The Peripheral Nerves of the Upper Back and Arms

Topics:

The Nerve Rating System
The Peripheral Nerves of the Upper Back and Arms
Other Nervous Conditions
DBQ for Peripheral Nervous Conditions
Principles that Apply

The Nervous System is divided over multiple pages: the Peripheral Nerves of the Upper Back and Arms (this page), the Peripheral Nerves of the Low Back and Legs, 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 VA Disability compensation is given 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 breath, 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 on 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, for all nerve ratings for the arms only, a higher rating is given if the arm affected is the dominant arm. If you are ambidextrous, then the arm affected by the nerve condition is considered the dominant arm.

Fourth, each nerve is paired, meaning that there are 2 of every nerve, one for each side of the body. The ulnar nerves exit the spine on both sides and travel down each arm. 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 ulnar nerves, then the additional bilateral factor would be added since both arms 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.

Fifth, 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.

Sixth, 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 radial nerve in his right arm. He is left-handed. The arm can bend at the elbow, but only to 55°. There is constant, mild pain and tingling down his upper arm and into his forearm. Tests show that the radial 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 arm can still move and function fairly well. This means that the other nerves that affect the same muscles as the radial 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 radial nerve section below. The code for this condition is 8514, and the rating under moderate paralysis for the dominant hand is 30% and 20% for the non-dominant. Since he is left-handed (dominant) and the condition is in his right arm, the rating for non-dominant hand would be applied.

Alright, so we know that the nerve rating for this condition under code 8514 is 20%. Now we need to determine what his condition would rate for limited motion of the elbow. Underneath each of the ratings for the individual nerves below is a section that gives the codes the limited motions for that nerve. We know that the elbow cannot bend more than 55°, so code 5206 would be the correct code. Under that code, if the elbow can bend to 55°, but not farther, it is rated 40% for the dominant and 30% for the non-dominant. The affected arm is the non-dominant, so the rating under code 5206 would be 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: 8514-5206. The first four-digit code defines the condition as a paralyzed radial nerve. The second four-digit code tells us that the condition was rated under limited motion of the elbow.

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 Upper Back and Arms

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 upper back that can be rated:

Upper Radicular Group (shoulder and elbow)
Middle Radicular Group (shoulder, elbow, and wrist)
Lower Radicular Group (wrist, hand and fingers)
All Three Radicular Groups
The Radial Nerve
The Median Nerve (carpal tunnel)
The Ulnar Nerve (cubital tunnel)
The Musculocutaneous Nerve
The Axillary Nerve
The Long Thoracic Nerve

Nerves leave the spinal cord in “trunks” before dividing into each individual nerve. These trunks are referred to by the VASRD as “radicular groups”. Nerve damage can occur anywhere along the path of the nerve. To rate a condition under the radicular group ratings, all or most of the nerves that separate off of that particular trunk must be affected. This can get pretty confusing since a single nerve could be in two or three of the groups. This is because the various branches of the nerves can merge into the same individual nerve. Thus, a single nerve may come from 2 or more trunks.

When trying to figure out how to rate the condition, remember that it is mostly based on the functioning of the arm. If the majority of the movements that a particular group performs can’t be done, then it is probably safe to rate it under that group, but only if multiple nerves in that group are affected. If only a couple are, then it should be rated on one of the single nerves that are ratable (the radial, median, ulnar, musculocutaneous, axillary and long thoracic nerves). Be careful, though, to make sure that the group/nerve chosen best describes the overall condition.

Here is a picture of the main ratable nerves in the shoulder and arm.

military disability rates nerves of the upper back and arms

 

 


The Upper Radicular Group leaves the spinal cord at the base of the neck from the fifth and sixth cervical vertebrae. This group includes the long thoracic nerve, median nerve, radial nerve, musculocutaneous nerve, axillary nerve, and all of their offshoots. These nerves control the following movements: raising and lowering the arm to the side, bending the elbow, turning the forearm up or down, or rotating the arm away from the body.

military disability rates nerves of the upper back and arms     military disability rates nerves of the upper back and arms      military disability rates nerves of the upper back and arms    military disability rates nerves of the upper back and arms

This condition is rated under one of the following codes with the corresponding ratings.

Code 8510: Paralysis of the upper radicular group. If the shoulder and elbow cannot move at all (complete paralysis), but the hand and wrist can still move, it is rated 70% for the dominant arm and 60% for the non-dominant arm. Incomplete, severe paralysis is rated 50% for the dominant arm and 40% for the non-dominant. Incomplete, moderate paralysis is rated 40% for the dominant and 30% for the non-dominant. Incomplete, mild paralysis is rated 20% for either arm.

