The VA decides claims on the file. Nerve claims are lost less often because the veteran is not disabled and more often because the objective findings that drive the rating criteria were never written down anywhere.
This is the checklist. Work through it before filing, and again before any exam is scheduled.
1. A current diagnosis
The file needs a named condition: lumbar or cervical radiculopathy, sciatica attributable to a specific level, peripheral neuropathy, carpal tunnel syndrome, or a named nerve injury. A note recording leg pain is not a diagnosis. VA treatment records, private records, and specialist consultations all count, as the VA's evidence page explains.
2. Objective neurologic findings
This is what separates a 10 percent grant from a 40 percent grant. The record should contain sensory testing described by dermatome, deep tendon reflex results, manual muscle strength grades, and any measured atrophy.
- EMG or nerve conduction study results when they exist
- MRI or CT showing disc protrusion, foraminal narrowing, or stenosis at the level matching the symptoms
- Reflex testing documented over more than one visit
- Strength grades and limb circumference measurements where weakness or atrophy is present
- Notes on gait, falls, foot drop, or use of a cane or brace
3. The in-service history
For a direct claim, the record needs the injury or the exposure: a documented back or neck injury, a fall or vehicle accident, sick call visits, or a duty history describing years of load bearing. For a secondary claim, the record needs the rating decision granting the underlying condition, as covered in our radiculopathy secondary guide.
Gaps in service treatment records are common and are not fatal. Our medical evidence guide explains how continuity is established when the paperwork is thin.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service or an already service-connected disability.
4. Continuity between service and now
The VA looks for a thread. Post-service treatment notes, chiropractic or physical therapy records, pharmacy history for nerve pain medication, and work accommodations all help show the condition persisted rather than starting recently.
5. Lay statements
Nerve symptoms are largely invisible on paper, which makes lay evidence unusually useful. A spouse describing a leg giving out on the stairs, a coworker describing dropped tools, or your own statement about what you can no longer feel adds detail no clinical note contains. Our guide on medical evidence guide covers what carries weight.
6. A well-reasoned medical opinion
When the diagnosis and the history are in the file but nothing connects them, that is the gap an independent medical opinion addresses. A sound opinion states the conclusion, explains the anatomy and the mechanism, addresses alternative causes such as diabetes or age, cites the records reviewed, and applies the correct standard.
Our guides on what a nexus letter is and the at least as likely as not standard cover both points. No honest provider can promise an outcome, and no opinion can substitute for records that do not exist.
Where to go next
Read the pillar guide for how these claims are structured, the diagnostic codes guide for the percentages, and the C&P exam guide before your appointment. Free accredited help with filing is available to every veteran through a Veterans Service Officer.