Diagnostic Code 8513 · 38 CFR §4.124a
Peripheral neuropathy of the upper extremities means the nerves in your arms and hands are damaged, causing numbness, tingling, burning pain, weakness, or loss of coordination. This is common in veterans with diabetes, toxic exposure history (Agent Orange, burn pits), or repetitive strain injuries from military duties. The VA rates upper extremity nerve damage based on which specific nerve is affected and how severe the impairment is. Higher ratings apply to your dominant hand. DC 8513 covers all the radicular groups of the upper extremity, but the VA may also rate under specific nerve codes depending on your situation.
| Rating | Criteria |
|---|---|
| 20% | Mild incomplete paralysis of the affected nerve group. You have noticeable numbness, tingling, or mild weakness but can still use your hand and arm for most tasks. This rating applies to both dominant and non-dominant sides. |
| 30% | Moderate incomplete paralysis of the non-dominant side, or mild-to-moderate on the dominant side. You have clear functional limitations — difficulty gripping objects, frequent dropping of items, or reduced fine motor control. |
| 40% | Moderate incomplete paralysis of the dominant hand, or moderately severe on the non-dominant side. Daily tasks like buttoning clothes, writing, or using tools become significantly difficult. |
| 50% | Moderately severe incomplete paralysis of the non-dominant side. You have substantial loss of grip strength and coordination with frequent pain or numbness episodes. |
| 60% | Severe incomplete paralysis of the non-dominant side, or moderately severe on the dominant side. The hand and arm have major functional deficits approaching but not reaching complete loss of use. |
| 70% | Severe incomplete paralysis of the dominant hand. You have very limited use of the affected hand and arm with significant pain, numbness, and weakness throughout. |
Nerve conduction studies (NCS) and electromyography (EMG) are the gold standard for documenting peripheral neuropathy. These tests objectively measure nerve damage severity. Medical records showing the underlying cause (diabetes, toxic exposure) and treatment history are also important. Document how the condition affects your daily life — inability to grip, dropping objects, difficulty with fine motor tasks.
Yes. If you have peripheral neuropathy in both arms, each is rated separately under its own diagnostic code. These ratings then combine using VA math, and the bilateral factor adds a small additional benefit.
Peripheral neuropathy is a presumptive condition for veterans exposed to Agent Orange, provided it manifested to a compensable degree within a certain timeframe. Check the current VA presumptive list for specifics on timing requirements.
Generally no — the VA avoids pyramiding (rating the same symptoms twice). However, if different nerves are affected (median nerve for carpal tunnel, other nerves for generalized neuropathy), separate ratings may be possible. This depends on the specific nerves involved.