Rating Criteria by Level
Under 38 CFR § 4.124a, nerve conditions are rated by degree of paralysis of the specific nerve involved. The levels below follow diagnostic code 8520 (sciatic nerve), the code that covers lower-extremity neuropathy and the one most veterans are rated under. The same mild, moderate, and severe language applies to the upper-extremity codes such as the median nerve (DC 8515) and ulnar nerve (DC 8516), but those scales cap lower and adjust for whether the affected arm is your dominant side.
Criteria: Wholly sensory symptoms in the affected extremity: numbness, tingling, burning, or reduced sensation, with no measurable loss of strength and no muscular atrophy.
This is the entry level and by far the most frequently assigned. Under 38 CFR 4.124a, when the involvement is wholly sensory the rating must stay in the mild or at most moderate range. The 10% figure below is per extremity, so a veteran with numbness in both feet holds two 10% ratings, not one.
Most common rating: wholly sensory symptoms, assigned per extremity
Criteria: Sensory loss plus objective findings: diminished or absent reflexes, mild weakness on strength testing, or an abnormal nerve conduction study, without significant atrophy.
Moderate is where an EMG and nerve conduction study earn their value. Documented reduced conduction velocity, absent ankle reflexes, or 4/5 strength on the exam are the findings that lift a claim out of the wholly sensory band. Note that 20% is the sciatic nerve figure; the same moderate level on the median nerve (DC 8515) rates 20% or 30% depending on which hand is dominant.
Criteria: Marked sensory loss with clear motor involvement: weakness on repeated strength testing, foot drop or an unsteady gait, and functional limits on standing, walking, or gripping.
At this level the neuropathy is visibly affecting how the limb works, not just how it feels. Examiners look for a gait abnormality, use of a cane or brace, and reduced strength that repeats on multiple attempts. This level applies to the sciatic nerve; the upper-extremity codes have their own scales and cap lower.
Criteria: Severe incomplete paralysis of the sciatic nerve with marked muscular atrophy, meaning visible and measurable wasting of the muscles served by the damaged nerve.
Marked muscular atrophy is the specific trigger. The examiner measures calf or thigh circumference against the opposite limb and records the difference. A single 60% extremity rating also meets the schedular threshold for TDIU on its own, which matters if the neuropathy prevents you from working.
Criteria: Complete paralysis of the sciatic nerve: the foot dangles and drops, no active movement of the muscles below the knee is possible, and flexion of the knee is weakened or lost.
This is the maximum schedular rating for a single sciatic nerve. It is uncommon and requires objective documentation of total motor loss rather than pain or sensory complaints. Veterans at this level should also review whether special monthly compensation (SMC) applies for loss of use of a foot.
Each extremity is rated on its own, then combined. Four limbs at 10% each do not equal 40%. Use the combined rating calculator to see the real total, including the bilateral factor that applies when both arms or both legs are affected.
How to Service-Connect Peripheral Neuropathy
Service connection requires a current diagnosis, an in-service event or exposure, and a medical nexus linking them. Peripheral neuropathy reaches the rating schedule three main ways:
Presumptive: Toxic Exposure
Early-onset peripheral neuropathy is a listed Agent Orange presumptive when it appears to a compensable degree within one year of exposure. Burn pit and airborne hazard veterans should also review the PACT Act presumptive list, which expanded coverage for toxic exposure claims.
Secondary to Type 2 Diabetes
Diabetic neuropathy is the single most common path. Type 2 diabetes is itself an Agent Orange presumptive, so once diabetes is service-connected the neuropathy in each foot and hand follows as a secondary claim with a short nexus statement from your treating physician.
Secondary to Spine or Joint Injury
Nerve damage from a service-connected back condition, cervical spine condition, or surgical repair of a knee or hip injury supports secondary connection. Where the damage traces to a compressed nerve root rather than the nerve itself, the claim is usually rated as radiculopathy instead.
