Many veterans with a rated back condition have symptoms that travel - pain, numbness, tingling, or weakness down one or both legs. Those symptoms are not part of the spine rating. They are evaluated separately under the peripheral nerve codes, and the separate evaluations combine with the orthopedic rating.
For the spine evaluation itself, see our back pain ratings guide.
Why the ratings are separate
The General Rating Formula in 38 CFR 4.71a directs that associated objective neurologic abnormalities be evaluated separately under an appropriate diagnostic code. The orthopedic rating measures motion and ankylosis; the nerve rating measures the neurological deficit. Combining them under 38 CFR 4.25 is expressly contemplated, not pyramiding.
The sciatic nerve - Diagnostic Code 8520
Most lumbar radiculopathy is rated under the sciatic nerve code for each affected extremity:
- 10 percent - mild incomplete paralysis
- 20 percent - moderate incomplete paralysis
- 40 percent - moderately severe incomplete paralysis
- 60 percent - severe incomplete paralysis with marked muscular atrophy
- 80 percent - complete paralysis, with the foot dangling and dropping and no active movement possible below the knee
Other nerves, and the wholly sensory rule
Depending on which nerve root is involved, ratings may fall under the external popliteal (common peroneal) nerve at Diagnostic Code 8521, the femoral (anterior crural) nerve at 8526, or another code in the same group. Cervical radiculopathy is rated under the upper-extremity nerve codes, covered in our cervical radiculopathy guide.
38 CFR 4.124a provides that when the involvement is wholly sensory, the rating should be for the mild, or at most the moderate, degree. That single sentence explains a great many 10 percent radiculopathy evaluations: numbness and tingling without weakness or atrophy is, by regulation, mild.
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 spine condition and your service or an already service-connected disability.
Both legs are rated separately
Radiculopathy affecting each lower extremity is evaluated separately, one rating per side. Where both are involved, the bilateral factor in 38 CFR 4.26 may apply when the combined evaluation is calculated. Our VA disability calculator applies that step.
What the record must document
Symptom reports alone rarely produce a separate nerve rating. Raters look for objective findings:
- A diagnosis of radiculopathy identifying the nerve root or distribution
- Reflex, sensory, and strength testing results
- Straight leg raise or equivalent provocative testing
- Electromyography or nerve conduction study results where performed
- Imaging showing nerve root compression or foraminal narrowing
Bowel, bladder, and other associated findings
The regulation's instruction to evaluate associated objective neurologic abnormalities separately is not limited to the extremities. Bowel or bladder impairment associated with a service-connected spine condition may also warrant a separate evaluation under the applicable code, and those findings should be documented specifically rather than described as part of the back condition.
When neurological findings exist but were never connected to the spine disability in an opinion, a paid medical records review is where veterans typically start. See also our evidence guide.