Code 8610: Neuritis of the upper radicular group. If the condition causes severe symptoms, it is rated 50% for the dominant arm and 40% for the non-dominant arm. If it causes moderate symptoms, it is rated 40% for the dominant and 30% for the non-dominant. Mild symptoms is 20% for either arm.

Code 8710: Neuralgia of the upper radicular group. Neuralgia cannot be rated higher than moderate, even if it is severe. If the condition is moderate, it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the shoulder, code 5201, or limited motion of the elbow, code 5206. If the condition is best rated as limitation of motion, then the final code will look like this: 8610-5206. 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 Middle Radicular Group leaves the spinal cord at the base of the neck from the seventh cervical vertebrae. This group includes the long thoracic nerve, musculocutaneous nerve, median nerve, and radial nerve. These nerves help control the following movements: raising the arm to the side, bending the elbow, turning the forearm up or down, or lifting the hand up at the wrist.

military disability rates nerves of the upper back and arms      military disability rates nerves of the upper back and arms      military disability rates nerves of the upper back and arms        military disability rates nerves of the upper back and arms

This condition is rated under one of the following codes with the corresponding ratings.

Code 8511: Paralysis of the middle radicular group. If the shoulder, elbow, and wrist cannot move at all (complete paralysis), it is rated 70% for the dominant arm and 60% for the non-dominant arm. Incomplete, severe paralysis is rated 50% for the dominant arm and 40% for the non-dominant. Incomplete, moderate paralysis is rated 40% for the dominant and 30% for the non-dominant. Incomplete, mild paralysis is rated 20% for either arm.

Code 8611: Neuritis of the middle radicular group. If the condition causes severe symptoms, it is rated 50% for the dominant arm and 40% for the non-dominant arm. If it causes moderate symptoms, it is rated 40% for the dominant and 30% for the non-dominant. Mild symptoms is 20% for either arm.

Code 8711: Neuralgia of the middle radicular group. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the shoulder, code 5201, limited motion of the elbow, code 5205-5208 or 5213, or limited motion of the wrist, code 5215. If the condition is best rated as limitation of motion, then the final code will look like this: 8611-5206. 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 Lower Radicular Group leaves the spinal cord at the base of the neck from the eighth cervical and first thoracic vertebrae. This group includes the radial nerve, median nerve, and ulnar nerve. These nerves control the following movements: bending the hand up at the wrist, turning the hand from side-to-side at the wrist, opening and closing the fingers, curling the fingers and bending the hand down at the wrist, and moving the thumb straight outward away from the palm.

military disability rates nerves of the upper back and arms       military disability rates nerves of the upper back and arms      military disability rates nerves of the upper back and arms         military disability rates nerves of the upper back and arms    military disability rates nerves of the upper back and arms

This condition is rated under one of the following codes with the corresponding ratings.

Code 8512: Paralysis of the lower radicular group. If the wrist and fingers cannot move at all (complete paralysis), it is rated 70% for the dominant arm and 60% for the non-dominant arm. Incomplete, severe paralysis is rated 50% for the dominant arm and 40% for the non-dominant. Incomplete, moderate paralysis is rated 40% for the dominant and 30% for the non-dominant. Incomplete, mild paralysis is rated 20% for either arm.

Code 8612: Neuritis of the lower radicular group. If the condition causes severe symptoms, it is rated 50% for the dominant arm and 40% for the non-dominant arm. If it causes moderate symptoms, it is rated 40% for the dominant and 30% for the non-dominant. Mild symptoms is 20% for either arm.

Code 8712: Neuralgia of the upper radicular group. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230. If the condition is best rated as limitation of motion, then the final code will look like this: 8612-5228. 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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If All Three Radicular Groups are affected, it is rated under one of the following codes with the corresponding ratings.

Code 8513: Paralysis of all three radicular groups. If the shoulder, arm, wrist and fingers cannot move at all (complete paralysis), it is rated 90% for the dominant arm and 80% for the non-dominant arm. Incomplete, severe paralysis is rated 70% for the dominant arm and 60% for the non-dominant. Incomplete, moderate paralysis is rated 40% for the dominant and 30% for the non-dominant. Incomplete, mild paralysis is rated 20% for either arm.

Code 8613: Neuritis of all three radicular groups. If the condition causes severe symptoms, it is rated 70% for the dominant arm and 60% for the non-dominant arm. If it causes moderate symptoms, it is rated 40% for the dominant and 30% for the non-dominant. Mild symptoms is 20% for either arm.

