Upper Extremity Peripheral Neuropathy — VA Disability Rating Criteria (DC 8513)
Diagnostic Code 8513 · 38 CFR §4.124a
What Is It?
Peripheral neuropathy of the upper extremities means the nerves in your arms and hands are damaged, causing numbness, tingling, burning pain, weakness, or loss of coordination. This is common in veterans with diabetes, toxic exposure history (Agent Orange, burn pits), or repetitive strain injuries from military duties. The VA rates upper extremity nerve damage based on which specific nerve is affected and how severe the impairment is. Higher ratings apply to your dominant hand. DC 8513 covers all the radicular groups of the upper extremity, but the VA may also rate under specific nerve codes depending on your situation.
Rating Criteria
| Rating | Criteria |
|---|---|
| 70% | Severe incomplete paralysis of the dominant hand. You have very limited use of the affected hand and arm with significant pain, numbness, and weakness throughout. |
| 60% | Severe incomplete paralysis of the non-dominant side, or moderately severe on the dominant side. The hand and arm have major functional deficits approaching but not reaching complete loss of use. |
| 50% | Moderately severe incomplete paralysis of the non-dominant side. You have substantial loss of grip strength and coordination with frequent pain or numbness episodes. |
| 40% | Moderate incomplete paralysis of the dominant hand, or moderately severe on the non-dominant side. Daily tasks like buttoning clothes, writing, or using tools become significantly difficult. |
| 30% | Moderate incomplete paralysis of the non-dominant side, or mild-to-moderate on the dominant side. You have clear functional limitations — difficulty gripping objects, frequent dropping of items, or reduced fine motor control. |
| 20% | Mild incomplete paralysis of the affected nerve group. You have noticeable numbness, tingling, or mild weakness but can still use your hand and arm for most tasks. This rating applies to both dominant and non-dominant sides. |
Evidence Needed
Nerve conduction studies (NCS) and electromyography (EMG) are the gold standard for documenting peripheral neuropathy. These tests objectively measure nerve damage severity. Medical records showing the underlying cause (diabetes, toxic exposure) and treatment history are also important. Document how the condition affects your daily life — inability to grip, dropping objects, difficulty with fine motor tasks.
C&P Exam Tips
Make sure you have recent EMG/NCS results in your file before the exam. Describe your worst symptoms honestly — the exam may catch you on a good day. Demonstrate grip weakness if present. Tell the examiner which hand is dominant and how the condition specifically limits that hand. Mention if you have had to modify how you do tasks or if you have dropped things that caused injuries.
How to File
File under the specific nerve code identified in your EMG/NCS results, or under DC 8513 for general upper extremity radicular neuropathy. If the neuropathy is secondary to diabetes (DC 7913) or toxic exposure, file as a secondary condition. Include EMG/NCS results, treatment records, and a nexus letter if filing as secondary.
Common Mistakes
Not getting EMG/NCS testing is the most common mistake. Without objective nerve testing, the VA relies solely on the examiner's clinical impression, which can underrate your condition. Another mistake is not specifying which hand is dominant — dominant hand ratings are higher. Also, many veterans file for neuropathy of both upper extremities but only claim one side. If both hands are affected, claim bilateral neuropathy.
Frequently Asked Questions
Does the VA rate each arm separately?
Yes. If you have peripheral neuropathy in both arms, each is rated separately under its own diagnostic code. These ratings then combine using VA math, and the bilateral factor adds a small additional benefit.
What if my neuropathy is from Agent Orange exposure?
Peripheral neuropathy is a presumptive condition for veterans exposed to Agent Orange, provided it manifested to a compensable degree within a certain timeframe. Check the current VA presumptive list for specifics on timing requirements.
Can I get rated for both carpal tunnel and peripheral neuropathy in the same arm?
Generally no — the VA avoids pyramiding (rating the same symptoms twice). However, if different nerves are affected (median nerve for carpal tunnel, other nerves for generalized neuropathy), separate ratings may be possible. This depends on the specific nerves involved.