Neurological
Peripheral Neuropathy
Nerve damage in the hands and feet, rated per nerve under §4.124a
Peripheral neuropathy — burning, numbness, and weakness in the hands and feet — is rated per affected nerve under §4.124a. It is frequently secondary to diabetes (§3.310) and is an Agent Orange presumptive for early-onset cases.
What Peripheral Neuropathy Really Is
It starts as tingling in your toes or fingers. Then burning at night, then numbness you cannot feel the floor through, then weakness. Peripheral neuropathy is nerve damage in the limbs, and for veterans it usually traces back to diabetes, a toxic exposure, or a spinal injury. The VA rates each affected nerve in each limb separately, which means this condition is frequently underclaimed by half.
What it actually means
It starts as tingling in your toes or fingers. Then burning at night, then numbness you cannot feel the floor through, then weakness. Peripheral neuropathy is nerve damage in the limbs, and for veterans it usually traces back to diabetes, a toxic exposure, or a spinal injury. The VA rates each affected nerve in each limb separately, which means this condition is frequently underclaimed by half.
What the VA measures
Rating is under 38 CFR 4.124a by nerve and by degree of incomplete paralysis: mild, moderate, moderately severe, and severe, with a maximum for complete paralysis. Where the involvement is wholly sensory, the rating is to be for the mild, or at most the moderate, degree.
Why claims get missed
Four limbs can mean four separate ratings, plus the bilateral factor. Veterans claim numbness in my feet and get one rating. Also missed: early idiopathic peripheral neuropathy is presumptive for herbicide-exposed veterans when it appears within a year of exposure, and diabetic neuropathy is a straightforward secondary claim that raises your combined rating substantially.
What in Your Service Causes Peripheral Neuropathy
Service connection is not a feeling, it is a chain of evidence. These are the pathways the VA already recognises. Find yours, then make sure your file says it out loud.
Service-connected diabetes
The most common cause by far. Diabetic peripheral neuropathy is a secondary claim that requires only the diagnosis and a medical link to the diabetes.
Agent Orange and herbicide exposure
Early-onset peripheral neuropathy is a presumptive condition for herbicide-exposed veterans under the applicable regulation.
Solvents, fuels, heavy metals, and burn pits
Neurotoxic industrial exposures during service support direct service connection with an appropriate opinion.
Spinal injury and nerve compression
Root-level compression from a service-connected spine condition produces limb nerve symptoms.
Cold injury
Documented frostbite or prolonged cold exposure has its own residual criteria and produces lasting nerve damage.
Rated Nerve by Nerve, Limb by Limb
Peripheral neuropathy is not one rating — it is evaluated under the specific nerve affected in §4.124a, graded by severity, in each extremity. A veteran with neuropathy in both feet and both hands can hold four separate ratings that combine. Veterans rated for a single “neuropathy” entry are often under-rated because the other affected limbs were never evaluated.
The Diabetes Connection
The most common path to service connection is secondary: diabetic peripheral neuropathy under §3.310. If your diabetes is service-connected — including as an Agent Orange presumptive — the neuropathy flowing from it should be service-connected too, with its own ratings for each limb. This is one of the largest sources of unclaimed compensation we see.
Agent Orange and Early-Onset
Early-onset peripheral neuropathy is an Agent Orange presumptive (§3.309(e))
Secondary to service-connected diabetes (§3.310)
Each affected hand and foot rated separately
Severity graded on objective EMG and neurological findings
Establishing Service Connection
To establish service connection for a neurological condition, veterans must meet three criteria. First, there must be a current diagnosis. Second, there must be evidence of an in-service injury, event, or exposure that could have caused or aggravated it — including head trauma, blast exposure, or an underlying service-connected condition. Third, a nexus — a medical link — must connect the in-service event to the current condition.
Current diagnosis of the neurological condition
In-service injury, event, or exposure (or a service-connected primary condition)
Medical nexus linking the condition to service ("at least as likely as not")
Records documenting frequency and severity of neurological symptoms
Imaging or specialist evaluation where available
Why Work With an Accredited Advocate
Veterans should seek the assistance of an Accredited VA Disability Advocate because we guide you through the complex claims process and ensure all necessary evidence is gathered and presented effectively. Our advocates are trained to identify and link service-related conditions, increasing the likelihood of a successful claim. We also provide personalized representation, helping veterans navigate appeals and secure the benefits they deserve. As a VA-Accredited Claims Agent, our fees are regulated under 38 CFR §14.636 — and there are no fees unless we win your appeal.
