VA Disability Rating for Ulnar Nerve Paralysis
Diagnostic Code 8516 · 38 CFR §4.124a
What Is It?
The ulnar nerve runs along the inner side of your arm and controls many of the small muscles in your hand that are responsible for fine movements. It also provides sensation to your ring and little fingers. When the ulnar nerve is damaged, you may develop a claw hand deformity where your ring and little fingers curl inward, lose grip strength, and have difficulty with tasks requiring precise hand movements like typing or turning keys. Veterans commonly develop ulnar nerve problems from elbow fractures, prolonged leaning on hard surfaces during field operations, blast injuries, or direct trauma to the arm or elbow area.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Complete paralysis in the major (dominant) arm: the "griffin claw" deformity, due to flexor contraction of the ring and little fingers; atrophy very marked in the dorsal interspace and the thenar and hypothenar eminences; loss of extension of the ring and little fingers; cannot spread the fingers (or reverse); cannot adduct the thumb; flexion of the wrist weakened. |
| 50% | Complete paralysis in the minor (non-dominant) arm. Same presentation as the 60 percent level. |
| 40% | Severe incomplete paralysis in the major (dominant) arm. |
| 30% | Severe incomplete paralysis in the minor (non-dominant) arm, or moderate incomplete paralysis in the major (dominant) arm. |
| 20% | Moderate incomplete paralysis in the minor (non-dominant) arm. |
| 10% | Mild incomplete paralysis. Same rating for the major and the minor arm. |
Evidence Needed
- Medical records showing ulnar nerve damage connected to military service
- Electromyography and nerve conduction study results at the elbow or wrist
- Documentation of grip and pinch strength deficits
- Records showing which hand is dominant
- Photographs documenting any claw hand deformity if present
C&P Exam Tips
- Show the examiner any claw deformity in your ring and little fingers
- Demonstrate difficulty spreading your fingers apart and bringing them together
- Show weakness when pinching between your thumb and index finger
- Describe numbness and tingling in your ring and little fingers
- Explain specific work or daily tasks that have become difficult
How to File
File under DC 8516 for ulnar nerve paralysis. Include nerve testing that localizes the problem to the ulnar nerve, whether at the elbow or wrist level. Clearly document your handedness. 38 CFR 4.124a prints complete paralysis at 60 percent for the major arm and 50 for the minor, severe incomplete paralysis at 40 and 30, moderate at 30 and 20, and mild at 10 percent for either arm.
Common Mistakes
- Not getting nerve testing to confirm ulnar nerve involvement versus other hand nerve conditions.
- Failing to document the claw hand deformity with photographs.
- Not mentioning the sensory loss in the ring and little fingers alongside the motor weakness.
- Missing the connection between an old elbow injury and the nerve damage that developed later.
Frequently Asked Questions
What is cubital tunnel syndrome and is it the same as ulnar nerve paralysis?
Cubital tunnel syndrome is compression of the ulnar nerve at the elbow. It is the most common cause of ulnar nerve problems. If the compression is severe enough and causes lasting damage, it can progress to ulnar nerve paralysis. VA rates the resulting nerve damage under DC 8516 regardless of the underlying cause.
Can I get separate ratings for ulnar nerve damage and an elbow condition?
Yes, you can receive a rating for the elbow joint condition and a separate rating for the ulnar nerve damage, as they affect different functions. The elbow rating addresses joint limitation while the nerve rating addresses hand weakness and sensory loss.