What is the VA rating for Peripheral Nerves, Upper Extremity?

All 30 codes in this schedule distinguish the major and minor extremity. That means which arm is affected, and which arm is dominant, can change how a published pathway is described.

• The dominant arm is commonly called the major extremity in the schedule; the nondominant arm is commonly called the minor extremity.
• A right arm is not always the major extremity, and a left arm is not always the minor extremity.
• Records are clearest when the DBQ or exam identifies the affected nerve, side, and dominant hand directly.
• RatingScope does not infer dominant-side status when it is missing.

Records to review: Peripheral Nerves DBQ; dominant-hand documentation; C&P examination history.

All 30 codes in this hub reduce to just 10 underlying tables -- one per nerve. Paralysis (DC 8510-8519) uses the full table (mild through complete). Neuritis (DC 8610-8619) and neuralgia (DC 8710-8719) reuse the EXACT SAME table for that nerve, just capped at a lower ceiling -- confirmed directly in the regulation's own table, where DC 8610-8619 and 8710-8719 appear as bare code-and-title entries with no percentage column of their own at all.

• Neuritis caps at severe incomplete paralysis (if 'organic changes' are documented present) or moderate incomplete (if not) -- complete paralysis is never reachable via neuritis.
• Neuralgia caps at moderate incomplete paralysis always -- severe and complete are never reachable via neuralgia (the trigeminal/tic douloureux exception to this cap applies only to a cranial nerve, not to any nerve in this hub's upper-extremity scope).
• This means, for example, DC 8614 (radial nerve neuritis) and DC 8714 (radial nerve neuralgia) both reuse DC 8514's own percentage numbers -- they are not separate scales with their own numbers.

Records to review: Peripheral Nerves DBQ; Neurological examination records documenting the specific nerve, severity, and category.

38 CFR 4.123's neuritis cap depends entirely on whether 'organic changes' are present -- but the regulation never defines this term anywhere in its own text, confirmed via fresh verbatim fetch.

• Per RSCH-045's own research, this ambiguity has two layers: what 'organic changes' means at all (commonly read as loss of reflexes and muscle atrophy, but not defined as such in the text), and whether 'not characterized by organic changes' requires the complete absence of ALL such changes or just any one.
• RatingScope discloses this as a genuinely open interpretive question -- it does not guess a definition or default to either the severe or moderate cap when organic-changes status is undocumented.
• This same ambiguity underlies a separate, unrelated regulatory contradiction specific to the sciatic nerve (lower extremity, not covered in this hub) -- confirmed by RSCH-045 as a genuine defect in the regulation itself, not something arising in any of this hub's 10 upper-extremity nerves.

Records to review: Neurological examination records documenting reflexes, muscle atrophy, and other objective findings.

DC 8513 ('all radicular groups') is this entire 30-code schedule's highest ceiling (90/80 percent) -- but has no corresponding item anywhere in VA's current Peripheral Nerves DBQ.

• The DBQ's relevant section runs nine items covering the other radicular-group and named-nerve codes, but skips DC 8513 entirely -- confirmed via direct examination of the current form.
• Per the source-hierarchy discipline this repository follows, the eCFR governs regardless of DBQ silence -- DC 8513 remains a real, ratable code and is fully represented in this hub's own criteria, not quietly omitted just because the standard exam form has no matching checkbox.
• This is disclosed as a genuine structural examination-tooling gap, not something to work around by only offering the nine codes the DBQ names.

Records to review: Peripheral Nerves DBQ (does not include a DC 8513-specific item); Neurological examination records documenting the extent of radicular group involvement, however captured.

This site's separate Radiculopathy hub covers only 2 of the 11 lower-extremity peripheral-nerve codes (sciatic, DC 8520; femoral, DC 8526) -- disclosed clearly here so it is never assumed comprehensive of the full peripheral-nerve schedule if cross-referenced.

• The Radiculopathy hub's own summary text does say 'sciatic and femoral' explicitly, so this is not a factual error in that hub -- but its general 'lower-extremity radiculopathy' framing can read as more comprehensive than it is.
• This hub (Peripheral Nerves, Upper Extremity) and the Radiculopathy hub cover entirely separate anatomical territory (upper vs. lower extremity) with no overlap -- this disclosure is about not over-assuming completeness on the lower-extremity side, not about any conflict between the two hubs.

Records to review: This site's Radiculopathy hub.

DC 8519 (long thoracic nerve)'s own Note states, verbatim, confirmed via two independent primary sources: 'Not to be combined with lost motion above shoulder level.' The regulation names no diagnostic code as the target -- RatingScope reads this as most likely reaching DC 5201, live on this site's Shoulder/Arm hub, but that is RatingScope's own interpretation, not regulatory text.

