher rating can be given under limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8625-5271. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Common Peroneal Nerve (a.k.a. external popliteal nerve, common fibular nerve, peroneal nerve, lateral popliteal nerve, or wow-this-has-too-many-stinking-names nerve) splits from the sciatic nerve just above the knee. It then travels around the kneecap to the front of the shin where it splits into the deep peroneal nerve and the superficial peroneal nerve. If the nerve is damaged below where it splits from the sciatic nerve but before it splits into the two peroneal nerves, it is rated under this code. This nerve controls the following movements: pointing and flexing the foot, turning your feet so you stand on the outward edge, and turning the feet outward.

muscle motion controlled by the common peroneal nerve              muscle motion controlled by the common peroneal nerve                     muscle motion controlled by the common peroneal nerve   

A condition of the common peroneal nerve is rated under one of the following codes with the corresponding ratings. paralysis of the common peroneal nerve

Code 8521: Paralysis of the common peroneal nerve. Complete paralysis: If the foot and toes cannot be raised or pointed but are stuck in a relaxed foot position, the foot cannot turn to point outward at all, it has trouble turning to point inward (but it still can), and the entire top of the foot and toes are numb, it is rated 40%. Incomplete, severe paralysis is rated 30%. Incomplete, moderate paralysis is rated 20%. Incomplete, mild paralysis is rated 10%.

Code 8621: Neuritis of the common peroneal nerve. If the condition causes severe symptoms, it is rated 30%. If it causes moderate symptoms, it is rated 20%. Mild symptoms is 10%.

Code 8721: Neuralgia of the common peroneal nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate it is rated 20%. If it is mild it is rated 10%.

Make sure to check to see if a higher rating can be given under limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8621-5271. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Deep Peroneal Nerve (a.k.a. anterior tibial nerve or deep fibular nerve) breaks off the common peroneal nerve just below the knee. It then runs down the leg and into the foot and toes. This nerve controls the following movements: pointing and flexing the foot, and turning your feet so you stand on the outward edge.

muscle motion controlled by the deep peroneal nerve                      muscle motion controlled by the deep peroneal nerve  

A condition of the deep peroneal nerve is rated under one of the following codes with the corresponding ratings.

Code 8523: Paralysis of the deep peroneal nerve. Complete paralysis: If the foot and toes cannot lift upward towards the shin (flex), it is rated 30%. Incomplete, severe paralysis is rated 20%. Incomplete, moderate paralysis is rated 10%. Incomplete, mild paralysis is rated 0%.

Code 8623: Neuritis of the deep peroneal nerve. If the condition causes severe symptoms, it is rated 20% If it causes moderate symptoms, it is rated 10%. Mild symptoms is 0%.

Code 8723: Neuralgia of the deep peroneal nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 10%. If it is mild, it is rated 0%.

Make sure to check to see if a higher rating can be given under limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8623-5271. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Superficial Peroneal Nerve (a.k.a. musculocutaneous nerve or superficial fibular nerve) breaks off the common peroneal nerve just below the knee exactly where the deep peroneal nerve separates. It then runs down the outside of the leg and into the foot and toes. This nerve controls the following movements: pointing and flexing your toes (not the whole foot, just the toes), and turning your feet so you stand on the outward edge.

muscle motion controlled by the superficial peroneal nerve                            muscle motion controlled by the superficial peroneal nerve

A condition of the superficial peroneal nerve is rated under one of the following codes with the corresponding ratings.

Code 8522: Paralysis of the superficial peroneal nerve. Complete paralysis: If the foot has trouble (but may be able to still do it a little bit) turning the ankle to lift the outside edge of the foot so that all the weight is on the inside edge and arch, it is rated 30%. Incomplete, severe paralysis is rated 20%. Incomplete, moderate paralysis is rated 10%. Incomplete, mild paralysis is rated 0%.

Code 8622: Neuritis of the superficial peroneal nerve. If the condition causes severe symptoms, it is rated 20%. If it causes moderate symptoms, it is rated 10%. Mild symptoms is 0%.

Code 8722: Neuralgia of the superficial peroneal nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 10% If it is mild, it is rated 0%.

Make sure to check to see if a higher rating can be given under limited motion of the ankle, code 5271. If the condition is best rated as limitation of motion, then the final code will look like this: 8622-5271. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Ilioinguinal Nerve leaves the spinal cord in the low back, curves around the hips to the abdomen, and ends in the groin. This nerve does not directly control any movements. Instead, it provides feeling to the skin in the upper thigh and groin.

A condition of the ilioinguinal nerve is rated under one of the following codes with the corresponding ratings.

Code 8530: Paralysis of the ilioinguinal nerve. Complete paralysis or Incomplete, severe paralysis is rated 10%. Incomplete, moderate or mild paralysis is rated 0%.

Code 8630: Neuritis of the ilioinguinal nerve. If the condition causes severe symptoms, it is rated 10%. If it causes moderate or mild symptoms, it is rated 0%.

Code 8730: Neuralgia of the ilioinguinal nerve. This condition, regardless of severity, is rated 0%.

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The Obturator Nerve leaves the spinal cord in the low back and travels down the leg to the inner thigh. This nerve helps power the following movements: lifting the leg out to the front, kicking the leg inward across the other leg, kicking the leg straight out to the side, and turning the hip so the knee falls across the other leg or out to the side.

muscle motion controlled by the obturator nerve                muscle motion controlled by the obturator nerve                 muscle motion controlled by the obturator nerve              muscle motion controlled by the obturator nerve     

A condition of the obturator nerve is rated under one of the following codes with the corresponding ratings.

