The median nerve, and the three codes that describe it

DC 8515 rates median nerve impairment. Two neighbors describe the same nerve differently: 8615 is median neuritis and 8715 is median neuralgia.

They are alternative characterizations of one nerve's impairment, not three ratings for the same numbness.

The levels

"Major" means your dominant hand, and it is decided by evidence

§4.69: handedness "will be determined by the evidence of record, or by testing on VA examination. Only one hand shall be considered dominant." Right is not automatically major.

For an ambidextrous person the rule is unusual and favorable: "The injured hand, or the most severely injured hand, of an ambidextrous individual will be considered the dominant hand for rating purposes."

At every level except mild, the dominant hand is worth ten more points. Which hand is yours is a documentable fact, and it is worth checking that the record got it right.

Complete versus incomplete

Complete paralysis under 8515 describes a specific and extensive picture — hand and finger posture, considerable thenar atrophy, impaired pronation, an inability to make a fist with the index and middle fingers remaining extended, thumb flexion and opposition defects, weakened wrist flexion, pain with trophic disturbances. Read the code text before concluding complete paralysis is present.

Incomplete paralysis means function lost or impaired to a degree substantially less than that. It does not mean the nerve is fine. Most real median nerve claims are rated somewhere on the incomplete scale.

If the involvement is wholly sensory, the introductory note to §4.124a says the rating "should be for the mild, or at most, the moderate degree." Numbness and tingling without motor findings is capped there.

The schedule gives no numerical definition of mild, moderate or severe. That is deliberate, and it means the argument is made with findings — sensory testing, motor strength, reflexes, atrophy, grip, dexterity, and what you can no longer do — compared against the degree assigned.

Neuritis and neuralgia have caps

• §4.123 — neuritis. Characterized by loss of reflexes, muscle atrophy, sensory disturbances and constant pain. With those organic changes, the maximum equals severe incomplete paralysis. Without them, the maximum is moderate.
• §4.124 — neuralgia. Capped at moderate incomplete paralysis.

So which of the three codes is used is not cosmetic — it sets a ceiling.

Both arms

§4.124a directs unilateral evaluations for each side, with the bilateral factor applied when it qualifies. Its note on combined nerve injuries calls for rating by the major nerve involved, or considering a radicular group rating if the involvement is extensive enough.

What to get documented

The diagnosed nerve and which side. Which hand is dominant, and on what evidence. Sensory findings and motor findings separately, because the wholly-sensory cap turns on exactly that. Reflexes, atrophy, grip and dexterity. And whether overlapping nerve diagnoses were counted once or more than once — see pyramiding.

Reviewed October 6, 2026