PARALYSIS OF SCIATIC NERVE

Summary

The Veteran, who served from June 1980 to June 2002, appeals the denial of an initial increased rating for right sciatic nerve radiculopathy beyond the 20 percent level. The Veteran asserts that the condition warrants a higher rating, specifically approximating moderate incomplete paralysis. The Board reviewed multiple VA examinations conducted between April 2011 and February 2026. While some examinations noted findings consistent with moderate incomplete paralysis, others were less specific or appeared to conflict regarding the presence and severity of radiculopathy. The Board remanded the issue multiple times to obtain clearer opinions on the severity, particularly concerning the impact of medication. A February 2026 VA examination ultimately determined the condition to be moderate incomplete paralysis, finding that the objective findings and functional history, including the Veteran's ability to ambulate and maintain employment, did not support a rating higher than moderate. The Board found this opinion highly probative and consistent with the evidence, concluding that the criteria for a rating higher than 20 percent were not met. The Veteran's lay assertion that the condition was worse than rated was not considered sufficient, as determining radiculopathy severity requires specialized medical knowledge.

Rationale

Multiple VA examinations reviewed.; February 2026 VA exam found moderate incomplete paralysis.; Objective findings and functional history supported moderate, not severe, paralysis.

Full Decision Text

Citation Nr: 26004622
Decision Date: 04/16/26	Archive Date: 04/16/26

DOCKET NO. 14-09 409
DATE: April 16, 2026

ORDER

Entitlement to an initial increased rating in excess of 20 percent for right sciatic nerve radiculopathy is denied.

FINDING OF FACT

Throughout the entire appeal period, the Veteran's right sciatic nerve radiculopathy more nearly approximated moderate incomplete paralysis of the sciatic nerve.  

CONCLUSION OF LAW

The criteria for entitlement to an initial increased rating in excess of 20 percent for right sciatic nerve radiculopathy have not been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from June 1980 to June 2002.

This matter originally came before the Board of Veterans' Appeals (Board) from a June 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).  This matter was denied in a December 2018 Board decision and was appealed to the United States Court of Appeals for Veterans Claims (CAVC), where it was set aside and remanded to the Board in September 2021.  It has since been remanded multiple times by the Board for further development, most recently in January 2026.  This matter is again before the Board and has been advanced on the docket pursuant to 38 C.F.R. § 20.902(c).

Entitlement to an initial increased rating in excess of 20 percent for right sciatic nerve radiculopathy is denied.

The Veteran asserts that entitlement to an initial increased rating in excess of 20 percent for right sciatic nerve radiculopathy is warranted.

Under 38 C.F.R. § 4.124a, Diagnostic Code 8520, a 20 percent rating is warranted for moderate incomplete paralysis of the sciatic nerve.  A 40 percent rating is warranted for moderately severe incomplete paralysis of the sciatic nerve.  A 60 percent rating is warranted for severe incomplete paralysis of the sciatic nerve with marked muscular atrophy.  An 80 percent rating is warranted for complete paralysis of the sciatic nerve, the foot dangles and drops, no active movement possible of the muscles below the knee, flexion of knee weakened or (very rarely) lost.

The words "moderate," "moderately severe," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule.  Regulations provide that ratings for peripheral neurological disorders are to be assigned based on the relative impairment of motor function, trophic changes, or sensory disturbance.  38 C.F.R. § 4.120.  Consideration is also given for loss of reflexes, pain, and muscle atrophy.  38 C.F.R. §§ 4.123, 4.124.

The Board will use dictionary definitions as a guide.  According to the Cambridge Dictionary, "moderate" is defined as "being within a middle range in size, amount, or degree; neither great nor little."  "Severe" means "causing very great pain, difficulty, worry, damage, etc.; very serious."  https://dictionary.cambridge.org/us/dictionary/english/ (last visited April 15, 2026).  "Moderately severe" includes impairment that is considered more than "moderate" but not to the extent as to be considered "severe."

