Athetosis, Acquired — VA Disability Rating (DC 8107)

Diagnostic Code 8107 · 38 CFR §4.124a

What Is It?

Athetosis is a movement disorder of slow, continuous, writhing involuntary movements, most often in the hands and feet and sometimes extending to the face and trunk. The acquired form this code covers develops in adulthood as a residual of brain injury — damage to the basal ganglia from an anoxic-ischemic event such as cardiac arrest or near-drowning, from traumatic brain injury, stroke, encephalitis, or drug exposure. It is distinct from the congenital athetosis of cerebral palsy, which is present from birth. For veterans the service-connection pathways run through a service-related head injury, anoxic event, stroke, or encephalitis. 38 CFR §4.124a opens the neurological schedule with a bracketed instruction: disability from the diseases it lists "may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function," referring the rater to the appropriate body system of the schedule for each manifestation. Inside the 8000–8025 block the schedule prints either a single flat percentage, a single minimum rating, or no percentage at all — there is no severity ladder anywhere in it. A Note closing the block adds two conditions: the minimum ratings for residuals require ascertainable residuals, and when a rating above the minimum is assigned, the diagnostic codes used as the basis of that evaluation must be cited alongside the code identifying the diagnosis. DC 8107's own rating cell is empty and its entry is three words: "Rate as chorea." That sends it to DC 8105's table — five steps, 100 / 80 / 50 / 30 / 10 — the same table Huntington's chorea at DC 8106 is rated on.

Rating Criteria

Evidence Needed

A neurology diagnosis distinguishing acquired athetosis from other movement disorders — chorea, dystonia, ballism, tics — and from congenital athetosis is the anchor. Brain imaging showing basal ganglia damage from the original insult supports the diagnosis, and documentation of the underlying cause establishes the nexus. Because the governing table is five severity steps with no defining criteria, the evidence that decides the percentage is descriptive: video documentation, and an examination that records the distribution, amplitude, and persistence of the movements at rest and with action, together with a concrete account of what they prevent. Treatment records covering medication and any interventional procedure such as deep brain stimulation demonstrate the management burden, and service medical records establishing the in-service triggering event close the nexus.

C&P Exam Tips

Bring the neurology diagnosis, brain imaging, video documentation, and medication history. Demonstrate the movements on examination — during quiet sitting, with action-induced exacerbation, across body parts. Because the rating rests on five undefined severity words borrowed from the chorea table, quantify the functional impact instead of leaving the examiner to pick an adjective: the tasks you can no longer perform, whether you can eat or dress without assistance, and your fall risk. If the athetosis followed a service-connected head injury, stroke, or anoxic event, frame the claim as secondary to that condition and emphasize the temporal relationship.

How to File

File VA Form 21-526EZ listing acquired athetosis under DC 8107 and reference 38 CFR §4.124a. Attach the neurology diagnosis, brain imaging, video documentation, and the records of the underlying cause — TBI, stroke, encephalitis, or anoxic event. If the athetosis is secondary to a service-connected condition, frame the claim through that condition with a nexus opinion. Request SMC evaluation when functional losses justify it, and file compensatory pain, mental health residuals, and injury sequelae separately.

Common Mistakes

Expecting DC 8107 to carry a table of its own. Its rating cell in §4.124a is empty and the entry reads "Rate as chorea," which sends it to DC 8105's five steps. Filing without brain imaging, leaving the underlying cause unclear and the diagnosis vulnerable. Confusing acquired athetosis with chorea, dystonia, or a tic disorder — DC 8103 in §4.124a is "Tic, convulsive" (severe 30, moderate 10, mild 0) and DC 8104 rates paramyoclonus multiplex as tic with severe cases at 60, so a medication-induced movement disorder may belong under one of those rather than here. Missing the SMC evaluation when bilateral upper-extremity athetosis effectively produces loss of use of the hands.

Frequently Asked Questions

What table is acquired athetosis rated on?

DC 8107's rating cell in 38 CFR §4.124a is empty and its entry reads, in full, "Rate as chorea." That sends it to DC 8105, Sydenham's chorea, whose table has five steps: pronounced, progressive grave types at 100 percent; severe at 80; moderately severe at 50; moderate at 30; and mild at 10. DC 8106 is routed into the same table.

How is acquired athetosis different from cerebral palsy?

Cerebral palsy is congenital, present from birth, and usually only relevant to a veteran claim through aggravation of a pre-service condition. Acquired athetosis develops in adulthood as a residual of an identifiable brain injury — traumatic, anoxic, infectious, or drug-induced. The underlying pathology and the service-connection pathways differ entirely, even though the movements can look similar.

Can a movement disorder caused by prescribed medication be service-connected?

It can, through the medication-side-effect pathway. Where an antipsychotic prescribed for a service-connected mental health condition produced a tardive movement disorder, that disorder is generally service-connectable as secondary to the underlying condition, because the medication was treatment for a service-connected disease. Which code applies depends on the movement: §4.124a's DC 8103 is "Tic, convulsive," rated severe 30, moderate 10, mild 0, and DC 8104 rates paramyoclonus multiplex as tic with severe cases at 60, while DC 8107 covers athetosis. Ask for evaluation under whichever fits the documented movement, and say so explicitly in the claim.