Code 8713: Neuralgia of all three radicular groups. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the shoulder, code 5201, limited motion of the elbow and arm, codes 5205-5208 or 5213, limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230. If the condition is best rated as limitation of motion, then the final code will look like this: 8613-5206. 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 Radial Nerve (a.k.a. musculospiral nerve) is one of the most important nerves in the shoulder, arm and hand. This nerve controls the following movements: bending the elbow, turning the forearm up or down, lifting the hand upward at the wrist, turning the hand from side-to-side at the wrist, and moving the thumb straight outward away from the palm.

military disability rates nerves of the upper back and arms       military disability rates nerves of the upper back and arms    military disability rates nerves of the upper back and arms      military disability rates nerves of the upper back and arms         military disability rates nerves of the upper back and arms

A condition of the radial nerve is rated under one of the following codes with the corresponding ratings. military disability rates nerves of the upper back and arms

Code 8514: Paralysis of the radial nerve. If the wrist and fingers are stuck in flexion (cannot move either up or side to side), the thumb is stuck at the side of the index finger, the hand cannot grip things, and the movement of the elbow is seriously weakened (complete paralysis), it is rated 70% for the dominant arm and 60% for the non-dominant arm. Incomplete, severe paralysis is rated 50% for the dominant arm and 40% for the non-dominant. Incomplete, moderate paralysis is rated 30% for the dominant and 20% for the non-dominant. Incomplete, mild paralysis is rated 20% for either arm.

If the nerve is damaged where it affects only the extensor communis digitorum muscle, then the most it can be rated is moderate. Symptoms of this damage would ONLY include the following: inability to lift the hand from the wrist and the inability to lift and separate the four fingers (excluding the thumb).

Code 8614: Neuritis of the radial nerve. If the condition causes severe symptoms, it is rated 50% for the dominant arm and 40% for the non-dominant arm. If it causes moderate symptoms, it is rated 30% for the dominant and 20% for the non-dominant. Mild symptoms is 20% for either arm.

Code 8714: Neuralgia of the radial nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 30% for the dominant and 20% for the non-dominant. If it is mild, it is rated 20% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the elbow and arm, codes 5205-5208 or 5213, limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230. If the condition is best rated as limitation of motion, then the final code will look like this: 8614-5206. 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 Median Nerve is one of the most important nerves in the forearm and hand. It passes through the carpal tunnel in the wrist, and thus is the nerve affected in carpal tunnel syndrome. This nerve controls the following movements: turning the forearm up or down, and curling the fingers and bending the hand down at the wrist.

military disability rates nerves of the upper back and arms                                                      military disability rates nerves of the upper back and arms

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

Code 8515: Paralysis of the median nerve. Complete paralysis: If the hand is stuck bent away from the body at the wrist, the middle and index fingers are stuck in extension more than normal (cannot move either down or side to side), thumb is straight and stuck right up next to the index finger (the hand is completely flat) and the muscles at the base of thumb are atrophied (wasting away), and the palm of the hand cannot be turned to face downward, it is rated 70% for the dominant arm and 60% for the non-dominant arm. Incomplete, severe paralysis is rated 50% for the dominant arm and 40% for the non-dominant. Incomplete, moderate paralysis is rated 30% for the dominant and 20% for the non-dominant. Incomplete, mild paralysis is rated 10% for either arm.

military disability rates nerves of the upper back and arms                                                               military disability rates nerves of the upper back and arms

Code 8615: Neuritis of the median nerve. If the condition causes severe symptoms, it is rated 50% for the dominant arm and 40% for the non-dominant arm. If it causes moderate symptoms, it is rated 40% for the dominant and 30% for the non-dominant. Mild symptoms is 10% for either arm.

Code 8715: Neuralgia of the median nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate it is rated 30% for the dominant and 20% for the non-dominant. If it is mild, it is rated 10% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230. If the condition is best rated as limitation of motion, then the final code will look like this: 8615-5228. 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 Ulnar Nerve is one of the largest nerves in the arm. It passes behind the elbow (the funny bone) and through the wrist to the little and ring fingers (it does affect some movements of the other fingers, but normally damage to this nerve only affects the little and ring fingers). This is the nerve that hurts when you hit your funny bone. This nerve controls the following movements: curling the fingers and bending the hand down at the wrist, lifting the hand upward at the wrist, and opening and closing the fingers.

military disability rates nerves of the upper back and arms                               military disability rates nerves of the upper back and arms                                   military disability rates nerves of the upper back and arms

A condition of the ulnar nerve is rated under one of the following codes with the corresponding ratings. military disability rates nerves of the upper back and arms

Code 8516: Paralysis of the ulnar nerve. Complete paralysis: If the ring and little fingers are permanently curled towards the palm, the other fingers and thumb are straight and can no longer spread apart or can no longer close together, the wrist cannot fully bend the hand downward, and the muscles between the fingers and at the base of thumb are atrophied, it is rated 60% for the dominant arm and 50% for the non-dominant arm.

