VA Disability Rating for Posterior Tibial Nerve Paralysis
Diagnostic Code 8525 · 38 CFR §4.124a
What Is It?
The posterior tibial nerve is the continuation of the tibial nerve as it passes behind your inner ankle bone through an area called the tarsal tunnel. It provides sensation to the bottom of your foot and controls some of the small muscles in your foot that help maintain your arch. Compression or damage at this location is called tarsal tunnel syndrome. Veterans may develop this from ankle fractures, flat feet that developed or worsened during service, prolonged standing and marching, ankle sprains, or swelling from other service-connected injuries in the ankle area.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Complete paralysis with total loss of sensation on the sole and significant weakness in the small foot muscles |
| 20% | Severe incomplete paralysis with substantial burning pain, numbness, and tingling on the bottom of the foot |
| 10% | Moderate incomplete paralysis with intermittent pain, numbness, or tingling in the sole of the foot |
Evidence Needed
- Medical records documenting posterior tibial nerve compression or damage linked to service
- Nerve conduction studies testing the tibial nerve at the tarsal tunnel
- Documentation of symptoms including burning, numbness, or tingling on the sole
- Records of treatment attempts such as orthotics, injections, or surgery
- Evidence of the service-connected cause such as ankle injury or flat feet
C&P Exam Tips
- Describe the exact location and quality of your pain, numbness, and tingling
- Mention what makes symptoms worse, such as prolonged standing or walking
- Show the examiner the inside of your ankle where the tarsal tunnel is located
- Explain how symptoms affect your ability to stand for work or exercise
- Report any nighttime symptoms that disturb your sleep
How to File
File under DC 8525 for posterior tibial nerve paralysis. If your tarsal tunnel syndrome developed secondary to a service-connected ankle injury or flat feet, file it as a secondary condition and explain that chain of causation. Include nerve testing performed at the tarsal tunnel level.
Common Mistakes
Confusing tarsal tunnel syndrome with plantar fasciitis since both cause foot pain Not getting nerve conduction studies at the tarsal tunnel to confirm the diagnosis Failing to connect the nerve compression to a service-connected ankle or foot condition Not reporting nighttime symptoms that indicate ongoing nerve irritation
Frequently Asked Questions
Is tarsal tunnel syndrome similar to carpal tunnel syndrome?
Yes, they are analogous conditions. Carpal tunnel involves nerve compression at the wrist, while tarsal tunnel involves nerve compression at the ankle. Both cause pain, numbness, and tingling in the area supplied by the compressed nerve.
Can flat feet cause tarsal tunnel syndrome?
Yes, flat feet change the alignment of your ankle and can increase pressure on the posterior tibial nerve as it passes through the tarsal tunnel. If you have service-connected flat feet and develop tarsal tunnel syndrome, you can file for the nerve condition as secondary to your flat feet.