The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type pictured for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration.  When the involvement is wholly sensory, the rating is mild, or at most, moderate.  The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor.  38 C.F.R. § 4.124a.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the veteran will receive the benefit of the doubt.  38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (2021).  When there is a doubt as to which of two evaluations should be assigned, the higher evaluation is used if the disability more nearly approximates the criteria required for that rating.  See 38 C.F.R. § 4.7.

An April
, the ratings combine with application of the bilateral factor.  38 C.F.R. § 4.124a.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the veteran will receive the benefit of the doubt.  38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (2021).  When there is a doubt as to which of two evaluations should be assigned, the higher evaluation is used if the disability more nearly approximates the criteria required for that rating.  See 38 C.F.R. § 4.7.

An April 2011 VA examination found normal deep tendon reflexes, normal sensory testing, and normal motion testing in the right lower extremity.  The Veteran reported that low back pain occasionally radiated down the right lower extremity.  

A September 2012 VA examination found normal muscle strength, absent deep tendon reflexes, normal sensory testing, and no radicular pain or other signs or symptoms due to radiculopathy in the right lower extremity.

An April 2018 VA examination found normal muscle strength, no muscle atrophy, hypoactive deep tendon reflexes, normal sensory testing, mild constant pain, mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness of the sciatic nerve in the right lower extremity.  It was determined that the severity of the radiculopathy was mild incomplete paralysis.

A June 2022 VA examination found normal muscle strength, no muscle atrophy, normal deep tendon reflexes, decreased sensory testing, mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness of the sciatic nerve in the right lower extremity.  The Veteran reported shooting pain that radiated to the right leg.  

A November 2022 VA examination found normal muscle strength, no muscle atrophy, normal deep tendon reflexes, normal sensory testing, and no radicular pain or any other signs or symptoms due to radiculopathy in the right lower extremity.  

A January 2024 VA examination found muscle strength at a 4/5, no muscle atrophy, normal deep tendon reflexes, and decreased sensation for the thigh/knee and lower leg/ankle.  The foot/toes were absent of sensation.  There was severe constant pain, moderate paresthesias and/or dysesthesias, and severe numbness of the sciatic nerve of the right lower extremity.  The Veteran reported sharp and burning pain radiating into the right lower extremity.

The Board notes that the January 2024 VA examination did not state what the severity of the radiculopathy was.  As such, the Board remanded the issue to obtain a VA medical opinion to address whether the findings of the January 2024 VA examination suggested a severity greater than moderate incomplete paralysis.  See January 2026 BVA Decision.

That medical opinion found that the January 2024 VA examination findings did not show a severity greater than moderate incomplete paralysis of the right lower extremity.  Specifically, the determination of severity for incomplete paralysis was based on the overall functional impairment, including motor function, sensory findings, reflexes, trophic changes, and impact on use of the extremity.  It was not based solely on the subjective descriptors of pain or numbness.  The objective findings and functional history supported moderate incomplete paralysis, rather than moderately severe or severe incomplete paralysis.  The Veteran remained employed as a salesman and was able to ambulate independently, though he reported needing to walk intermittently during the day to manage symptoms.  This demonstrated preserved functional use of the right lower extremity.  There was no documentation of muscle atrophy, significant motor weakness, foot drop, or near loss of the use of the extremity.  Severe incomplete paralysis would be expected to include marked motor impairment, muscle atrophy, or substantial functional loss approximating near loss of effective use of the extremity.  Such findings were not present.  Although the Veteran experienced severe pain and severe numbness, pain intensity alone did not equate to severe incomplete paralysis in the absence of corresponding motor deficits or significant functional impairment.  The preserved ability to ambulate and maintain employment further supported that the disability did not rise to a level greater than moderate incomplete paralysis.  Therefore, considering the predominantly sensory nature of the impairment, preserved motor function, lack of atrophy, and retained functional use of the extremity, the overall disability picture was most consistent with moderate incomplete paralysis.  See February 2026 C&P Exam.

