PERIPHERAL NERVE DISORDERS OF THE LOWER EXTREMITY

Summary

The Veteran, who served in the Air Force from July 1969 to March 1973, appeals a rating decision concerning his bilateral lower extremity sciatic nerve peripheral neuropathy and a claim for Total Disability based on Individual Unemployability (TDIU). The Veteran sought an earlier effective date for his 100 percent rating, but the Board construed his appeal as addressing an April 2025 rating decision that denied higher ratings for his neuropathy, stemming from a January 2024 Fully Developed Claim. The Board reviewed the evidence of record as of the April 2025 decision. The Veteran was service-connected for bilateral lower extremity sciatic nerve peripheral neuropathy, with a July 2024 rating granting 20 percent. The Board considered the VA examination from May 2024, which diagnosed moderately severe incomplete paralysis, and an April 2025 VA examination that excluded diabetic neuropathy. The Board found the May 2024 examination probative and granted a 40 percent rating for both the right and left sciatic nerve peripheral neuropathy as of January 18, 2024, noting the absence of evidence for higher ratings. For the TDIU claim, the Board found it raised by the record, considering the Veteran's service-connected disabilities, including the neuropathy, which impacted his ability to work as a truck driver. Resolving doubt in the Veteran's favor, the Board granted TDIU as of January 18, 2024.

Rationale

May 2024 VA examination diagnosed moderately severe incomplete paralysis.; April 2025 VA examination excluded diabetic peripheral neuropathy, offering no probative value.; No evidence established marked muscular atrophy or complete paralysis.

Full Decision Text

Citation Nr: A26023745
Decision Date: 03/17/26	Archive Date: 03/17/26

DOCKET NO. 260105-626144
DATE: March 17, 2026

ORDER

A 40 percent rating percent for right lower extremity peripheral neuropathy of the sciatic nerve as of January 18, 2024, is granted.

A 40 percent rating percent for left lower extremity peripheral neuropathy of the sciatic nerve as of January 18, 2024, is granted.

A total disability rating based on individual unemployability due to service-connected disabilities (TDIU) as of January 18, 2024, is granted.

FINDINGS OF FACT

1. The Veteran's bilateral lower extremity peripheral neuropathy of the sciatic nerve was found to cause moderately severe incomplete paralysis.

2. The Veteran's service connected disabilities as of a January 18, 2024, prevented him from obtaining or maintaining gainful employment. 

CONCLUSIONS OF LAW

1. The criteria for a 40 percent rating for right lower extremity peripheral neuropathy of the sciatic nerve as of January 18, 2024, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8520.

2. The criteria for a 40 percent rating for left lower extremity peripheral neuropathy of the sciatic nerve as of January 18, 2024, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, DC 8520.

3. The criteria for a TDIU as of January 18, 2024, have been met. 38 C.F.R. §§ 3.340, 3.341, 4.16(a).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 1969 to March 1973. His service decorations include the Air Force Good Conduct Medal.

In the January 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

The Board notes that the Veteran sought to appeal an October 2025 rating decision which assigned higher ratings for his lower extremity peripheral neuropathy raising his total assigned disability rating to 100 percent as of February 27, 2025. The Veteran specifically stated in a statement filed in conjunction with his January 2026 NOD that he was seeking an earlier effective date for his 100 percent rating, stating that he had continually pursued his claim since filing a Fully Developed Claim (FDC) in January 2024. 

The current appeal stream, however, stems from the Veteran's application for a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) which was received by VA in February 2024 and was de facto granted (i.e. Veteran's total disability rating was raised to 100%) in an October 2025 rating decision. Thus, appeal of the October 2025 rating decision does not afford the Veteran an effective date back to his January 2024 FDC.

The Board, however, is afforded the ability to construe the Veteran's January 2026 NOD liberally. See 38 C.F.R. § 20.202.   

As such, in order to provide the relief sought by the Veteran, the Board will construe the January 2026 NOD as an appeal of an April 2025 rating decision which denied higher ratings for the Veteran's bilateral lower extremity sciatic nerve peripheral neuropathy and arises out of his originally filed January 2024 FDC.

Therefore, the Board may only consider the evidence of record at the time of the April 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Furthermore, the Veteran asserted that he was unable to work as a result of his
 cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Furthermore, the Veteran asserted that he was unable to work as a result of his sciatic nerve lower extremity peripheral neuropathy. See February 2025 TDIU application. As the Veteran's appeal for higher ratings of his lower extremity radiculopathy was still pending at the time of his TDIU application, the Board finds that entitlement to a TDIU has been raised by the record, pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009), in this current matter.

Increased Ratings

Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3.

Bilateral Lower Extremity Sciatic Nerve Peripheral Neuropathy 

As noted above, the Veteran sought service connection for his bilateral lower extremity peripheral neuropathy in January 2024. A July 2024 rating decision granted service connection and assigned a 20 percent rating as of January 18, 2024, under DC 8520.

Under DC 8520, a 10 percent evaluation is assigned for mild incomplete paralysis of the sciatic nerve of the lower extremity. 

