Neurological Conditions and Convulsive Disorders§ 4.124aUpdated
Rating criteria

VA Diagnostic Code 8515Paralysis of:

Rated from 10% to 70% under § 4.124a. Here is what the VA requires at each level.

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What each rating requires

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  1. 70%60% non-dominant

    Complete; the hand inclined to the ulnar side, the index and middle fingers more extended than normally, considerable atrophy of the muscles of the thenar eminence, the thumb in the plane of the hand (ape 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 the thumb, at right angles to palm; flexion of wrist weakened; pain with trophic disturbances

  2. 50%40% non-dominant

    Incomplete: Severe

  3. 30%20% non-dominant

    Incomplete: Moderate

  4. 10%10% non-dominant

    Incomplete: Mild

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note: Combined nerve injuries should be rated by reference to the major involvement, or if sufficient in extent, consider radicular group ratings.

Paralysis of the Median Nerve (VA Diagnostic Code 8515)

Understanding VA disability ratings for median nerve paralysis under 38 CFR § 4.124a

What This Condition Is

Diagnostic Code 8515 falls under the VA's category of Neurological Conditions and Convulsive Disorders and addresses paralysis affecting the median nerve. Because it is a nerve condition, the VA evaluates how the paralysis affects the hand, fingers, thumb, and wrist — and whether the impairment is complete or incomplete.

An important part of this rating is that the VA distinguishes between your dominant (major) and non-dominant (minor) extremity. The same level of impairment is rated at a different percentage depending on which arm is affected.

Available Rating Levels

The VA assigns ratings along a ladder based on the severity of the paralysis. Each level lists the rating for the dominant (major) extremity first, followed by the rating for the non-dominant (minor) extremity.

70% (Dominant) / 60% (Non-Dominant) — Complete Paralysis

Assigned when paralysis is complete, with signs that may include:

  • The hand inclined to the ulnar side, with the index and middle fingers more extended than normal
  • Considerable atrophy of the muscles of the thenar eminence, with the thumb in the plane of the hand (referred to as "ape hand")
  • Incomplete and defective pronation
  • Absence of flexion of the index finger and feeble flexion of the middle finger — the person cannot make a fist, and the index and middle fingers remain extended
  • Inability to flex the distal phalanx of the thumb
  • Defective opposition and abduction of the thumb, held at right angles to the palm
  • Weakened flexion of the wrist
  • Pain with trophic disturbances

50% (Dominant) / 40% (Non-Dominant) — Incomplete: Severe

Assigned for severe incomplete paralysis.

30% (Dominant) / 20% (Non-Dominant) — Incomplete: Moderate

Assigned for moderate incomplete paralysis.

10% (Dominant) / 10% (Non-Dominant) — Incomplete: Mild

Assigned for mild incomplete paralysis. At this level, the rating is 10% for both the dominant and non-dominant extremity.

What the VA Looks For

When rating this condition, the VA considers:

  • Whether the paralysis is complete or incomplete. Complete paralysis is rated at the highest level, while incomplete paralysis is graded as mild, moderate, or severe.
  • Which extremity is affected. Ratings differ for the dominant (major) versus the non-dominant (minor) side.
  • The specific physical signs of median nerve involvement, such as atrophy of the thenar muscles, the position and function of the thumb and fingers, the ability to make a fist, wrist flexion, and the presence of pain or trophic disturbances.

Note: Combined nerve injuries should be rated by reference to the major involvement, or — if sufficient in extent — the VA may consider radicular group ratings.


This information is drawn from the VA rating schedule at 38 CFR § 4.124a for Diagnostic Code 8515. It is provided for general educational purposes to explain how this condition is described in the rating schedule.

These criteria are a rendering of § 4.124a, diagnostic code 8515. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 8515 and attach the evidence for the level you are asking for. Other Neurological Conditions and Convulsive Disorders codes may cover your secondary conditions.

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