The Board finds the VA medical opinion highly probative, as it included consideration of the relevant evidence of record and provided adequate rationale.  See Nieves-Rodriguez
 present.  Although the Veteran experienced severe pain and severe numbness, pain intensity alone did not equate to severe incomplete paralysis in the absence of corresponding motor deficits or significant functional impairment.  The preserved ability to ambulate and maintain employment further supported that the disability did not rise to a level greater than moderate incomplete paralysis.  Therefore, considering the predominantly sensory nature of the impairment, preserved motor function, lack of atrophy, and retained functional use of the extremity, the overall disability picture was most consistent with moderate incomplete paralysis.  See February 2026 C&P Exam.

The Board finds the VA medical opinion highly probative, as it included consideration of the relevant evidence of record and provided adequate rationale.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). 

April 2024 VA examinations found normal muscle strength, no muscle atrophy, hypoactive deep tendon reflexes, decreased sensation for the lower leg/ankle and foot/toes, moderate constant pain, moderate paresthesias and/or dysesthesias, and moderate numbness of the sciatic nerve of the right lower extremity.  The Veteran reported that pain radiated to the right lower extremity.  See May 2024 C&P Exam.

October 2024 VA examinations found normal muscle testing, no muscle atrophy, hypoactive reflexes, decreased sensation for the lower leg/ankle and foot/toes, no trophic changes, moderate constant pain, moderate paresthesias and/or dysesthesias, and moderate numbness of the sciatic nerve of the right lower extremity.  The Veteran reported shooting pain going down his right lower extremity.  The severity of the radiculopathy was determined to be moderate incomplete paralysis.  See January 2025 C&P Exam.

October 2025 VA examinations found muscle strength at a 4/5 for ankle plantar flexion, ankle dorsiflexion, and great toe extension; no muscle atrophy; hypoactive reflexes; decreased sensation for the lower leg/ankle and the foot/toes; no trophic changes; moderate constant pain; moderate paresthesias and/or dysesthesias; and moderate numbness of the sciatic nerve of the right lower extremity.  It was determined that the severity of the radiculopathy was moderate incomplete paralysis.  The Veteran reported sharp, throbbing, and shooting pain radiating down the right lower extremity with associated numbness and tingling.  

The Board notes that some of the above examinations did not state what the severity of the radiculopathy was, that some of the above examinations which took place close in time to each other seemed to disagree on whether radiculopathy existed, and that none of the above examinations stated what the severity of the radiculopathy would have been without the ameliorative effects of medication.  As such, the Board remanded the issue for a VA medical opinion to determine, if possible, the severity of the radiculopathy throughout the appeal period with and without the ameliorative effects of medication.  See July 2024 BVA Decision; August 2025 BVA Decision.

An October 2025 VA medical opinion found that the severity of the Veteran's radiculopathy throughout the appeal period with and without the ameliorative effects of medication could not be provided.  Because of the limitations of a reasonable medical examination for the radiculopathy with and without the ameliorative effects of medication, the examinations were the most accurate documentation of the severity possible.  Due to the limitations of a reasonable medical examination for the radiculopathy with and without the ameliorative effects of medication and with or without singular effects of one of the medications the Veteran took at a time, no medical practitioner could specifically state what the radiculopathy severity would have been with and without the ameliorative effects of medication.  The Veteran was noted at different times to have multiple treatments that included rotation of several medications or medication injections.  This meant that the Veteran was almost always on a medication that could have affected the radiculopathy.  Factors like when a medication took effect, how effective it was, and how long it lasted, differed for each medication for each person.  Additionally, a variety of different factors could affect severity, such as swelling, pinching, treatment, and/or repeated use.  It was not medically possible to determine the severity of radiculopathy with or without the ameliorative effects of medication due to pain with repeated use, status of inflammation or pinching, or the different effects of medications.  The available medical records did not note any additional medical evidence about the radiculopathy severity with or without the ameliorative effects of medication.  Radiculopathy severity could
 medication that could have affected the radiculopathy.  Factors like when a medication took effect, how effective it was, and how long it lasted, differed for each medication for each person.  Additionally, a variety of different factors could affect severity, such as swelling, pinching, treatment, and/or repeated use.  It was not medically possible to determine the severity of radiculopathy with or without the ameliorative effects of medication due to pain with repeated use, status of inflammation or pinching, or the different effects of medications.  The available medical records did not note any additional medical evidence about the radiculopathy severity with or without the ameliorative effects of medication.  Radiculopathy severity could vary from examination to examination based on flare-ups, repeated use over time, and other factors such as medication, which precluded a retrospective estimate for the severity of radiculopathy.  