A 20 percent evaluation is assigned for moderate incomplete paralysis of the sciatic nerve of the lower extremity. 

A 40 percent evaluation is assigned for moderately severe incomplete paralysis of the sciatic nerve of the lower extremity. 

A 60 percent evaluation is assigned for severe incomplete paralysis, with marked muscular atrophy, of the sciatic nerve of the lower extremity. 

Finally, an 80 percent evaluation is warranted for complete paralysis of the sciatic nerve of the lower extremity. 38 C.F.R. § 4.124a, DC 8520. Complete paralysis of the sciatic nerve is indicated where the foot dangles and drops, there is no active movement possible of the muscles below the knee, and flexion of the knee is weakened or (very rarely) lost. Id.

The term incomplete paralysis indicates a degree of lost or impaired function that is substantially less than that which is described in the criteria for an evaluation for complete paralysis of this nerve, whether the less than total paralysis is due to the varied level of the nerve lesion or to partial nerve regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 

The words "mild," "moderate," 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. See 38 C.F.R. §§ 4.123, 4.124.

Here, a May 2024 VA examination diagnosed the Veteran with peripheral neuropathy of the bilateral lower extremity sciatic nerves and assessed that he had moderately severe incomplete paralysis. An April 2025 VA examination of the Veteran's peripheral nerves excluded diabetic peripheral neuropathy and, as such, offers no probative value to the evaluation of the severity of the Veteran's service connected conditions. 

As such, and based on the foregoing, the Board finds that a 40 percent rating for both right and left peripheral neuropathy of the lower extremity sciatic nerve is granted. There is no evidence of record which establishes that the Veteran's sciatic nerve peripheral neuropathy caused marked muscular atrophy or complete paralysis such that higher ratings are warranted. A 40 percent rating, then, for his right and left
 Veteran with peripheral neuropathy of the bilateral lower extremity sciatic nerves and assessed that he had moderately severe incomplete paralysis. An April 2025 VA examination of the Veteran's peripheral nerves excluded diabetic peripheral neuropathy and, as such, offers no probative value to the evaluation of the severity of the Veteran's service connected conditions. 

As such, and based on the foregoing, the Board finds that a 40 percent rating for both right and left peripheral neuropathy of the lower extremity sciatic nerve is granted. There is no evidence of record which establishes that the Veteran's sciatic nerve peripheral neuropathy caused marked muscular atrophy or complete paralysis such that higher ratings are warranted. A 40 percent rating, then, for his right and left sciatic nerve peripheral neuropathy individually as of January 18, 2024, is granted.

TDIU

A TDIU may be assigned where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more, or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent or more and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a).

In determining employability for VA purposes, consideration is given to the level of education, special training, and work experience, but not to age or nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16(a), 4.19; Faust v. West, 13 Vet. App. 342 (2000). The question is whether the Veteran is capable of performing the physical and mental acts required by employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993); 38 C.F.R. §§ 4.1, 4.15, 4.16(a). When there is an approximate balance of positive and negative evidence as to any issue, all reasonable doubt will be resolved in favor of the claimant. 

As of his January 18, 2024, claim, the Veteran was service connected for right upper extremity neuropathy at a 40 percent rating, left and right lower sciatic nerve peripheral neuropathy at a 40 percent rating each, left upper extremity peripheral neuropathy at a 30 percent rating, type II diabetes mellitus (DM) at a 20 percent rating, tinnitus at a 10 percent rating, and bilateral hearing loss and hypertension at a non-compensable rate. His total combined rating as of January 18, 2024, was 90 percent. Thus, the Veteran met the schedular criteria necessary to be considered for a TDIU as of January 18, 2024.

The Veteran's prior employment was as a truck driver.  The medical evidence of record shows that the functional impact of the Veteran's upper and lower extremity peripheral neuropathy was that it was hard for him to stand or walk for long time due to numbness and tingling in both legs and feet. It was also hard to grasp items, write, type or lift anything more than 10 lbs due numbness and tingling in hands and fingertips. See May 2024 VA examination. In the April 2025 VA examination, he reported intermittent episodes of numbness starting in his feet and radiating up to the knee and bilateral feet.

In his TDIU application, the Veteran reported that he graduated from high school and had previously been a truck driver prior to ending employment in 2023. He stated that his neuropathy made it impossible to return to work as he cannot freely or safely get in or out of the trucks that he used to drive. In a March 2025 statement, the Veteran reported that his sciatic nerve paralysis had gotten so bad that he was not able to make routine trips to the hardware store and that his legs got weak and he almost fell. 

Resolving any reasonable doubt in favor of the Veteran, the Board finds that the severity of the Veteran's upper and lower extremity peripheral neuropathy was such that obtaining and/or maintaining gainful employment was prohibited by his service connected disabilities as of January 18, 2024. The Veteran's bilateral upper and lower extremity neuropathy impacted his ability to perform his job duties as a truck driver and would have impeded his ability to perform other tasks such to obtain or maintain gainful employment. As such, a TDIU as of January 18, 2024, until his 100 percent rating effective February 27, 2025, is granted.  

 

 

Ardie A. Bland

Veterans Law Judge

Board