What Happens at Your C&P Exam
The VA schedules a compensation and pension exam using the peripheral nerves DBQ. For neuropathy, the examiner will typically:
- Review any EMG and nerve conduction study results already in your file
- Test sensation in each extremity with monofilament, vibration, and light touch
- Check deep tendon reflexes at the ankles, knees, biceps, and triceps
- Grade muscle strength on a 0 to 5 scale in each affected limb
- Measure calf, thigh, or forearm circumference to document muscular atrophy
- Record which extremity is affected and whether your dominant hand is involved
- Provide a nexus opinion when the claim is filed as secondary to diabetes or a spine condition
Bring your most recent EMG and nerve conduction report, your diabetes treatment records if the claim is secondary, and a note of which specific limbs are affected. Do not let the examiner record a single global finding: each arm and leg needs its own documented severity, because each one is rated separately.
Secondary Conditions to Peripheral Neuropathy
Once neuropathy is service-connected, conditions it causes or worsens can be claimed secondary. Each adds its own rating to your combined total.
Depression and AnxietyChronic burning nerve pain and lost function drive mood disorders. Rated 0 to 100% on the mental disorders scale. See depression and anxiety.
Sleep ImpairmentNocturnal neuropathic pain fragments sleep and is a documented aggravator of existing sleep disorders.
Falls and Joint InjuryLoss of sensation and foot drop cause falls. Resulting knee, hip, and back injuries are compensable secondary claims.
Skin Ulcers and InfectionsLoss of protective sensation in the feet allows unnoticed wounds. Rated on the skin and scar codes by size and severity.
Erectile DysfunctionAutonomic nerve involvement is a recognized cause. Usually 0% schedular but qualifies for special monthly compensation under SMC-K.
Gait-Related Back PainAn altered gait from lower-extremity neuropathy aggravates the lumbar spine. Rated 10 to 100% on flexion limits.
Mental health secondaries are common and often undervalued. Read the depression and anxiety guides for the criteria that apply once a chronic pain condition is already on file.
SourcesLast reviewed: July 2026
Peripheral Neuropathy VA Rating FAQ
What is the VA rating for peripheral neuropathy?
It is rated per affected extremity on an incomplete paralysis scale. For the sciatic nerve (DC 8520), mild rates 10%, moderate rates 20%, moderately severe rates 40%, severe with marked muscular atrophy rates 60%, and complete paralysis rates 80%. Upper-extremity nerve codes use their own scales and are also adjusted for whether the arm is dominant.
Is peripheral neuropathy rated separately for each leg and arm?
Yes. Each extremity gets its own rating. Neuropathy in both feet and both hands can produce four separate ratings, combined under VA math rather than added. When both arms or both legs are involved, the bilateral factor adds 10 percent of the combined value of the paired ratings before the final total is computed.
Is peripheral neuropathy a presumptive condition for Agent Orange?
Early-onset peripheral neuropathy is presumptive for Agent Orange exposure if it appeared to a compensable degree within one year of exposure. Later-onset neuropathy is still routinely granted as secondary to Type 2 diabetes, which is itself an Agent Orange presumptive condition.
What is the difference between peripheral neuropathy and radiculopathy?
Radiculopathy starts at a compressed spinal nerve root and follows one dermatome down a single limb. Peripheral neuropathy is damage to the nerves themselves and is usually symmetric and distal, the stocking-and-glove pattern. They share the same nerve codes in the rating schedule, and the VA will not assign two ratings for the same nerve.
What tests does the VA use to confirm peripheral neuropathy?
An EMG and nerve conduction study is the strongest objective evidence. The C&P examiner adds monofilament and vibration sensory testing, deep tendon reflex checks, muscle strength grading, and measurement for atrophy. Atrophy findings are what separate the 60% level from everything below it.
Can peripheral neuropathy qualify for TDIU?
Yes. Ratings across multiple extremities often combine past the TDIU threshold, and a single 60% extremity rating meets it outright. What matters most is documented evidence that the neuropathy prevents substantially gainful employment, such as loss of grip for tool work or an inability to stand for a full shift.
Can peripheral neuropathy get worse and be re-rated?
Yes. Neuropathy is a progressive condition, and an increase claim is appropriate when sensory symptoms progress to weakness, gait changes, or atrophy. File the increase with a current EMG and treatment records, since a rating built on an older exam will not reflect the current level of nerve damage.