VA Disability Rating for Upper Radicular Group (Erb-Duchenne) Paralysis
Diagnostic Code 8510 · 38 CFR §4.124a
What Is It?
The upper radicular group refers to the C5 and C6 nerve roots in the brachial plexus, which is the network of nerves that controls your shoulder and upper arm. When these nerves are damaged, you lose the ability to raise your arm, bend your elbow, and rotate your forearm outward. This pattern of paralysis is sometimes called Erb-Duchenne palsy. Veterans commonly develop this from shoulder dislocations, heavy rucksack injuries, falls, blast injuries, or other trauma that stretches or tears the upper brachial plexus nerves.
Rating Criteria
| Rating | Criteria |
|---|---|
| 70% | Complete paralysis in the major (dominant) arm: all shoulder and elbow movements lost or severely affected, hand and wrist movements not 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 records showing brachial plexus injury connected to military service
- Electromyography and nerve conduction study results identifying C5-C6 involvement
- Documentation of which arm is your dominant hand
- Range of motion measurements for the shoulder and elbow
- Records of any surgical interventions or nerve repair procedures
C&P Exam Tips
- Make sure the examiner documents which arm is your dominant arm
- Demonstrate the specific movements you cannot perform at the shoulder and elbow
- Show any muscle wasting in the shoulder or upper arm area
- Describe your worst days, not just how you feel at the exam
- Explain how the limitation affects daily tasks like dressing, driving, and personal hygiene
How to File
File under DC 8510 for upper radicular group paralysis. VA rates this condition differently depending on whether the affected arm is your dominant or non-dominant side, so make sure your records clearly state your handedness. Include nerve testing results that specifically identify the C5 and C6 nerve roots as involved.
Common Mistakes
- Not specifying which arm is dominant in the claim.
- Having the condition rated as a simple shoulder injury instead of a nerve condition.
- Not getting electromyography testing to confirm the nerve roots involved.
- Failing to describe how the paralysis affects activities beyond just range of motion.
Frequently Asked Questions
Why does it matter which arm is dominant?
38 CFR 4.124a prints separate figures for the major (dominant) and the minor arm. Under DC 8510, complete paralysis is 70 percent for the major arm and 60 percent for the minor; severe incomplete paralysis is 50 and 40; moderate is 40 and 30; and mild is 20 percent for either arm. Under 38 CFR 4.69, handedness is determined by the evidence of record or by testing on VA examination, and only one hand is considered dominant.
Can brachial plexus injuries heal on their own?
Some brachial plexus injuries, particularly stretch injuries, can improve over months to years. However, nerve root avulsions where the nerve is torn from the spinal cord generally do not heal without surgery. Document your condition as it currently exists for rating purposes.