VA Disability Rating for Internal Saphenous Nerve Paralysis
Diagnostic Code 8527 · 38 CFR §4.124a
What Is It?
The internal saphenous nerve, commonly called the saphenous nerve, is a purely sensory nerve that provides feeling to the inner side of your knee, lower leg, and foot. It is the longest sensory nerve in your body. Since it does not control any muscles, damage to this nerve causes numbness, tingling, or burning pain along the inner leg but does not cause muscle weakness. Veterans may develop saphenous nerve damage from knee surgeries, inner knee injuries, thigh trauma, varicose vein procedures, or blast injuries that affect the inner thigh or knee area during service.
Rating Criteria
| Rating | Criteria |
|---|---|
| 10% | Severe to complete paralysis of the nerve, which DC 8527 prints as one level ("Severe to complete"). Because the nerve is purely sensory, §4.124a's note on wholly sensory involvement (rated at the mild, or at most, the moderate degree) may keep a sensory-only presentation below this level. |
| 0% | Mild to moderate paralysis, which DC 8527 prints as one level ("Mild to moderate") at 0 percent. Numbness or pain along the inner knee, leg, and foot at this degree is rated 0 percent; a 0 percent rating still records the condition as service connected. |
Evidence Needed
- Medical records documenting saphenous nerve damage connected to service
- Nerve conduction studies or clinical examination findings
- Documentation of the specific area of numbness or pain
- Records showing how symptoms affect walking, sitting, or wearing certain clothing
- Evidence connecting the nerve damage to a service-related injury or surgery
C&P Exam Tips
- Map out the exact area of numbness or pain on your inner leg for the examiner
- Describe the quality of the pain, whether burning, shooting, or aching
- Explain how the numbness creates problems like not feeling hot water or injuries
- Mention if kneeling or certain positions make the symptoms worse
- Describe how symptoms affect your sleep if they do
How to File
File under DC 8527 for internal saphenous nerve paralysis. DC 8527 prints two levels: 10 percent for severe to complete paralysis and 0 percent for mild to moderate. This is a sensory-only nerve, and §4.124a adds: "When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree." VA may apply that note to hold a sensory-only presentation at 0 percent. If the nerve damage resulted from a service-connected knee surgery or injury, file it as secondary to that condition. Focus your evidence on the pain, the area of lost sensation, and the functional impact rather than muscle weakness.
Common Mistakes
- Expecting a high rating for a sensory-only nerve condition.
- Not documenting the specific pain quality and distribution.
- Failing to connect the nerve damage to a known knee injury or surgical procedure.
- Not reporting how neuropathic pain affects sleep and daily activities.
Frequently Asked Questions
Why is the maximum rating for saphenous nerve damage so low?
DC 8527 prints only two figures: 10 percent for severe to complete paralysis and 0 percent for mild to moderate. The saphenous nerve is purely sensory, and §4.124a says that when the involvement is wholly sensory the rating should be for the mild, or at most, the moderate degree, which on this code is 0 percent. VA may apply that note to a sensory-only presentation. You can still receive separate ratings for the underlying condition that caused the nerve damage.
Can saphenous nerve damage happen during knee surgery?
Yes, the saphenous nerve runs very close to the inner knee and is vulnerable during knee surgeries, arthroscopic procedures, and vein harvesting for heart bypass surgery. If your nerve damage occurred during a VA surgery, you may also be eligible for benefits under section 1151.