PARALYSIS OF THE SCIATIC NERVE

M. C. GRAHAM · 2026 · Case ID: A26040167

GRANTED

Summary

The veteran, who served in the U.S. Navy from June 2009 to July 2010, appeals the denial of higher initial disability ratings for bilateral lower extremity radiculopathy, sciatic nerve. The veteran sought 20 percent ratings for each leg, arguing that separate ratings under Diagnostic Codes 8520, 8620 (neuritis), and 8720 (neuralgia) were warranted. The Board reviewed the evidence, including a December 2024 VA examination and treatment records from April and November 2024. The VA examiner found moderate incomplete paralysis in each leg, characterized by decreased sensation, moderate intermittent pain, paresthesias, and numbness, but normal reflexes, strength, and no muscle atrophy. The Board found this evidence, after resolving reasonable doubt in the veteran's favor, most closely approximated moderate incomplete paralysis, warranting 20 percent ratings for each leg under Diagnostic Code 8520. The Board determined that higher ratings or separate ratings for neuritis or neuralgia were not warranted, as the existing ratings encompassed the symptoms and separate ratings would constitute impermissible pyramiding. The Board accorded greater weight to the VA examiner's findings over the veteran's subjective complaints. The Board also noted that the veteran's claims for TDIU were pending at the AOJ and deferred adjudication of that issue. Ultimately, the Board granted 20 percent ratings for each lower extremity radiculopathy, sciatic nerve, finding that the evidence persuasively weighed against higher ratings.

Rationale

Resolved reasonable doubt in veteran's favor; Symptoms approximated moderate incomplete paralysis; No muscle atrophy or normal reflexes/strength

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

8520

Docket No.

251013-597242

Full Decision Text

Citation Nr: A26040167
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 251013-597242
DATE: April 29, 2026

ORDER

Entitlement to an initial rating of 20 percent, but no higher, for right lower extremity radiculopathy, sciatic nerve, is granted, subject to the law and regulations governing the payment of monetary benefits.

Entitlement to an initial rating of 20 percent, but no higher, for left lower extremity radiculopathy, sciatic nerve, is granted, subject to the law and regulations governing the payment of monetary benefits.

FINDINGS OF FACT

1. Throughout the initial appeal period, resolving reasonable doubt in the Veteran's favor, the evidence reflects the Veteran's right lower extremity radiculopathy, sciatic nerve, was manifested by moderately severe incomplete paralysis.

2. Throughout the initial appeal period, resolving reasonable doubt in the Veteran's favor, the evidence reflects the Veteran's left lower extremity radiculopathy, sciatic nerve, was manifested by moderately severe incomplete paralysis.

CONCLUSIONS OF LAW

1. The criteria for an initial rating of 20 percent, but no higher, for the right lower extremity radiculopathy, sciatic nerve, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.123, 4.124, 4.124a, Diagnostic Code 8520.

2. The criteria for an initial rating of 20 percent, but no higher, for the left lower extremity radiculopathy, sciatic nerve, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.123, 4.124, 4.124a, Diagnostic Code 8520.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from June 2009 to July 2010. The Board of Veterans' Appeals (Board) thanks the Veteran for his service to our country.

The March 26, 2025 rating decision on appeal was issued on April 2, 2025 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the March 26, 2025 agency of original jurisdiction (AOJ) decision on appeal, issued on April 2, 2025. 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 claims of entitlement to higher ratings for the right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Also, in his October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, expressed disagreement as to "1. Evaluation of left lower extremity radiculopathy, sciatic nerve" and "2. Evaluation of right lower extremity radiculopathy, sciatic nerve". While the Veteran's October 2025 VA Form 10182 did request higher initial ratings, it did not express any disagreement with the effective dates assigned for right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. Accordingly, this appeal is limited to claims for entitlement to higher initial ratings for the Veteran's right lower extremity radiculopathy, sciatic nerve, and his left lower extremity radiculopathy, sciatic nerve
his attorney representative, expressed disagreement as to "1. Evaluation of left lower extremity radiculopathy, sciatic nerve" and "2. Evaluation of right lower extremity radiculopathy, sciatic nerve". While the Veteran's October 2025 VA Form 10182 did request higher initial ratings, it did not express any disagreement with the effective dates assigned for right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. Accordingly, this appeal is limited to claims for entitlement to higher initial ratings for the Veteran's right lower extremity radiculopathy, sciatic nerve, and his left lower extremity radiculopathy, sciatic nerve.