The Rating Schedule, Spelled Out
Peripheral neuropathy is rated under 38 CFR §4.124a according to the specific nerve involved, as “incomplete paralysis” graded mild, moderate or severe, up to complete paralysis. Ratings for the upper extremities also depend on whether the affected side is dominant (major) or non-dominant (minor). Each affected nerve and each extremity is rated separately.
Mild incomplete paralysis.
Moderate incomplete paralysis.
Moderately severe incomplete paralysis.
Severe incomplete paralysis, with marked muscular atrophy.
Complete paralysis; the foot dangles and drops.
Mild incomplete paralysis (either extremity).
Moderate incomplete paralysis — 20% minor, 30% major.
Severe incomplete paralysis — 40% minor, 50% major.
Complete paralysis — 60% minor, 70% major — with the hand inclined to the ulnar side and the thumb in the plane of the palm (“ape hand”).
Key Points to Remember
Rated under 38 CFR §4.124a by the nerve affected and severity of incomplete paralysis
Frequently secondary to service-connected diabetes or a spine condition (§3.310)
Each affected extremity is rated separately
Document sensory loss, weakness, and impact on balance and daily tasks
What to Expect at Your Peripheral Neuropathy C&P Examination
Peripheral neuropathy is rated nerve by nerve and limb by limb under 38 CFR §4.124a, so a veteran with symptoms in all four extremities should walk out with four separate evaluations, plus the bilateral factor applied to the paired ones. The exam has to identify WHICH nerves are affected — not simply record that your feet are numb — because upper and lower extremity nerves sit on entirely different rating scales with entirely different ceilings.
Identification of each affected nerve by name and by side, so each one can be rated under its own diagnostic code.
Sensory testing to light touch, pinprick, vibration with a tuning fork, and position sense, mapped in a stocking-and-glove distribution and by dermatome.
Monofilament testing of the feet, which is the standard screen for diabetic and toxic-exposure neuropathy.
Muscle strength grading 0 to 5 in each limb, deep tendon reflexes, and measurement of limb circumference for atrophy.
Gait and balance testing, including Romberg, and documentation of falls, foot drop or the need for an assistive device.
Review of EMG and nerve conduction studies, plus laboratory work identifying the underlying cause — diabetes, alcohol, B12 deficiency or toxic exposure — which matters for secondary service connection.
A severity statement in regulatory language for each extremity, and an explicit answer to whether the involvement is wholly sensory, since that answer caps the rating.
What Happens Once the C&P Exam Is Complete
The examiner compiles a detailed report — your medical history, physical findings, and diagnostic results — and assesses the severity, symptoms, and impact of your condition. That report is sent to the VA Regional Office handling your claim and becomes part of your official file, reviewed alongside your other evidence.
The VA may send the report back for corrections, clarification, or a second opinion if it finds it incomplete or unclear. This can delay your claim, because the VA requires thorough and accurate information to decide. Your claim only moves to the decision phase once the VA is satisfied with the evidence — which is exactly why the quality of the file we build for you matters so much. Once decided, your effective date controls how far back your back pay reaches, and any denial can be challenged through a Supplemental Claim, Higher-Level Review, or Board appeal.
The Advocate’s Take
If you are diabetic and service-connected, the numbness in your feet and hands is not just a symptom — it is very likely several separate ratings the VA never added.
Every Level the VA Can Assign You
These percentages come straight out of the rating schedule that governs peripheral neuropathy — Diagnostic Code 8520. Read them slowly. If your current rating does not match what your records actually show, that gap is exactly what an appeal exists to correct.
10%
Mild incomplete paralysis.
20%
Moderate incomplete paralysis.
40%
Moderately severe incomplete paralysis.
60%
Severe incomplete paralysis, with marked muscular atrophy.
80%
Complete paralysis;
Secondary Claims — Both Directions
Under 38 CFR §3.310, a condition caused or made worse by an already service-connected condition is itself service connected. That runs in both directions, and it is the single largest pool of unclaimed compensation in the system.
What can cause peripheral neuropathy
If one of these is already service connected, this condition can be claimed as secondary to it.
Diabetes mellitus type 2
The dominant secondary pathway, and one of the most valuable claims a diabetic veteran can file.
Lumbar or cervical spine condition
Compressive nerve injury produces limb symptoms.
Chronic kidney disease
Uremic neuropathy is a recognized complication.
Medication for another service-connected condition
Certain chemotherapy and long-term drug therapies are neurotoxic.
