Carpal Tunnel
Carpal Tunnel is a VA-ratable condition under diagnostic code 8515 in the Upper Extremity Nerves category. Maximum rating: 70%.
Rating Criteria
| Rating | Criteria |
|---|---|
| 70% | Complete paralysis (major extremity): Hand inclined to ulnar side, index and middle fingers more extended than normal, considerable thenar eminence atrophy, thumb in plane of hand; pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist (index and middle fingers remain extended); cannot flex distal phalanx of thumb, defective opposition and abduction of thumb at right angles to palm; flexion of wrist weakened; pain with trophic disturbances |
| 60% | Complete paralysis (minor extremity): Hand inclined to ulnar side, index and middle fingers more extended than normal, considerable thenar eminence atrophy, thumb in plane of hand; pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist (index and middle fingers remain extended); cannot flex distal phalanx of thumb, defective opposition and abduction of thumb at right angles to palm; flexion of wrist weakened; pain with trophic disturbances |
| 50% | Severe incomplete paralysis (major extremity): Significant weakness of flexor muscles of forearm, marked thenar atrophy, severe sensory loss in median nerve distribution, significant functional impairment of thumb opposition and finger flexion |
| 40% | Severe incomplete paralysis (minor extremity): Significant weakness of flexor muscles of forearm, marked thenar atrophy, severe sensory loss in median nerve distribution, significant functional impairment of thumb opposition and finger flexion |
| 30% | Moderate incomplete paralysis (major extremity): Moderate thenar atrophy, decreased grip strength, sensory deficits in median nerve distribution (thumb, index, middle, and radial half of ring finger), impaired fine motor control |
| 20% | Moderate incomplete paralysis (minor extremity): Moderate thenar atrophy, decreased grip strength, sensory deficits in median nerve distribution (thumb, index, middle, and radial half of ring finger), impaired fine motor control |
| 10% | Mild incomplete paralysis (either extremity): Mild thenar atrophy or weakness, intermittent or mild paresthesias (numbness, tingling) in median nerve distribution, minimal functional impact, symptoms may be reproduced by Tinel's or Phalen's signs |
Important Notes
Median nerve paralysis (DC 8515) controls thumb opposition, finger flexion, and sensation in thumb/index/middle fingers. COMPLETE PARALYSIS (70%/60%) means total loss of median nerve function with visible deformities ('Hand of Benediction'), inability to make a fist, and trophic changes. INCOMPLETE PARALYSIS (50%/40%/30%/20%/10%) means partial nerve dysfunction with varying degrees of weakness, atrophy, and sensory loss—most carpal tunnel syndrome cases fall here. Rate on dominant (major) vs non-dominant (minor) extremity. Common manifestations: carpal tunnel syndrome, wrist trauma, nerve compression.
Filing Tips
Pro Tip: The VA won't connect the dots for you. That's your job. Build the paper trail before you file.
Gather medical evidence showing a current diagnosis of this condition.
Document in-service events, injuries, or exposures that caused or aggravated this condition.
Consider a nexus letter from a medical professional linking your condition to service.
Review the rating criteria for DC 8515 to understand what symptoms warrant higher ratings.
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