VA Disability Rating for Middle Radicular Group Paralysis
Diagnostic Code 8511 · 38 CFR §4.124a
What Is It?
The middle radicular group involves the C7 nerve root in the brachial plexus. This nerve root primarily controls your ability to straighten your elbow, extend your wrist, and straighten your fingers. When the C7 nerve root is damaged, you have difficulty pushing away from surfaces, extending your arm, and gripping objects that require wrist stability. Veterans may develop this condition from injuries that affect the middle portion of the brachial plexus, including falls onto an outstretched hand, heavy lifting injuries, or blast exposure during service. The rating schedule describes complete paralysis of this group as adduction, abduction and rotation of the arm, flexion of the elbow, and extension of the wrist lost or severely affected.
Rating Criteria
| Rating | Criteria |
|---|---|
| 70% | Complete paralysis in the major (dominant) arm: adduction, abduction and rotation of the arm, flexion of the elbow, and extension of the wrist lost or severely affected. |
| 60% | Complete paralysis in the minor (non-dominant) arm. Same presentation as the 70 percent level. |
| 50% | Severe incomplete paralysis in the major (dominant) arm. |
| 40% | Severe incomplete paralysis in the minor (non-dominant) arm, or moderate incomplete paralysis in the major (dominant) arm. |
| 30% | Moderate incomplete paralysis in the minor (non-dominant) arm. |
| 20% | Mild incomplete paralysis. Same rating for the major and the minor arm. |
Evidence Needed
- Medical documentation of C7 nerve root damage connected to service
- Electromyography and nerve conduction study results
- Documentation of handedness for dominant versus non-dominant rating
- Grip strength testing and wrist extension measurements
- Records showing functional limitations in daily activities
C&P Exam Tips
- Ensure the examiner records which hand is your dominant hand
- Demonstrate difficulty with pushing motions and extending your wrist
- Show any weakness in straightening your fingers
- Describe tasks that have become difficult such as doing pushups or opening jars
- Mention any dropping of objects due to wrist weakness
How to File
File under DC 8511 for middle radicular group paralysis. Include nerve testing that identifies C7 involvement specifically. Make sure your claim clearly states which arm is affected and whether it is your dominant or non-dominant side. 38 CFR 4.124a prints separate figures for the major and minor arm under DC 8511: complete paralysis is 70 and 60 percent, severe incomplete paralysis 50 and 40, moderate 40 and 30, and mild is 20 percent for either arm.
Common Mistakes
- Confusing C7 radiculopathy with carpal tunnel syndrome since both affect hand function.
- Not specifying dominant versus non-dominant arm in the claim.
- Getting rated under the wrong diagnostic code for a different nerve root level.
- Not documenting wrist drop or finger extension weakness thoroughly.
Frequently Asked Questions
How is middle radicular group paralysis different from carpal tunnel syndrome?
While both can cause hand weakness, they affect different nerves at different locations. Middle radicular group paralysis involves the C7 nerve root at the neck level and primarily affects your ability to extend your wrist and straighten your fingers. Carpal tunnel involves compression of the median nerve at the wrist and mainly causes numbness and tingling in certain fingers.
Can I receive separate ratings for C7 radiculopathy and a neck condition?
Yes, you can receive a rating for the underlying cervical spine condition and a separate rating for the nerve damage it causes, as long as they are evaluating different functional impairments. This is a common combination in VA claims.