VA Disability Rating for Deep Peroneal Nerve (Anterior Tibial Nerve) Paralysis
Diagnostic Code 8523 · 38 CFR §4.124a
What Is It?
The deep peroneal nerve controls the muscles that lift your foot upward at the ankle and extend your toes. It also provides a small area of sensation in the web space between your big toe and second toe. When this nerve is damaged, you develop foot drop, meaning your foot slaps the ground when you walk because you cannot lift it properly. You may need a brace to walk safely. Veterans commonly develop this from knee injuries, lower leg fractures, compartment syndrome, crossing legs for prolonged periods during field operations, or direct trauma to the front of the lower leg.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Complete paralysis with foot drop, total inability to dorsiflex the foot or extend the toes |
| 20% | Severe incomplete paralysis with significant foot drop requiring a brace for safe walking |
| 10% | Moderate incomplete paralysis with mild weakness in foot dorsiflexion or toe extension |
| 0% | Mild symptoms with documented nerve involvement but no significant functional limitation |
Evidence Needed
- Medical records documenting deep peroneal nerve damage connected to service
- Nerve conduction studies isolating the deep peroneal nerve
- Documentation of foot drop and its severity
- Records of ankle-foot orthosis prescription or brace usage
- Gait analysis or physical therapy notes describing walking abnormalities
C&P Exam Tips
- Demonstrate your inability to lift your foot and extend your toes
- Bring your ankle-foot orthosis or brace to the exam and show walking with and without it
- Describe falls or near-falls caused by foot drop
- Show the examiner your gait pattern, including any high-stepping compensation
- Mention the sensory loss between your big toe and second toe
How to File
File under DC 8523 for deep peroneal nerve paralysis. If you use an ankle-foot orthosis or brace, include the prescription and documentation of its medical necessity. Nerve testing results that specifically identify the deep branch of the peroneal nerve will strengthen your claim.
Common Mistakes
Not distinguishing deep peroneal nerve damage from common peroneal nerve damage in the claim Failing to bring your brace to the C&P exam Not documenting falls or trip hazards caused by foot drop Not claiming secondary conditions in the back, hip, or opposite knee from compensatory walking
Frequently Asked Questions
Do I need to wear a brace to get a higher rating?
Using an ankle-foot orthosis demonstrates the severity of your foot drop and supports a higher rating. The need for a brace indicates that the paralysis significantly affects your ability to walk safely. Make sure your medical records include the prescription for the brace.
Can foot drop from peroneal nerve damage be fixed with surgery?
In some cases, nerve repair or tendon transfer surgery can improve foot drop. However, even after surgery, residual weakness often remains. Your rating should be based on your current level of function after any treatment you have received.