VA Disability Rating for Radial Nerve (Musculospiral Nerve) Paralysis
Diagnostic Code 8514 · 38 CFR §4.124a
What Is It?
The radial nerve is one of the major nerves in your arm, running from your neck down the back of your arm to your hand. It controls your ability to extend your wrist, straighten your fingers, and turn your forearm so your palm faces upward. The most recognizable sign of radial nerve damage is wrist drop, where your hand hangs limply because you cannot lift it at the wrist. Veterans commonly develop radial nerve injuries from fractures of the upper arm bone, compression injuries from sleeping in awkward positions during field conditions, blast injuries, or direct trauma to the arm.
Rating Criteria
| Rating | Criteria |
|---|---|
| 70% | Complete paralysis in the major (dominant) arm: drop of hand and fingers, wrist and fingers perpetually flexed, the thumb adducted falling within the line of the outer border of the index finger; cannot extend the hand at the wrist, extend the proximal phalanges of the fingers, extend the thumb, or make lateral movement of the wrist; supination of the hand and extension and flexion of the elbow weakened, and the loss of synergic motion of the extensors seriously impairs the hand grip. Total paralysis of the triceps occurs only as the greatest rarity. |
| 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. |
| 30% | Moderate incomplete paralysis in the major (dominant) arm. |
| 20% | Moderate incomplete paralysis in the minor (non-dominant) arm, or mild incomplete paralysis in either arm. Mild is the same 20 percent for the major and the minor arm. |
Evidence Needed
- Medical records linking the radial nerve injury to military service
- Electromyography and nerve conduction studies showing radial nerve involvement
- Documentation of wrist drop or finger extension weakness
- Grip strength testing results
- Records indicating which arm is dominant
C&P Exam Tips
- Show the examiner your wrist drop if present, both with and without a splint
- Demonstrate difficulty extending your fingers and turning your palm upward
- Describe specific tasks you cannot do such as turning a doorknob or typing
- Make sure the examiner records your dominant hand
- Mention any numbness on the back of your hand between the thumb and index finger
How to File
File under DC 8514 for radial nerve paralysis. Include nerve testing results and documentation of wrist drop if present. Make sure records clearly state which arm is affected and whether it is your dominant side. 38 CFR 4.124a prints complete paralysis at 70 percent for the major arm and 60 for the minor, severe incomplete paralysis at 50 and 40, moderate at 30 and 20, and mild at 20 percent for either arm. A Note under DC 8514 limits lesions involving only "dissociation of extensor communis digitorum" and "paralysis below the extensor communis digitorum" to the moderate rating.
Common Mistakes
- Not getting nerve conduction studies to confirm radial nerve involvement.
- Failing to document the severity of wrist drop at its worst.
- Not specifying dominant versus non-dominant arm.
- Not claiming secondary conditions that develop from compensating for wrist drop.
Frequently Asked Questions
What is Saturday night palsy and can it lead to a VA claim?
Saturday night palsy is a colloquial name for radial nerve compression that occurs from prolonged pressure on the upper arm, such as sleeping with your arm draped over a chair. If this happened during military service due to field conditions or sleeping arrangements, it can be service-connected, especially if it resulted in lasting nerve damage.
Do I need a wrist splint to get a higher rating?
No. The schedule rates radial nerve paralysis on its degree (mild, moderate, or severe incomplete paralysis, or complete paralysis), not on whether you use a splint. Wear the splint because you need it. At your exam, show the examiner your hand function both with and without the splint so the degree of paralysis is recorded accurately.