The Board finds the VA medical opinion highly probative, as it included consideration of the relevant evidence of record and provided adequate rationale.  See Nieves-Rodriguez, 22 Vet. App. at 295. 

A November 2025 VA examination found muscle strength at a 4/5; no muscle atrophy; normal deep tendon reflexes; decreased sensation for the thigh/knee, lower leg/ankle, and the foot/toes; moderate intermittent pain; and mild paresthesias and/or dysesthesias of the sciatic nerve of the right lower extremity.  It was noted that the Veteran took medication.  The Veteran reported intermittent pain shooting into the right lower extremity.  

The Board notes that the November 2025 VA examination did not state what the severity of the radiculopathy was and did not state what the severity of the radiculopathy would have been without the ameliorative effects of medication.  However, based on the October 2025 VA medical opinion, it does not appear that it is possible to get a retrospective opinion to successfully obtain such information.  As such, a remand to attempt to do so is not warranted.    

A February 2026 VA examination found muscle strength at a 4/5 for knee extension, ankle plantar flexion, and ankle dorsiflexion; no muscle atrophy; hypoactive reflexes for the knee and ankle; decreased sensation; trophic changes; moderate intermittent pain; moderate paresthesias and/or dysesthesias; and moderate numbness of the sciatic nerve of the right lower extremity.  It was determined that the severity of the radiculopathy was moderate incomplete paralysis.  It was noted that the Veteran was not taking any relevant medications.  The Veteran reported increased frequency of sharp pain, numbness, and tingling in the right lower extremity.

The Board notes that the February 2026 VA examiner was instructed to report all signs, symptoms, and related impairment that would have been present without the 

relief provided by medications to treat the disability.  See January 2026 BVA Decision.  However, as the Veteran was not taking any relevant medications, there was no possible way for the examination to have done this.  As such, the Board finds that there was substantial compliance with this remand instruction.  See Stegall v. West, 11 Vet. App. 268 (1998).        

The Board finds the information provided by the above VA examinations highly probative as it was based on in-person examinations of the Veteran.  See Nieves-Rodriguez, 22 Vet. App. at 295.  The Board also finds the Veteran competent to report the above, finds the reports credible, and finds the reports greatly probative.  See Layno v. Brown, 6 Vet. App. 465 (1994). 

Finally, the Board notes the Veteran's report that the radiculopathy is worse than it is rated.  See July 2024 Appellate Brief.   However, the Veteran is not competent to report such.  Determining the severity of radiculopathy is medically complex and does not lie within the range of common experience or common knowledge but requires special experience or special medical knowledge.  See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).  As the evidence does not show that the Veteran has this medical expertise, this lay assertion cannot constitute evidence upon which to grant the claim.  

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Based on the above, the Board finds that throughout the appeal period, the Veteran's right sciatic nerve radiculopathy more nearly approximated moderate incomplete paralysis of the sciatic nerve.  Specifically,
 lie within the range of common experience or common knowledge but requires special experience or special medical knowledge.  See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).  As the evidence does not show that the Veteran has this medical expertise, this lay assertion cannot constitute evidence upon which to grant the claim.  

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Based on the above, the Board finds that throughout the appeal period, the Veteran's right sciatic nerve radiculopathy more nearly approximated moderate incomplete paralysis of the sciatic nerve.  Specifically, none of the VA examinations of record, nor any of the other competent evidence of record, shows moderately severe incomplete paralysis, severe incomplete paralysis, or complete paralysis. Therefore, entitlement to an initial increased rating in excess of 20 percent for right sciatic nerve radiculopathy is denied.

 

T. V. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Dougan, Adam T.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.