Additionally, the Board notes that it is cognizant of the decision issued by the United States Court of Appeals for Veterans Claims (Court) in the case of Williams v. McDonough, 37 Vet. App. 305 (2024). There, the Court held, in essence, that the Board must refrain from deciding a case until the case proceeds to the point where a docket switch is no longer permitted under the terms of 38 C.F.R. § 20.202(c)(2). However, in the present case, on his October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, stated "Williams waiver - The veteran does not intend to change lanes and waives the right to do so" and requested the Board "do not delay in rendering a decision until the time period to change lanes has expired." Accordingly, as any remaining Williams period has been waived, the Board may proceed to adjudication.

As a final preliminary matter, as to the issue of entitlement to a total rating for compensation purposes based on individual unemployability (TDIU), the Board recognizes the March 26, 2025 rating decision on appeal, issued on April 2, 2025, also deferred adjudication of a claim for a TDIU. Thereafter, an August 21, 2025 rating decision, issued on August 22, 2025, denied entitlement to a TDIU, and in September 2025, the Veteran, thorough his attorney representative, submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, in response. A September 30, 2025 rating decision, issued on October 2, 2025, continued the denial of entitlement to a TDIU, and in December 2025, the Veteran, thorough his attorney representative, submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), which currently remains pending at the AOJ. Further, to the extent the Veteran is claiming entitlement to a TDIU pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009) based on his right lower extremity radiculopathy, sciatic nerve, and/or left lower extremity radiculopathy, sciatic nerve, the Board finds it is more favorable for the Veteran's TDIU claim to be addressed by the AOJ based on his pending VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), because this allows for a longer evidence window (as of the September 30, 2025 rating decision, issued on October 2, 2025) and the Board will not address a TDIU claim in this decision.

1. Entitlement to an initial rating in excess of 10 percent rating for the right lower extremity radiculopathy, sciatic nerve

2. Entitlement to an initial rating in excess of 10 percent rating for the left lower extremity radiculopathy, sciatic nerve

The Veteran seeks higher initial ratings for his right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. In a November 2024 application for disability benefits to the Social Security Administration, the Veteran reported lower and middle back pain and also that he sometimes felt pain in his glutes, hips or legs. During the December 2024 VA examination report, the Veteran reported, as to his lower extremities, sharp shooting pain, throbbing, aching, and a pins and needles sensation. Also, in argument attached to the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, argued for each lower extremity, 20 percent ratings were warranted under Diagnostic Code 8520, that 20 percent ratings were also warranted under Diagnostic Code 8620, and 20 percent ratings were also warranted under Diagnostic Code 8720
Veteran reported lower and middle back pain and also that he sometimes felt pain in his glutes, hips or legs. During the December 2024 VA examination report, the Veteran reported, as to his lower extremities, sharp shooting pain, throbbing, aching, and a pins and needles sensation. Also, in argument attached to the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, argued for each lower extremity, 20 percent ratings were warranted under Diagnostic Code 8520, that 20 percent ratings were also warranted under Diagnostic Code 8620, and 20 percent ratings were also warranted under Diagnostic Code 8720.

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

VA must consider whether to "stage" the rating, meaning assign different ratings at different times during the rating period to compensate the Veteran for times when the disability may have been more severe than at others. Consideration of the appropriateness of a staged rating is required for increased rating claims, irrespective of whether it is an initial rating at issue or instead an established rating. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2008).

Under the AMA, the Board is bound by favorable findings of the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104. However, the March 26, 2025 rating decision, issued on April 2, 2025, did not provide any favorable findings as to these claims. Here, the AOJ granted service connection for disabilities of the Veteran's right sciatic nerve and left sciatic nerve and assigned evaluations of 10 percent each effective March 2, 2024. Thus, the appeal period for consideration for this claim is from March 2, 2024, the date service connection was awarded to April 2, 2025, the date the AOJ decision on appeal was issued.

The Veteran's right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve, have each been rated under Diagnostic Code 8520, for paralysis of the sciatic nerve.

Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. Neuritis and neuralgia of that group are evaluated under Diagnostic Codes 8620 and 8720, respectively. Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. §4.124a.

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.

In absence of an express definition, words are given their ordinary meaning. Prokarym v. McDonald, 27 Vet. App. 307, 310 (2015) (citing Terry v. Principi, 340 F.3d 1378, 1382-83 (Fed. Cir. 2003)). Here, the terms "mild," "moderate," "moderately severe" and "severe" under applicable diagnostic codes are not defined in the rating schedule; rather than applying a mechanical formula; however, relevant to this case are M21-1 provisions regarding evaluations of paralysis of the circumflex nerve. The Board "is required to discuss any relevant provisions contained in the M21-1 as part of its duty to provide adequate reasons or bases." Overton v. Wilkie, 30 Vet. App. 257, 264 (2018).

