38 CFR Part 4 — 38 CFR § 4.124a
Ulnar Nerve Paralysis
dc-8516-ulnar-nerve-paralysis
Peripheral nerves
Diagnostic code
8516
Why your DC matters: DC 8516 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 8516 — Ulnar Nerve Paralysis — is listed under 38 CFR § 4.124a in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (8516) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “8516”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 8516 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 8516 in the subpart for your body system (use Find in Page if needed).
Ulnar nerve neuropathy under DC 8516 is rated for each hand separately, with dominance affecting the tier (dominant hand rates higher). The full-paralysis picture — claw hand, atrophy, anesthesia — is rare; most veterans have 'mild' or 'moderate' incomplete paralysis. The play is documenting electrodiagnostic testing (NCS/EMG) + specific functional deficits (grip weakness, sensory loss, intrinsic muscle atrophy). Diabetic peripheral neuropathy is the most common etiology — file as secondary to DM if applicable. Note: For neuritis or neuralgia variants without paralysis, see DCs 8616 and 8716 — same dominant/non-dominant tier structure but capped lower.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 60% | Complete paralysis (dominant) — 'griffin claw' deformity, atrophy of intrinsic hand muscles, loss of flexion of ring/little fingers, abduction of thumb, anesthesia of ulnar distribution. | EMG showing complete denervation; clinical exam documenting claw hand + intrinsic atrophy + sensory loss. |
| 50% | Complete paralysis (non-dominant). | Same as above on non-dominant side. |
| 40% | Severe incomplete paralysis (dominant). | EMG with severe findings; significant atrophy + sensory loss + functional impairment. |
| 30% | Severe incomplete paralysis (non-dominant) OR moderate incomplete paralysis (dominant). | EMG moderate-severe; documented strength loss. |
| 20% | Moderate incomplete paralysis (non-dominant) OR mild incomplete paralysis (dominant). | EMG mild-moderate; some sensory + motor findings. |
| 10% | Mild incomplete paralysis (non-dominant). | EMG mild abnormality; intermittent symptoms. |
What Qualifies Under DC 8516?
Ulnar nerve dysfunction documented by EMG/NCS or clinical exam
Sensory loss in ulnar distribution (medial palm, ring + little fingers), motor weakness in intrinsic hand muscles, +/- atrophy.
Tier driven by severity + dominance
DC 8516 schedule (incomplete paralysis):
- • 10% — mild non-dominant
- • 20% — mild dominant OR moderate non-dominant
- • 30% — moderate dominant OR severe non-dominant
- • 40% — severe dominant
- • 50% — complete non-dominant
- • 60% — complete dominant
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Griffin claw deformity / claw hand”
Classic ulnar paralysis sign. Ring and little fingers held in hyperextension at MCP + flexion at IP joints. Photograph the deformity for the record.
“Intrinsic muscle atrophy (hypothenar, interossei)”
Atrophy = motor denervation. Photograph the dorsum of the hand showing 'guttering' between metacarpals. Strongly supports severe/moderate tiers.
“Sensory loss in ulnar distribution (ring + little fingers + medial palm)”
Specific dermatomal sensory loss. Examiner uses monofilament; document specific anatomical area of anesthesia.
Evidence Checklist — Specific to This Condition
Electrodiagnostic testing (NCS + EMG)
CRITICALConfirms ulnar nerve involvement and severity. NCS measures conduction velocity; EMG measures denervation. Foundational evidence.
Neurology evaluation with motor + sensory documentation
CRITICALGrip strength testing, intrinsic muscle bulk, monofilament sensory mapping, deep tendon reflexes.
Photographs of hand deformity or atrophy
IMPORTANTClaw hand, hypothenar wasting, dorsal hand guttering. Photographs > narrative.
Functional impact documentation
IMPORTANTGrip strength values (dynamometer), pinch strength, fine motor task limitations.
Etiology workup
IMPORTANTDiabetes labs (A1C), B12, thyroid panel, alcohol history. Establishes primary cause for service-connection pathway.
C&P Exam Tips
Bring NCS/EMG report
Objective evidence the examiner can't ignore. Drives the mild/moderate/severe gradation.
Bring grip-strength measurements
Dynamometer values from prior visits. Objective + numerical = strong evidence.
Photograph atrophy at home in good light
Examiners often gloss over subtle atrophy. Your photos with anatomical comparison shots help.
Don't say 'It's just numbness'
If symptoms include weakness, atrophy, or functional loss, mention all of them — not just the most obvious symptom.
Common Mistakes That Cost Veterans Points
Filing as 'hand numbness' instead of ulnar neuropathy
Generic terms don't anchor to DC 8516. Use 'ulnar nerve neuropathy' or 'ulnar nerve paralysis (incomplete).'
Not specifying dominant vs. non-dominant
Tier varies. Make sure the claim specifies hand dominance and which hand is affected.
Not pursuing diabetes secondary if applicable
If you have service-connected DM, ulnar neuropathy is a clear DM secondary. File the nexus explicitly.
