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.
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.
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.
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.
Buddy statements from people who saw the change
A statement from a fellow service member, a spouse, or a friend can describe things no clinical record captures: a leg that buckled on stairs before any diagnosis existed, a hand that dropped tools at work, or a noticeable limp that developed over months. These statements do not replace medical evidence, but they help establish continuity, particularly for the period between service and the first formal diagnosis.
A useful statement is specific. Naming dates, describing what was observed rather than repeating a diagnosis, and explaining how the person knows the veteran gives the statement more weight than a general comment that the veteran seemed to be in pain.
Occupational and vocational evidence
Work records can matter as much as medical records for nerve claims. Written accommodations, a supervisor's note about missed shifts, a change to lighter duty, or documentation of a job change due to standing or lifting limitations all support the severity and the functional impact of a nerve condition.
This evidence is separate from, but relevant alongside, a rating claim. When nerve symptoms combined with other service-connected conditions affect the ability to sustain full-time work, this kind of documentation is also part of what supports a Total Disability based on Individual Unemployability claim.
Organizing the file before you submit
A claim is easier to evaluate correctly when the evidence is organized around what each diagnostic code requires: the diagnosis, the objective findings, the in-service event or the underlying service-connected condition for a secondary claim, and continuity since then. Submitting records without any explanation of how they connect leaves that work to the rater, who may not draw the same conclusions a treating provider or a reviewing physician would.
A cover statement identifying each condition claimed, the nerve or nerves involved, and a short summary of the supporting evidence for each helps make sure nothing gets read out of context or overlooked in a large file.
Frequently asked questions
Do I need an EMG for a nerve claim to succeed?
No. An EMG or nerve conduction study is valuable objective evidence when it exists, but the VA's rating criteria are built around clinical findings, reflexes, strength, sensory testing, and atrophy, that a physician, a physician assistant, or a nurse practitioner can document during a routine examination without specialized testing.
Who can provide the objective findings I need in my file?
Any treating provider qualified to perform a neurologic examination, including physicians, physician assistants, and nurse practitioners, can document sensory testing, reflexes, strength grading, and atrophy. What matters is that the findings are specific and recorded consistently over time, not which type of provider recorded them.
What is the single most commonly missing piece of evidence in nerve claims?
Objective findings beyond the veteran's own description of symptoms. Numbness and pain are important, but reflex testing, strength grading, and any measured atrophy are what allow a rating above the wholly sensory ceiling in 38 CFR 4.124a, and they are frequently never recorded in ordinary treatment visits focused on other complaints.
How far back should my evidence go?
As far back as records exist that are relevant to the condition, particularly anything documenting the in-service event or the earliest post-service symptoms. For secondary claims, the file also needs the rating decision that granted the underlying service-connected condition, since that establishes the connection the current claim relies on.