The exam form
The examiner fills out VA's "Peripheral Nerves Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy)" form (a Disability Benefits Questionnaire, or DBQ). See the form on VA.gov
Form version checked: Updated on 2026-06-01 (v26_1).
What the exam is for
The exam records which nerves are affected, on which side, and how much use you've lost: pain, numbness, tingling, weakness, muscle loss and reflexes. Nerve problems that come from your back or neck (radiculopathy) are also checked at a back or neck exam. Nerve damage from diabetes (diabetic peripheral neuropathy) uses a separate VA form.
What the examiner will ask and measure
- Your diagnosis, and how your nerve condition started and changed.
- Your dominant hand: right, left, or both equally (ambidextrous).
- Symptoms in each arm and leg: constant pain (which may be extreme at times), pain that comes and goes (usually dull), tingling or other odd feelings (paresthesias or dysesthesias), and numbness. The examiner marks each one as none, mild, moderate or severe.
- Muscle strength on a scale from 0 (no movement) to 5 (normal), at the elbow, wrist, grip, pinch (thumb to index finger), knee and ankle. Any muscle loss (atrophy) is measured in centimeters on both sides.
- Reflexes in your arms, knees and ankles, and whether you can feel a light touch on your shoulder, forearm, hand, thigh, knee, lower leg, ankle, foot and toes.
- Trophic changes: skin changes from poor nerve supply, such as hair loss on an arm or leg, or smooth, shiny skin.
- How you walk (your gait), and the cause of any problem.
- Tests for the median nerve (the nerve involved in carpal tunnel syndrome), called Phalen's and Tinel's signs, if the examiner needs them.
- The severity for each nerve, on each side: normal; mild, moderate or severe incomplete paralysis; or complete paralysis. The sciatic nerve also has "moderately severe" and "severe, with marked muscular atrophy."
- Devices you use to get around, such as a wheelchair, brace, crutches, cane or walker, and whether you use them now and then, regularly or all the time.
- What use is left in a hand or foot: whether gripping and handling things, or balance and walking, are as limited as if you had an amputation with an artificial limb. The form says this question isn't asking whether you should have an amputation.
- EMG results, if you've had the test. The form says EMG is rarely needed to diagnose a nerve condition.
- Scars from the condition or its treatment, and how your nerve condition affects work, with examples.
Be ready to describe
- When your nerve symptoms started, and how they've changed. If they come from your back or neck, say so.
- Exactly where you feel pain, numbness, tingling or weakness, on each side, and whether it's constant or comes and goes.
- Things that are hard to do, such as gripping, buttoning, writing, holding a cup, walking, using stairs or keeping your balance.
- Any brace, cane, crutches, walker or wheelchair, and how often you use it.
- Nerve tests you've had, with the dates and where they were done.
- Medicines, shots, surgery, and any side effects.
- How your nerve condition affects work, with examples.
Common mistakes
- Talking only about pain, and leaving out weakness, dropping things, tripping or muscle loss.
- Describing only one side when both arms or both legs have symptoms. VA rates each side on its own.
- Forgetting to say which hand you use most.
- Leaving your brace, cane or walker at home and not mentioning it.
How VA rates it
VA rates each nerve by how much use you've lost: mild, moderate or severe "incomplete paralysis," or complete paralysis. It looks at where and what the injury is, how much movement and strength you've lost, skin changes (trophic changes), and changes in feeling. Arm nerves have higher levels for your dominant arm. Other nerves, such as the radial nerve and the nerve roots from the neck (radicular groups), use the same scale, with their own levels listed in the Rating Criteria Lookup. VA proposed changes to its rules for neurological conditions, including nerve conditions, in November 2024 (89 FR 88917). As of October 2026 they aren't final, so the current rules still apply.
In plain English
- What "incomplete paralysis" means: you've lost some use of the nerve, but much less than the complete paralysis VA describes for that nerve. When the problem is only with feeling (sensation), VA rates it as mild, or at most moderate.
- Sciatic nerve (sciatica): 10% mild; 20% moderate; 40% moderately severe; 60% severe, with marked muscle loss (atrophy); 80% complete paralysis: the foot dangles and drops, you can't move any muscles below the knee, and bending the knee is weak or (very rarely) lost.
- Femoral nerve (anterior crural nerve, at the front of the thigh): 10% mild; 20% moderate; 30% severe; 40% complete paralysis of the thigh muscles that straighten the knee (quadriceps).
- Median nerve (carpal tunnel syndrome is one cause): mild 10% for either arm; moderate 30% for your dominant arm or 20% for your other arm; severe 50% or 40%; complete paralysis 70% or 60%. Complete paralysis means: the hand tilts toward the little-finger side; the index and middle fingers stay straighter than normal; the muscles at the base of the thumb waste away a lot, and the thumb lies flat with the hand ("ape hand"); turning the palm down is weak and incomplete; you can't bend the index finger, can barely bend the middle finger, and can't make a fist; you can't bend the tip of the thumb; moving the thumb across the palm or out at a right angle to it is weak; bending the wrist is weak; and there's pain with trophic changes.
- Ulnar nerve: mild 10% for either arm; moderate 30% for your dominant arm or 20% for your other arm; severe 40% or 30%; complete paralysis 60% or 50%. Complete paralysis means: a "griffin claw" hand, with the ring and little fingers pulled into a bent position; very marked muscle loss between the bones on the back of the hand and at the base of the thumb and little finger; you can't straighten the ring and little fingers, can't spread your fingers or bring them back together, and can't pull your thumb in toward your hand; bending the wrist is weak.