The M21-1 describes mild incomplete paralysis as a
.3d 1378, 1382-83 (Fed. Cir. 2003)). Here, the terms "mild," "moderate," "moderately severe" and "severe" under applicable diagnostic codes are not defined in the rating schedule; rather than applying a mechanical formula; however, relevant to this case are M21-1 provisions regarding evaluations of paralysis of the circumflex nerve. The Board "is required to discuss any relevant provisions contained in the M21-1 as part of its duty to provide adequate reasons or bases." Overton v. Wilkie, 30 Vet. App. 257, 264 (2018).

The M21-1 describes mild incomplete paralysis as a disability "limited to sensory deficits that are lower graded, less persistent, or affecting a smaller area." Part V, sbpt. iii, ch. 12, sec. A.2.c. Moderate incomplete paralysis, per the M21-1, should be "reserved for the most significant cases of sensory-only impairment," where the sensory involvement covers "a larger area in the nerve distribution." Id. M21-1 examples of a moderate disability include "motor and/or reflex impairment such as weakness or diminished or hyperactive reflexes (with or without sensory impairment) graded as medically moderate." Id. The M21-1 describes moderately severe incomplete paralysis as a disability with "[m]otor and/or reflex impairment (for example, weakness or diminished or hyperactive reflexes) at a grade reflecting a high level of limitation or disability is expected" and also notes "[a]trophy may be present" but for "marked muscular atrophy" to see the criteria for a severe evaluation under Diagnostic Code 8520. The M21-1 provides that a severe evaluation (that is, a 60% rating) is available when there is "motor and/or reflex impairment (for example atrophy, weakness, or diminished or hyperactive reflexes) at a grade reflecting a very high level of limitation or disability." Id. Accordingly, the Board will therefore apply these definitions in the instant claim.

The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type of picture 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 for the mild, or at most, the moderate degree. 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, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017).

In rating peripheral nerve disability, neuritis, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete paralysis. The maximum rating to be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate incomplete paralysis, or with sciatic nerve involvement, for moderately severe incomplete paralysis. 38 C.F.R. § 4.123. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, can receive a maximum rating of moderate incomplete paralysis, except for tic douloureux or trifacial neuralgia, which may be rated up to complete paralysis. 38 C.F.R. § 4.124.

Here, the Board finds that after resolving reasonable doubt in the Veteran's favor, the Veteran's symptoms, of each sciatic nerve, more nearly approximated moderate incomplete paralysis so as to warrant 20 percent ratings each, but no higher, under Diagnostic Code 8520. In this regard, a December 2024 VA examiner found the Veteran had as to muscle strength testing, 4 out of 5, which corresponds to active movement against some resistance, as to ankle dorsiflexion, and great toe extension, bilaterally. However, he also had as to muscle strength testing, 5 out of 5, which corresponds to normal strength, as to hip flexion, knee extension, and ankle plantar flexion, bilaterally. The December 2024 VA examiner also found the Veteran had no muscle atrophy. The December 2024 VA examiner found the Veteran's deep tendon reflexes were normal
ratings each, but no higher, under Diagnostic Code 8520. In this regard, a December 2024 VA examiner found the Veteran had as to muscle strength testing, 4 out of 5, which corresponds to active movement against some resistance, as to ankle dorsiflexion, and great toe extension, bilaterally. However, he also had as to muscle strength testing, 5 out of 5, which corresponds to normal strength, as to hip flexion, knee extension, and ankle plantar flexion, bilaterally. The December 2024 VA examiner also found the Veteran had no muscle atrophy. The December 2024 VA examiner found the Veteran's deep tendon reflexes were normal, as to his ankle and knee, bilaterally. The December 2024 VA examiner also found sensation testing for light touch was normal as the Veteran's upper anterior thigh (L2) and his thigh/knee (L3/4), and decreased as to his lower leg/ankle (L4/L5/S1), and foot/toes (L5), bilaterally. Also, notably, the December 2024 VA examiner found the Veteran had, as to each lower extremity, mild constant pain, moderate intermittent pain (usually dull), moderate paresthesias and/or dysesthesias, and moderate numbness.

Also, the Veteran's VA treatment records, dated proximate to and during the appeal period, documented complaints related to lower extremity radiculopathy. For example, an April 2024 VA treatment record documented the Veteran continued to complain of low back pain and endorsed pain that started in his back and radiated down into lateral knees. A later April 2024 VA treatment record documented the Veteran reported he did not feel like his pain had improved but he felt stronger in his legs, and re-evaluation demonstrated significant improvements in overall lower extremity strength and functional lower extremity strength via physical therapy testing, but noted he subjectively reported no improvements in pain levels. A subsequent April 2024 VA treatment record also documented the Veteran reported severe middle and lower back pain since two days prior, that he stated he was walking his dog and suddenly felt severe back pain radiating to his right upper leg. Also, a November 2024 VA treatment record documented the Veteran reported bilateral, right more than left, lumbar back pain for the last one week, and that he had "[n]o radiation of pain or leg weakness or paresthesia or bowel or bladder incontinence or saddle anesthesia." Also, the Board recognizes March 2024 and April 2024 VA treatment records also provided repetitive physical therapy findings as to each lower extremity; however, as such findings were not explained and as sufficient context was not provided, the Board has not discussed these findings.