Tactical Plays
⚡ File EACH HAND separately + claim bilateral factor
Diabetic ulnar neuropathy is often bilateral. Each hand under DC 8516 rates separately; § 4.25 bilateral factor adds 10% of the combined value. Many veterans claim only the dominant hand and miss the bump.
⚡ Diabetic secondary = direct nexus
If service-connected for DM, ulnar neuropathy is a direct secondary via diabetic peripheral neuropathy. No nexus letter usually needed — the medical chain is well-established.
⚡ Get EMG/NCS BEFORE the C&P exam
Without electrodiagnostics, examiners default to 'mild' regardless of symptoms. Objective testing is what differentiates 10% from 40%.
Secondary Conditions to File With This One
Diabetes mellitus (primary cause)
STRONGDC 7913
If SC for DM, ulnar neuropathy is presumptive secondary via diabetic peripheral neuropathy chain. File directly.
Cubital tunnel syndrome
MODERATESpecific compression neuropathy variant; can develop after elbow surgery/trauma — establish in-service cause.
Contralateral ulnar neuropathy
MODERATEDC 8516
Diabetic / systemic causes often affect both hands. File each separately for bilateral factor.
Painful surgical scar (post-cubital release)
SITUATIONALDC 7804
If you had cubital tunnel release, the scar is separately ratable if painful.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Mild non-dominant ulnar neuropathy.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Mild dominant or moderate non-dominant.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Moderate dominant or severe non-dominant.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Severe dominant incomplete paralysis.
Bilateral 20% ulnar neuropathy (both hands)
Base rating
$795.84
TOTAL
$795.84/mo
Two 20% ulnars combine to ~36% then +3.6 bilateral factor = 40% rounded. Common in diabetic veterans.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
✍️What's 'Dominant Hand' for VA ratings?
The hand the veteran uses preferentially for writing and skilled tasks. Ratings for dominant hand are typically one tier higher than non-dominant. Document at the claim filing.
🦅What is 'Griffin Claw' Deformity?
Classic complete ulnar paralysis sign — ring and little fingers hyperextended at MCP joints, flexed at IP joints, due to intrinsic muscle loss. Photograph for the record.
📊What's the difference between 8516, 8616, and 8716?
DC 8516 = ulnar nerve paralysis (motor + sensory). DC 8616 = ulnar neuritis (mainly motor inflammation). DC 8716 = ulnar neuralgia (mainly sensory/pain). Tier structures vary; 8516 is the higher-ceiling option.
How to File Your Claim
Get NCS/EMG of bilateral ulnar nerves
Objective electrodiagnostic confirmation + severity gradation.
Get neurology evaluation with motor + sensory documentation
Grip strength, monofilament, atrophy assessment.
File 21-526EZ specifying 'ulnar nerve neuropathy (DC 8516)' for EACH hand
Specify dominant vs. non-dominant. If DM-secondary, note it explicitly.
Photograph any hand deformity or atrophy
Submit color photos with hand alongside ruler or reference object.
Stack contralateral hand + scar + DM primary if applicable
Bilateral factor applies; surgical scars from any cubital release rate separately.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Dominant vs. non-dominant matters
Ratings are tier-shifted by hand dominance. Make sure the claim specifies which hand and which is dominant.
Diabetic peripheral neuropathy is the easy nexus path
If SC for DM, ulnar neuropathy is a clean secondary via the diabetic neuropathy chain.
Bilateral diabetic neuropathy = file each hand + bilateral factor
Don't let VA collapse bilateral hands into a single rating.
Distinguish 8516 / 8616 / 8716 carefully
Paralysis (8516) vs. neuritis (8616) vs. neuralgia (8716). 8516 has the highest ceiling. File under whichever fits the clinical picture most closely.
Related Tools & Resources
Frequently Asked Questions
Is ulnar neuropathy presumptive for Agent Orange?
Early-onset peripheral neuropathy is on the Agent Orange presumptive list if it manifested within one year of last exposure and was at least 10% disabling. Late-onset peripheral neuropathy is NOT presumptive. Verify your specific timeline.
Can I get a rating for cubital tunnel syndrome?
Yes — cubital tunnel syndrome is a specific ulnar nerve compression. Rate under DC 8516. If you had release surgery, the scar rates separately under DC 7804.
What if my EMG is normal but I have symptoms?
A normal EMG is a problem for VA ratings — examiners often default to 0% or 10% without objective findings. Pursue specialty neurology consult and repeat testing during a symptomatic period.
Can ulnar neuropathy from a service-era elbow injury be SC'd?
Yes — establish in-service elbow trauma + current ulnar neuropathy + nexus opinion linking them. Direct service connection pathway.
Official Regulatory Source
Ulnar nerve disorders are rated under 38 CFR § 4.124a, DCs 8516 (paralysis), 8616 (neuritis), 8716 (neuralgia).
38 CFR § 4.124a — Neurological Conditions (eCFR) →Scroll to DC 8516.
Next Steps
If your rating decision lists DC 8516, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 8516 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.