- Your dominant arm (VA's word is "major") gets the higher levels. Only one hand counts as dominant. If you use both hands equally, VA counts the injured hand, or the more injured one, as dominant.
- Neuritis (loss of reflexes, muscle loss, changes in feeling, and constant pain, at times extreme) is rated on the same scale as the nerve involved, up to severe incomplete paralysis. If it doesn't have those physical (organic) changes, the top level is moderate, or moderately severe for the sciatic nerve (38 CFR 4.123).
- Neuralgia (usually dull pain that comes and goes, in a pattern that shows which nerve it is) is rated on the same scale, up to moderate incomplete paralysis (38 CFR 4.124).
- Each side is rated on its own. When both arms or both legs are affected, VA combines the two ratings and adds a small extra amount (the bilateral factor).
The regulation, word for word
Quoted from 38 CFR Part 4 (current as of October 16, 2026). This is what VA applies. The plain-English version above is our summary of it.
| Criteria | Rating |
|---|
| 8520 Paralysis of: | |
| Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost | 80 |
| Incomplete: | |
| Severe, with marked muscular atrophy | 60 |
| Moderately severe | 40 |
| Moderate | 20 |
| Mild | 10 |
38 CFR 4.124a, diagnostic code 8526: Anterior crural nerve (femoral), paralysis Open in the Rating Criteria Lookup
| Criteria | Rating |
|---|
| 8526 Paralysis of: | |
| Complete; paralysis of quadriceps extensor muscles | 40 |
| Incomplete: | |
| Severe | 30 |
| Moderate | 20 |
| Mild | 10 |
| Criteria | Major | Minor |
|---|
| 8515 Paralysis of: | | |
| Complete; the hand inclined to the ulnar side, the index and middle fingers more extended than normally, considerable atrophy of the muscles of the thenar eminence, the thumb in the plane of the hand (ape hand); pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist, index and middle fingers remain extended; cannot flex distal phalanx of thumb, defective opposition and abduction of the thumb, at right angles to palm; flexion of wrist weakened; pain with trophic disturbances | 70 | 60 |
| Incomplete: | | |
| Severe | 50 | 40 |
| Moderate | 30 | 20 |
| Mild | 10 | 10 |
| Criteria | Major | Minor |
|---|
| 8516 Paralysis of: | | |
| Complete; the “griffin claw” deformity, due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar eminences; loss of extension of ring and little fingers cannot spread the fingers (or reverse), cannot adduct the thumb; flexion of wrist weakened | 60 | 50 |
| Incomplete: | | |
| Severe | 40 | 30 |
| Moderate | 30 | 20 |
| Mild | 10 | 10 |
Related
About every C&P exam
What is it?
After you file a claim, VA may ask you to have a claim exam, also called a compensation and pension (C&P) exam. It helps VA decide whether your condition is connected to your service, and how severe it is. It isn't treatment: the examiner won't treat you, prescribe medicine or refer you to anyone.
Who does it?
A VA provider or a provider from one of VA's exam contractors (Loyal Source, OptumServe, QTC or VES). VA picks; you can't choose. Hearing, mental health, eye and dental exams are done by specialists. For a reproductive, breast, rectal or mental health exam, or a claim related to military sexual trauma, you can ask for a male or female examiner.
How long does it take?
VA says anywhere from 15 minutes to an hour or more, depending on what you claimed. Some exams are by phone or video. If you claimed more than one condition, VA tries to schedule them on the same day.
Does the examiner decide my claim?
No. The examiner writes a report on a standard form (a Disability Benefits Questionnaire, or DBQ) and sends it to VA. VA decides your claim using all the evidence: the report, your medical and service records, and statements from you and others. The examiner can't tell you the results or answer questions about your claim.
Does everyone get one?
No. If your records already have what VA needs, VA can decide from the records alone (VA calls this Acceptable Clinical Evidence, or ACE).
What if I can't make it?
Call the number on your appointment letter at least 48 hours ahead to reschedule. Missing an exam delays your claim. VA may decide your claim on the evidence it already has, and some claims, such as a claim for an increase, are denied (38 CFR 3.655). If you had a good reason, such as being in the hospital or a death in your family, tell VA and ask for a new exam.
What should I bring?
VA says you don't need to bring anything. Send any new medical records to VA before the exam, because the examiner can't send them in for you. Arrive 15 minutes early and wear clothes you can move in. Many veterans find it helps to bring a short list of their symptoms, medicines and side effects, and key dates, so nothing is forgotten.
Can someone come with me?
You can ask the examiner. They may ask family members or caregivers to wait outside. For a sensitive physical exam, you can ask for a chaperone in the room.
Can I get a copy of the report?
Yes. Ask VA with a Freedom of Information Act or Privacy Act request (VA Form 20-10206). VetEZ Claim can help you fill it out and send it.
Can my own doctor fill out the form instead?
For many conditions, yes. VA publishes the exam forms (DBQs) your own doctor can fill out and you can send in. VA doesn't pay for this. A few exam forms are for VA's own examiners.
Checked against VA's forms and rules on October 20, 2026. General information only, not medical or legal advice about your claim. VA decides every claim.