Incomplete, severe paralysis is rated 40% for the dominant arm and 30% for the non-dominant. Incomplete, moderate paralysis is rated 30% for the dominant and 20% for the non-dominant. Incomplete, mild paralysis is rated 10% for either arm.

Code 8616: Neuritis of the ulnar nerve. If the condition causes severe symptoms, it is rated 40% for the dominant arm and 30% for the non-dominant arm. If it causes moderate symptoms, it is rated 30% for the dominant and 20% for the non-dominant. Mild symptoms is 10% for either arm.

Code 8716: Neuralgia of the ulnar nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate it is rated 30% for the dominant and 20% for the non-dominant. If it is mild, it is rated 10% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230. If the condition is best rated as limitation of motion, then the final code will look like this: 8616-5228. 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 Musculocutaneous Nerve is a nerve in the arm that helps other nerves control movements of the elbow and forearm. This nerve helps control the following movements: bending the elbow, and turning the forearm so the palm is up.

military disability rates nerves of the upper back and arms                military disability rates nerves of the upper back and arms

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

Code 8517: Paralysis of the musculocutaneous nerve. Complete paralysis: If the elbow has trouble bending (but can still do it) and if the arm has trouble turning palm-down (but can still do it), it is rated 30% for the dominant arm and 20% for the non-dominant arm. Remember that this nerve only helps other nerves do these motions. If this nerve is completely paralyzed, the motions will still be able to be made by the other nerves, but they will be more difficult. Incomplete, severe paralysis is rated 20% for either arm. Incomplete, moderate paralysis is rated 10% for either arm. Incomplete, mild paralysis is rated 0% for either arm.

Code 8617: Neuritis of the musculocutaneous nerve. If the condition causes severe symptoms, it is rated 20% for either arm. If it causes moderate symptoms, it is rated 10% for either arm. Mild symptoms is rated 0% for either arm.

Code 8717: Neuralgia of the musculocutaneous nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate it is rated 10% for either arm, and if it is mild, it is rated 0% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the elbow, code 5206, or limited motion of the forearm, codes 5213. If the condition is best rated as limitation of motion, then the final code will look like this: 8617-5228. 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 Axillary Nerve (a.k.a. circumflex nerve) controls the deltoid and teres minor muscles in the upper arm. This nerve controls the following movements: lifting the arm to the side, and twisting the arm out from the body.

military disability rates nerves of the upper back and arms                                           military disability rates nerves of the upper back and arms

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

Code 8518: Paralysis of the axillary nerve. Complete paralysis: If the arm cannot be lifted from the shoulder away from the body, and the arm has trouble rotating the hand away from the body with the elbow bent (but it isn’t impossible), it is rated 50% for the dominant arm, and 40% for the non-dominant arm. Incomplete, severe paralysis is rated 30% for the dominant arm and 20% for the non-dominant. Incomplete, moderate paralysis is rated 10% for either arm. Incomplete, mild paralysis is rated 0% for either arm.

Code 8618: Neuritis of the axillary nerve. If the condition causes severe symptoms, it is rated 30% for the dominant arm and 20% for the non-dominant arm. If it causes moderate symptoms, it is rated 10% for either arm. Mild symptoms is rated 0% for either arm.

Code 8718: Neuralgia of the axillary nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 10% for either arm. If it is mild, it is rated 0% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the shoulder, code 5201. If the condition is best rated as limitation of motion, then the final code will look like this: 8618-5201. 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 Long Thoracic Nerve (a.k.a. external respiratory nerve of Bell or posterior thoracic nerve) controls the muscles in the rib cage under the arm. This nerve is essential to lifting overhead, throwing, punching, and other motions of the scapula bone in the shoulder. These muscles also help to expand the ribs when breathing.

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

Code 8519: Paralysis of the long thoracic nerve. Complete paralysis: If the arm cannot be raised above shoulder level and there is a winged scapula deformity, it is rated 30% for the dominant arm, and 20% for the non-dominant arm. Incomplete, severe paralysis is rated 20% for either arm. Incomplete, moderate paralysis is rated 10% for either arm. Incomplete, mild paralysis is rated 0% for either arm.

Code 8619: Neuritis of the long thoracic nerve. If the condition causes severe symptoms, it is rated 20% for either arm. If it causes moderate symptoms, it is rated 10% for either arm. Mild symptoms is rated 0% for either arm.

Code 8719: Neuralgia of the long thoracic nerve. Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 10% for either arm. If it is mild, it is rated 0% for either arm.

Make sure to check to see if a higher rating can be given under limited motion of the shoulder, code 5201. If the condition is best rated as limitation of motion, then the final code will look like this: 8618-5201. 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. This is the only nerve condition where an unrelated limited motion condition of the shoulder cannot be rated in addition to a nerve rating.

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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 Low Back and Legs 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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