Code 8528: Paralysis of the obturator nerve. Complete paralysis or Incomplete, severe paralysis is rated 10%. Incomplete, moderate or mild paralysis is rated 0%.

Code 8628: Neuritis of the obturator nerve. If the condition causes severe symptoms, it is rated 10%. If it causes moderate or mild symptoms, it is rated 0%.

Code 8728: Neuralgia of the obturator nerve. This condition, regardless of severity, is rated 0%.

Make sure to check to see if a higher rating can be given under limited motion of the hip, code 5252 or 5253. If the condition is best rated as limitation of motion, then the final code will look like this: 8628-5252. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Femoral Nerve (a.k.a. anterior crural nerve) emerges from the spinal cord in the lower back, comes around the outside of the hip towards the abdomen, and then travels down the thigh. The internal saphenous nerve splits off of this nerve in the thigh. If the femoral nerve is damaged above this split, it is rated here. If the internal saphenous nerve is damaged after the split, it is rated below. The femoral nerve controls the following movements: kicking the leg straight forward, straightening the leg at the knee, and lifting the torso from the hips (like doing a sit-up).

muscle motion controlled by the femoral nerve             muscle motion controlled by the femoral nerve          muscle motion controlled by the femoral nerve      

A condition of the femoral nerve is rated under one of the following codes with the corresponding ratings.

Code 8526: Paralysis of the femoral nerve. Complete paralysis: If the muscles on the front of the thigh cannot function at all, making it impossible to straighten the knee, it is rated 40%. Incomplete, severe paralysis is rated 30%. Incomplete, moderate paralysis is rated 20%. Incomplete, mild paralysis is rated 10%.

Code 8626: Neuritis of the femoral nerve. If the condition causes severe symptoms, it is rated 30%. If it causes moderate symptoms, it is rated 20%. Mild symptoms is 10%.

Code 8726: Neuralgia of the femoral nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 20%. If it is mild, it is rated 10%.

Make sure to check to see if a higher rating can be given under limited motion of the hip, code 5252, or limited motion of the knee, code 5261. If the condition is best rated as limitation of motion, then the final code will look like this: 8626-5261. The first four-digit number is whichever of the three nerve codes the condition best fits under (paralysis, neuritis, or neuralgia), and the second is the limited motion code where it is rated.

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The Internal Saphenous Nerve (a.k.a. long saphenous nerve or saphenous nerve) breaks off of the femoral nerve in the thigh. If the femoral nerve is damaged above the split, then the condition is rated above. If the internal saphenous nerve is damaged below the split, it is rated here. After the split, this nerve travels down the inside of the thigh and calf into the foot. This nerve does not directly control any movements. Instead, it provides feeling to the skin at the inside of the thigh and calf, and top of the foot.

A condition of the internal saphenous nerve is rated under one of the following codes with the corresponding ratings.

Code 8527: Paralysis of the internal saphenous nerve. Complete paralysis or Incomplete, severe paralysis is rated 10%. Incomplete, moderate or mild paralysis is rated 0%.

Code 8627: Neuritis of the internal saphenous nerve. If the condition causes severe symptoms, it is rated 10%. If it causes moderate or mild symptoms, it is rated 0%.

Code 8727: Neuralgia of the internal saphenous nerve. This condition, regardless of severity, is rated 0%.

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The Lateral Femoral Cutaneous Nerve (a.k.a. external cutaneous nerve or lateral cutaneous nerve) extends from the spinal cord in the low back. It then curves around side of the hip and splits into two branches that go to the front and back of the thigh. Any damage to this nerve (before or after the split) is rated here. This nerve does not directly control any movements. Instead, it provides feeling to the skin of the front and back thigh.

A condition of the lateral femoral cutaneous nerve is rated under one of the following codes with the corresponding ratings.

Code 8529: Paralysis of the lateral femoral cutaneous nerve. Complete paralysis or incomplete, severe paralysis is rated 10%. Incomplete, moderate or mild paralysis is rated 0%.

Code 8629: Neuritis of the lateral femoral cutaneous nerve. If the condition causes severe symptoms, it is rated 10%. If it causes moderate or mild symptoms, it is rated 0%.

Code 8729: Neuralgia of the lateral femoral cutaneous nerve. This condition, regardless of severity, is rated 0%.

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Other Nervous Conditions

Make sure to check the other Nervous System pages. If your condition cannot be found, then it is rated analogously (see the Analogous and Equivalent Codes page) with the nervous system code that best defines the condition. The bottom-line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQ for Peripheral Nerve Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for peripheral nerve conditions: Peripheral Nerve DBQ and Diabetic Peripheral Neuropathy DBQ.

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Principles that Apply

Pyramiding: A single condition can only be rated once! However, if a mental disorder or another condition exists that is additional to the nervous condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

For mental and psychiatric conditions, please see the Mental Disorders page. For conditions of the cranial nerves, see The Cranial Nerves page. For other peripheral nerve conditions, see the Nerves of the Upper Back and Arms page. For TBI, see the Traumatic Brain Injury (TBI) page. For all other nervous system conditions, see The Central Nervous System page.

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Military Disability Made Easy is a national website dedicated to helping
Disabled Veterans take control of their Military Disability. From the Medical Evaluation Board and Physical Evaluation Board
to the laws of the VASRD, Military Disability Made Easy can educate you on every aspect of DoD Disability and
VA Disability. Find all the answers you need to maximize your Military Disability Benefits and VA Disability Benefits today!
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