A Veteran has severe incomplete paralysis of the common peroneal nerve under and moderate incomplete paralysis of the tibial nerve under . In this case, a single 30-percent evaluation is assigned under . Both of these nerves are part of the same sciatic branch, and Analysis: therefore the functions associated with these nerves are not separate and distinct. The 30-percent evaluation shall be assigned under DC 8521 since it represents the predominant disability. The amputation rule under is applied in evaluating peripheral Note: not nerves of the lower extremity as long as separate evaluations are warranted, as described above. For more information References: separate evaluations and pyramiding, see M21-1, Part III, Subpart iv, 6.C.5.d, and nerve branches of the lower extremities, see M21-1, Part III, Subpart iv, 4.G.4.c e. Determining When evaluating peripheral nerve disabilities of the upper or lower Individual extremities, the rating activity must conduct a thorough review of the medical Nerves Affected evidence of record to determine the individual nerve(s) affected. in the Upper and Lower VA examiners are required, to the extent possible, to select the individual Extremities nerves affected when completing DBQs. However, the examiner may not When necessarily conduct a review of all previous clinical records or perform Evaluating comprehensive tests to pinpoint the exact nerve and/or symptoms attributable Disabilities to that nerve. Important: It is the responsibility of the rating activity, in accordance with , to interpret the DBQ along with the whole recorded history, and accurately identify and assess the current level of peripheral nerve disability. This includes identifying the appropriate nerve from a review of the evidence so that the appropriate evaluation can be assigned. Include the following language in all Peripheral Nerves DBQ requests: Examiner: Please identify the specific affected. If you are unable to identify the specific nerve(s), please provide a rationale in the Remarks section. Thank you. Follow the guidance in the table below when reviewing medical evidence pertaining to peripheral nerve disabilities of the upper or lower extremities. If the DBQ or equivalent… And… Then… indicates the specific nerve there is no conflicting evaluate the specific nerve affected information under the appropriate DC. indicates the specific there is conflicting information evaluate the nerve that is affected on what nerve is affected, but most beneficial to the
A Veteran has severe incomplete paralysis of the common peroneal nerve under and moderate incomplete paralysis of the tibial nerve under . In this case, a single 30-percent evaluation is assigned under . Analysis: Both of these nerves are part of the same sciatic branch, and therefore the functions associated with these nerves are not separate and distinct. The 30-percent evaluation shall be assigned under DC 8521 since it represents the predominant disability. Note: The amputation rule under is not applied in evaluating peripheral nerves of the lower extremity as long as separate evaluations are warranted, as described above. References: For more information separate evaluations and pyramiding, see M21-1, Part III, Subpart iv, 6.C.5.d, and nerve branches of the lower extremities, see M21-1, Part III, Subpart iv, 4.G.4.c e. Determining Individual Nerves Affected in the Upper and Lower Extremities When Evaluating Disabilities When evaluating peripheral nerve disabilities of the upper or lower extremities, the rating activity must conduct a thorough review of the medical evidence of record to determine the individual nerve(s) affected. VA examiners are required, to the extent possible, to select the individual nerves affected when completing DBQs. However, the examiner may not necessarily conduct a review of all previous clinical records or perform comprehensive tests to pinpoint the exact nerve and/or symptoms attributable to that nerve. Important: It is the responsibility of the rating activity, in accordance with , to interpret the DBQ along with the whole recorded history, and accurately identify and assess the current level of peripheral nerve disability. This includes identifying the appropriate nerve from a review of the evidence so that the appropriate evaluation can be assigned. Include the following language in all Peripheral Nerves DBQ requests: Examiner: Please identify the specific affected. If you are unable to identify the specific nerve(s), please provide a rationale in the Remarks section. Thank you. Follow the guidance in the table below when reviewing medical evidence pertaining to peripheral nerve disabilities of the upper or lower extremities. If the DBQ or equivalent… And… Then… indicates the specific nerve affected there is no conflicting information evaluate the specific nerve under the appropriate DC. indicates the specific affected there is conflicting information on what nerve is affected, but evaluate the nerve that is most beneficial to the
01-12-2016_Key%20Changes_M21-1III_iv_4_SecG.docx