What peripheral neuropathy can cause
If this condition is already service connected, each of these is a separate claim you may be owed.
Falls, fractures, and joint injury
Loss of position sense causes documented falls and new injuries.
Foot ulceration and infection
Insensate feet develop wounds that go unnoticed, and severe cases reach loss of use.
Erectile dysfunction and bladder dysfunction
Autonomic neuropathy supports these claims and special monthly compensation.
Insomnia, depression, and anxiety
Night-time burning pain is a documented driver of both.
A secondary claim still needs two things: a current diagnosis of the secondary condition, and a medical opinion saying it is at least as likely as not caused or aggravated by the service-connected condition. You do not have to prove it happened in service.
Building a Peripheral Neuropathy Claim That Wins
Every claim stands on three legs. Knock one out and the claim falls over, no matter how bad your symptoms are. Before you file, look at your file and find all three.
A current diagnosis
A doctor has to say you have it, now, in writing. Not "reports symptoms of" — a diagnosis. Without this leg, nothing else in the file matters.
A link to your service
An event, an injury, an exposure, or an already service-connected condition. Service records, unit records, buddy statements, and your own account all count as evidence.
A nexus that ties the two together
A medical opinion stating it is at least as likely as not that your service caused or aggravated the condition. That phrase is a legal standard: 50 percent or better. It is the leg most denials break.
Document the problem before you file
• Keep a dated symptom log for at least 30 days. Frequency, severity, and what it stopped you from doing.
• Get statements from people who see it — a spouse, a coworker, a battle buddy. Lay evidence is legal evidence.
• Pull your private treatment records. The VA only has to help; it does not have to go find everything.
• Write down what you have stopped doing. Lost work, lost sleep, lost activities. That is what impairment looks like on paper.
Your Rights in This Process
It costs nothing to file
Filing a VA claim is free. Accredited representatives may only charge for work on an appeal after an initial decision, and those fees are capped by 38 CFR §14.636.
The VA has a Duty to Assist you
Under 38 CFR §3.159 the VA must help you get the evidence it needs, and it must tell you what is missing before it denies you for missing it.
You can ask for a different examiner
You may request a trauma-informed clinician, or a clinician of a specific gender, for a C&P examination. Ask before the exam is scheduled.
You can claim every condition you have
There is no limit and no penalty. Primary conditions, secondary conditions, and conditions made worse by service all get filed.
You can appeal and be re-evaluated
A denial is not the end. You may submit new evidence, request a higher-level review, appeal to the Board, and ask for re-evaluation when your condition worsens.
You must be considered for TDIU
If your service-connected conditions keep you from holding substantially gainful employment, you may be paid at the 100 percent rate without a 100 percent rating.
Questions Veterans Ask About Peripheral Neuropathy Claims
I have numbness in both feet and both hands. How many ratings should I have?
Potentially four, one per affected extremity under the appropriate nerve code, and the bilateral factor applies to the paired extremities. If you have a single rating covering all of it, the decision needs review.
My neuropathy is from my service-connected diabetes. Do I need to prove exposure?
No. This is a secondary claim. You need the neuropathy diagnosis and a medical opinion, often satisfied by your treating provider, that it is at least as likely as not due to your service-connected diabetes.
Why is my rating stuck at 10 percent per limb?
Sensory-only findings are limited to mild or at most moderate. Documented strength testing, atrophy measurements, absent reflexes, and EMG or nerve conduction results are what support the higher levels.
When You Are Ready to File
Talk to an accredited representative before you file. It costs nothing to ask, and the order you file in changes what the VA is allowed to award you. Albert L. Thombs Jr. is VA-Accredited Claims Agent #45147.
The application itself
This is the form that opens a disability compensation claim. List every condition you are claiming, and name the secondary conditions explicitly.
Release for private records
Authorises the VA to request records from your private doctors. Without it, treatment outside the VA may never reach your file.
Lay or buddy statement
The official form for your own statement and for statements from people who witnessed the event or the change in you.
Resources Worth Keeping
These are real, staffed VA lines. Tap to call from your phone.
Veterans Crisis Line
988
Then press 1. Text 838255. Available 24 hours a day, every day. You do not need to be enrolled in VA health care.
VA Benefits & Facility Line
1-800-827-1000
Claim status, general benefits questions, and help finding the right VA office.
Women Veterans Call Center
1-855-829-6636
Call or text. Staffed by women veterans who can connect you to services in your area.
Vet Centers
1-877-927-8387
Community-based counselling for combat veterans and their families. No VA enrollment required.
