Long Thoracic Nerve Neuritis — VA Disability Rating (DC 8619)
Diagnostic Code 8619 · 38 CFR §4.123
What Is It?
Neuritis of the long thoracic nerve (DC 8619) refers to inflammation of this nerve, causing pain, tenderness, and impaired function along its distribution. The long thoracic nerve innervates the serratus anterior muscle, which holds the shoulder blade against the rib cage. Damage causes the scapula to protrude outward, known as winged scapula. Under 38 CFR §4.123, neuritis characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is rated on the scale provided for injury of the nerve involved — here DC 8519 — with a maximum equal to severe incomplete paralysis. Neuritis without those organic changes is capped at moderate incomplete paralysis. DC 8519 prints incomplete paralysis as severe 20 percent, moderate 10 percent, and mild 0 percent, the same for the major and the minor arm. That puts DC 8619 at 0, 10, and 20 percent.
Rating Criteria
| Rating | Criteria |
|---|---|
| 20% | Severe incomplete paralysis level of DC 8519. Same rating for the major and the minor arm. Severe is the neuritis maximum under §4.123, and it applies only to neuritis with the organic changes that section describes (loss of reflexes, muscle atrophy, sensory disturbances, and constant pain). |
| 10% | Moderate incomplete paralysis level of DC 8519. Same rating for the major and the minor arm. Moderate is the most §4.123 allows for neuritis without those organic changes. |
| 0% | Mild incomplete paralysis level of DC 8519. Same rating for the major and the minor arm. |
Evidence Needed
- Medical records documenting nerve inflammation and its connection to military service
- Electromyography (EMG) and nerve conduction studies showing nerve dysfunction
- Clinical findings of reflex changes, sensory disturbances, or muscle atrophy
- Treatment records showing ongoing management with anti-inflammatory or neuropathic pain medications
- If claiming secondary to another condition, a medical nexus opinion linking the neuritis to your service-connected disability
C&P Exam Tips
- Describe pain patterns honestly — note whether pain is constant or intermittent and its severity
- Point out any muscle wasting or tenderness along the shoulder blade to the examiner
- Mention all medications you take for the condition and their effectiveness
- Explain how the condition affects your daily activities on your worst days
- Do not minimize symptoms during strength or sensory testing
How to File
File under DC 8619 on VA Form 21-526EZ. If claiming as secondary to a service-connected condition, clearly identify the primary disability and explain how it caused nerve inflammation. Include EMG or nerve conduction study results if available. VA rates neuritis on the DC 8519 scale, up to the severe incomplete paralysis level (20 percent for either arm) when the organic changes in §4.123 are present, so make sure your medical evidence documents reflexes, muscle bulk, sensation, and pain, and which arm is your dominant one.
Common Mistakes
Veterans often fail to distinguish neuritis from general pain, missing the opportunity for a separate rating. Another common error is not obtaining nerve conduction studies that document inflammatory changes. Some veterans accept a lower rating by not reporting the full impact of constant pain and sensory disturbance on daily function. Make sure your records specify neuritis of the long thoracic nerve rather than a vague peripheral neuropathy diagnosis.
Frequently Asked Questions
What is the difference between DC 8519 and DC 8619?
DC 8519 covers paralysis (motor and sensory loss) of the long thoracic nerve, while DC 8619 covers neuritis (inflammation) of the same nerve. Neuritis is rated on the DC 8519 scale with a maximum equal to severe incomplete paralysis; without the organic changes §4.123 lists (loss of reflexes, muscle atrophy, sensory disturbances, constant pain), the maximum is moderate incomplete paralysis.
Can I receive ratings for both paralysis and neuritis of the same nerve?
Generally not. 38 CFR §4.14 says the evaluation of the same disability under various diagnoses is to be avoided, and paralysis and neuritis of one nerve are rated on the same DC 8519 scale. Expect one rating, under whichever code best describes your condition.