How the VA Rates Carpal Tunnel Syndrome

The rating levels

Criteria paraphrased from 38 CFR § 4.124a, DC 8515 (paralysis of the median nerve) / 8615 (neuritis) / 8715 (neuralgia) — major (dominant) / minor (non-dominant); caps in §§ 4.123 and 4.124 for readability. Monthly amounts are the 2026 rate (effective December 1, 2025) for a veteran with no dependents if this were the only rated condition — dependents add more, and multiple conditions combine under the VA’s own math.

1. 70%

   $1,808.45/month

   Complete paralysis of the median nerve on the MAJOR hand — 70% (DC 8515 only): 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, weakened wrist flexion.

   Examples from this level’s criteria

   • 'Ape hand' deformity
   • Cannot flex index/middle fingers to make a fist
   • Marked thenar atrophy
   • Loss of thumb opposition and weakened wrist flexion
2. 60%

   $1,435.02/month

   Complete paralysis of the median nerve on the MINOR hand — 60% (DC 8515 only).

   Examples from this level’s criteria

   • 'Ape hand' deformity (non-dominant hand)
   • Loss of thumb opposition
3. 50%

   $1,132.90/month

   Severe incomplete paralysis of the median nerve on the MAJOR hand — 50% (DC 8515, or DC 8615 neuritis with organic changes — its maximum under § 4.123). Neuritis characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain may reach this level; neuralgia (8715) may not.

   Examples from this level’s criteria

   • Thenar (thumb-base) muscle atrophy
   • Cannot oppose the thumb effectively
   • Frequent dropping of objects; marked weakness
4. 40%

   $795.84/month

   Severe incomplete paralysis of the median nerve on the MINOR hand — 40% (DC 8515, or DC 8615 neuritis with organic changes, where severe incomplete is the maximum under § 4.123).

   Examples from this level’s criteria

   • Thenar (thumb-base) muscle atrophy (non-dominant hand)
   • Marked weakness; frequent dropping of objects
5. 30%

   $552.47/month

   Moderate incomplete paralysis of the median nerve on the MAJOR (dominant) hand — 30% (DC 8515, 8615, or 8715). For DC 8715 (neuralgia), 30% is the maximum (§ 4.124). For neuritis (DC 8615) not characterized by organic changes, moderate is also the maximum (§ 4.123).

   Examples from this level’s criteria

   • Significant grip/pinch weakness in the dominant hand
   • Persistent numbness with functional loss
   • Difficulty grasping and holding objects
6. 20%

   $356.66/month

   Moderate incomplete paralysis of the median nerve on the MINOR (non-dominant) hand — 20% (DC 8515, 8615, or 8715). For DC 8715 (neuralgia), 20% is the maximum on the minor hand.

   Examples from this level’s criteria

   • Constant numbness in the median distribution
   • Weak grip and pinch
   • Difficulty with fine motor tasks (buttoning, writing)
7. 10%

   $180.42/month

   Mild incomplete paralysis of the median nerve — 10% major / 10% minor (DC 8515, 8615, or 8715). When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree.

   Examples from this level’s criteria

   • Tingling/numbness in thumb, index, middle fingers
   • Night-time wrist/hand symptoms
   • Positive Tinel's or Phalen's sign
   • No significant weakness or atrophy

The listed symptoms are examples that appear in each level’s criteria — not a checklist that earns a percentage. Raters apply the criteria as a whole.