What This Rating Is Worth (2026)
| 10% | $180.42/mo |
| 20% | $356.66/mo |
| 30% | $552.47/mo |
| 40% | $795.84/mo |
| 50% | $1,132.90/mo |
| 60% | $1,435.02/mo |
| 70% | $1,808.45/mo |
| 80% | $2,102.15/mo |
| 90% | $2,362.30/mo |
| 100% | $3,938.58/mo |
Rates shown are the veteran-alone amounts effective December 1, 2025. A spouse, children, or dependent parents increase your payment at 30% and above. Every 10% you are under-rated can cost you thousands of dollars a year for the rest of your life.
Estimate Your Exact Pay
Veteran RepresentationYour VA Claim Exam: What to Expect
This official VBA video walks you through the entire C&P exam process. Understanding what happens in that room is the difference between a rating that reflects your true condition and one that undervalues you.
Veteran RepresentationWhat It Takes to Win These Benefits
The Three-Part Test
Service connection under 38 CFR §3.303 requires all three:
- 1A current, diagnosed disability
- 2An in-service event, injury, or exposure
- 3A medical nexus linking the two
Veteran RepresentationThe medical evidence the VA is actually looking for:
VA Claim Exams: Neurological
This exam is specific to your body system. The examiner uses a specialized DBQ for this category of conditions, and the tests they perform determine your exact rating level. Watch this before your appointment.
What to Expect at Your C&P Exam
Your Compensation & Pension (C&P) exam is not treatment. It is a rating tool. The examiner will not fix anything — they complete a Disability Benefits Questionnaire (DBQ) and check the boxes that decide your rating. What happens in that room can move your rating an entire level, so walk in prepared.
Veteran RepresentationThe Forms You File — We Prepare Them For You
These are the forms that drive this claim. Start any of them on our site and an accredited agent prepares and files it for you — correctly, the first time.
Application for Disability Compensation
The core application that opens or reopens your claim.
Start this with usStatement in Support of Claim
Your own account and buddy/lay statements that fill the gaps in your record.
Start this with usAppoint Us as Your Representative
Authorizes our accredited agent to act on your behalf with the VA.
Start this with usUnemployability (TDIU) Application
Claims 100% pay when your conditions keep you from working — even below 100%.
Start this with usDisability Benefits Questionnaire
The exam form that captures the severity criteria for this specific condition.
Start this with usSMC & TDIU — When Your Rating Isn't the Whole Story
TDIU — Paid at 100% Without a 100% Rating
Total Disability based on Individual Unemployability (38 CFR §4.16) pays you at the 100% rate when your service-connected conditions prevent substantially gainful employment — even if your combined rating is lower. You may qualify if:
- One condition is rated 60% or higher, or
- Two+ conditions combine to 70% with at least one rated 40%, and
- Those conditions keep you from holding steady, gainful work.
- Cannot meet the numbers? Extraschedular TDIU under §4.16(b) may still apply.
Special Monthly Compensation (SMC)
SMC (38 CFR §3.350) pays above the normal schedule for especially serious losses — loss or loss of use of a body part, being housebound, or needing the aid and attendance of another person. Common levels:
- SMC-K — Loss / loss of use — Add-on for loss or loss of use of a specific body part (hand, foot, eye, reproductive organ, or certain other losses). Paid on top of your regular compensation. Can stack (up to the statutory cap).
- SMC-S — Housebound — Statutory housebound: a single 100% disability plus additional disabilities of 60%+, or substantially confined to your home. Veteran-alone rate shown.
- SMC-L — Aid & Attendance — You need the regular aid and attendance of another person, or have anatomical loss/loss of use of both feet, one hand and one foot, blindness, or are permanently bedridden. Veteran-alone rate shown.
- SMC-M — Higher Aid & Attendance — A higher level of aid and attendance (e.g., loss of use of both hands, or loss of use of both legs at a higher level). Veteran-alone rate shown.
These are the benefits veterans most often leave on the table because no one told them they qualified. If any of this sounds like your situation, call an accredited agent at 702-992-4883 — we screen for SMC and TDIU on every case.
Talk to a VA-accredited claims agent about peripheral neuropathy
Albert L. Thombs Jr. is a US Army veteran, VA-Accredited Claims Agent #45147, and 100% service-connected himself. He personally reviews every request. Fees are capped by 38 CFR §14.636 — and there are no fees unless you win.
Three Ways to Put an Accredited Agent on Peripheral Neuropathy
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