• DC 8519's own complete-paralysis criterion is phrased 'inability to raise arm above shoulder level,' and DC 5201 is the only 38 CFR 4.71a code phrased in terms of shoulder level, which is why RatingScope reads DC 5201 as the most likely target. This is a well-supported reading, not a confirmed one -- the regulation's own text does not cite DC 5201 or any other code by number.
• The Note also supplies no 'whichever is higher,' 'rate as,' or 'predominant' instruction, unlike comparable cross-code instructions elsewhere in 38 CFR Part 4. If the bar does reach DC 5201, which evaluation controls is not stated in the regulation's text, and RatingScope does not guess at an answer the regulation itself does not give.
• The Note is printed directly after DC 8519's own rows and before DC 8619 (neuritis) and DC 8719 (neuralgia) of the same nerve, a position that leaves both readings textually plausible: that the Note governs only DC 8519, or that it extends to 8619/8719 as well. RatingScope applies the narrower reading, that the Note governs DC 8519 specifically, since that is the code it is directly attached to, and does not assume the bar also reaches a DC 8619 or DC 8719 rating of the same nerve. The regulation does not confirm or rule out the broader reading.
• RatingScope discloses this as a cross-reference to check separately -- it does not auto-compute a combined or adjusted result using the Shoulder/Arm hub's own facts.

Records to review: This site's Shoulder/Arm hub; Examination records documenting shoulder range of motion.

A separate Note, confirmed verbatim via two independent primary sources, reads: 'Combined nerve injuries should be rated by reference to the major involvement, or if sufficient in extent, consider radicular group ratings.' Its scope, DC 8519-specific or general to the whole peripheral nerve schedule, is not stated by the regulation.

• This Note is printed only once in the entire regulation's neurological schedule, directly after DC 8619 (neuritis) and DC 8719 (neuralgia) of the long thoracic nerve, and before the next nerve's table (sciatic) begins -- it is not repeated as a header or footer for any of the other 9 nerve tables in this hub.
• That single, nerve-specific printed position is the strongest textual evidence for reading this Note as tied to the long thoracic nerve group (DC 8519/8619/8719) rather than as a general instruction for the whole schedule. RatingScope applies this narrower reading.
• A pending VA rulemaking, RIN 2900-AQ73, proposes to 'number the notes that will appear under DC 8519,' plural -- language that suggests VA itself may read both this Note and the shoulder-motion Note above as belonging to DC 8519. This is disclosed as evidence from a proposed, not-yet-finalized rule, not as settled regulatory text, and it does not resolve the question on its own. The proposed rule's replacement table could not be retrieved through any available channel, so whether it retains, revises, or deletes either Note is unconfirmed.
• RatingScope discloses this scope question; it does not apply this Note's routing language to any other nerve's rating.

Records to review: Neurological examination records documenting whether multiple nerves are involved.

38 CFR 4.124a's general principles state that when nerve involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree -- confirmed verbatim via two independent primary sources.

• This cap applies across this hub's 10 nerve tables whenever the documented findings show sensory involvement only, with no motor component -- severe incomplete and complete paralysis tiers are not reachable under a wholly sensory picture.
• This is a general-principle instruction in the regulation's own text governing the whole peripheral nerve schedule (DC 8510-8519 and, by extension via the shared-table architecture, DC 8610-8619 and DC 8710-8719), not something unique to a single nerve.
• RatingScope discloses this cap; it does not itself determine whether a specific documented finding is 'wholly sensory' -- that determination depends on the medical record.

Records to review: Neurological examination records documenting whether motor findings, sensory findings, or both are present.

38 CFR 4.124a's general principles state: 'The ratings for the peripheral nerves are for unilateral involvement; when bilateral, combine with application of the bilateral factor' -- confirmed verbatim via two independent primary sources.

• This means each arm's tier is rated independently under this hub's 10 shared nerve tables, then the two ratings combine under 38 CFR 4.25 (the standard combined-ratings table) WITH the 38 CFR 4.26 bilateral factor added.
• This differs from the cranial nerve schedule's own rule, which combines bilateral findings WITHOUT the bilateral factor -- the two are governed by separate general-principle sentences in the regulation, not the same rule applied twice.
• This hub discloses this combination rule for documented bilateral upper-extremity involvement (e.g. left arm and right arm both affected); it does not perform the 38 CFR 4.25/4.26 combination itself, matching the same disclosure-only pattern already used for Cranial Nerves and Amputations' bilateral cases.

Records to review: Neurological examination records documenting findings for both arms, if bilateral.