Thus, after resolving reasonable doubt in the Veteran's favor, the Board finds the evidence reflects the Veteran's right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve, are each comparable to moderate incomplete paralysis throughout the initial appeal period, as each disability was manifested intermittent pain (usually dull), paresthesias and/or dysesthesias, and numbness, all graded as medically moderate. Additionally, the Veteran's right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve, were each manifested by decreased sensation as to his lower leg/ankle (L4/L5/S1), and foot/toes (L5), which approximates a larger area in the nerve distribution that either area alone.

However, moderately severe incomplete paralysis was not met or approximated for either lower extremity, as the Veteran had normal deep tendon reflexes, as to his ankle and knee, bilaterally, as he had normal strength, as to hip flexion, knee extension, and ankle plantar flexion, bilaterally, and he did not have muscle atrophy. For these reasons, the Board finds that higher initial ratings of 20 percent, but no higher, are warranted for each lower extremity under Diagnostic Code 8520.

In argument attached to the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran, through his attorney representative, argued "[p]roviding separate ratings under DCs 8520, 8620 and 8720 would not be pyramiding." Specifically, the Veteran's representative argued that separate 20 percent ratings were warranted, bilaterally, for "neuritis in the form of sensory disturbances and constant pain" and "[t]he exam also shows moderate intermittent pain, usually dull of the left and right lower extremity indicative of neuralgia." In this regard, the Board recognizes 38 C.F.R. § 4.124a does not necessarily prohibit the assignment of separate compensable ratings for paralysis, neuritis, and neuralgia. Banschbach v. McDonough, 37 Vet. App. 422 (2024). Accordingly, the Board also considered whether separate ratings or higher ratings could be assigned for neuritis, under Diagnostic Codes 8620, and neuralgia, under Diagnostic Code 8720.

However, in this case, the Veteran's ratings for each lower extremity already encompass the manifestations listed for neuralgia and neuritis and separate ratings here would constitute impermissible pyramiding. 38 C.F.R. § 4.14. Specifically, as discussed above, the Board has assigned 20 percent ratings, bilaterally, under Diagnostic Code 8520 for symptoms, including moderate intermittent pain (usually dull). Accordingly, a separate rating under Diagnostic Code 8720 for neuralgia, characterized usually by a dull and intermittent pain, of typical distribution, is not warranted as it would constitute impermissible pyramiding. Further, higher ratings are not warranted as to neuralgia, as moderate incomplete paralysis is the highest available rating for the sciatic nerve as to neuralgia, which has been assigned herein for each lower extremity. 38 C.F.R. § 4.124. Further, while the Veteran had sensory disturbances and constant pain, the Board has already assigned 20 percent ratings, bilaterally, under Diagnostic Code 8520 for such symptoms. Additionally, as the lay and medical evidence does not demonstrate the Veteran had muscle atrophy, higher or separate ratings, for either lower extremity, are not warranted for neuritis under Diagnostic Code 8620. 38 C.F.R. § 4.123.

The Board has also considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves. Indeed, the December 2024 VA examiner determined that the Veteran's bilateral lower extremity radiculopathy was of the sciatic nerve. Therefore, additional separate or higher ratings are not warranted. See Copeland v. McDonald, 27 Vet. App. 333, 338 (2015).

Further, while the Veteran, as a layperson, is competent to report the symptoms he has experienced; however, he has not been shown to have the requisite knowledge or training to be deemed competent to identify a specific level of disability for right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve, according to the rating criteria. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Such competent evidence concerning the nature and extent of the Veteran's right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve has been provided by the December 2024 VA examiner's findings which directly address the criteria under which the Veteran's disabilities have been rated. The Board finds the December 2024 VA examiner's findings to be competent, objective, and probative evidence of record, and are therefore accorded greater weight than the Veteran's subjective complaints of symptomatology for his right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve.

Additionally, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record with respect to his right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. See Doucette v. Shulkin, 28 Vet. App. 366 (2017).

Thus, for the reasons and bases discussed above, the Board finds after resolving reasonable doubt in the Veteran's favor, the evidence of record reflects initial ratings of 20 percent, but no higher, are warranted for right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. However, the evidence is persuasively against initial ratings in excess of 20 percent for right lower extremity radiculopathy, sciatic nerve, and left lower extremity radiculopathy, sciatic nerve. As the evidence of record persuasively weighs against ratings separate or higher than already assigned, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (2021).

M. C. GRAHAM

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Espinoza, Counsel

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.

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