Foot Drop VA Rating Explained

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VA disability ratings for foot drop generally range from 10% to 40%, with breaks at 20% and 30%, depending on the severity of the condition, the degree of paralysis, and how it impacts your ability to function in daily life.

While foot drop itself does not have a standalone diagnostic code, it is usually evaluated under 38 CFR § 4.124a, Diagnostic Code 8521, which pertains to the paralysis of the external popliteal (common peroneal) nerve.

The VA may also consider other diagnostic codes depending on the underlying cause of foot drop, such as Diagnostic Codes 8520 (sciatic nerve paralysis) or 8524 (internal popliteal nerve paralysis), if the condition is part of a broader neurological disorder.

If left untreated or if it leads to further complications such as frequent falls or secondary musculoskeletal issues, foot drop can significantly impact a veteran’s VA disability rating.

The VA will evaluate the condition under the most appropriate diagnostic code, considering all related symptoms and functional limitations.

Alright, let’s take a closer look at how the VA rates foot drop and related conditions for disability benefits and the key factors that can influence your final rating.

Summary of Key Points

• Foot Drop Disability Percentages Range From 10% to 40%: The VA assigns ratings based on the severity of foot drop and its impact on daily functioning, under Diagnostic Code 8521 for external popliteal nerve paralysis. Ratings increase from 10% for mild incomplete paralysis to 40% for complete paralysis, where the foot dangles and no active movement is possible below the knee.

• Evaluation Based on Nerve Involvement: Foot drop is primarily rated under Diagnostic Code 8521, but other codes may apply depending on the underlying cause, such as Diagnostic Code 8520 for sciatic nerve paralysis or Diagnostic Code 8524 for internal popliteal nerve paralysis.

• Risk Factors Specific to Veterans: Military veterans may develop foot drop due to factors such as spinal injuries, peripheral neuropathy, exposure to toxins, and traumatic brain injury (TBI). These conditions can contribute to nerve damage or exacerbate existing nerve issues, leading to foot drop.

• Establishing Service Connection for Foot Drop: Veterans must establish a direct, secondary, or aggravated service connection for foot drop to receive a VA rating. This can involve showing a link to military service or an existing service-connected disability and may require a nexus letter from a healthcare provider.

What is Foot Drop?

Foot drop is a medical condition characterized by difficulty or inability to lift the front part of the foot, leading to dragging of the toes while walking.

This condition can significantly affect a person’s gait, causing them to lift their knees higher than usual to avoid tripping, often referred to as a “steppage gait.”

Causes of Foot Drop

Foot drop is generally caused by weakness or paralysis in the muscles that lift the foot (dorsiflexors), which can result from various underlying issues, including:

• Nerve Damage: Often due to compression or injury to the peroneal nerve, which controls the muscles that lift the foot. This can be associated with conditions like radiculopathy or nerve compression from prolonged sitting or crossing legs.

• Muscle Disorders: Conditions like muscular dystrophy, which weaken or degenerate muscles over time, can cause foot drop.

• Neurological Conditions: Disorders such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), stroke, or cerebral palsy can lead to foot drop by affecting the nerves and muscles involved in foot movement.

• Spinal Issues: Herniated discs, spinal stenosis, or traumatic injuries to the spine can impact the nerves that control foot movement, resulting in foot drop.

Symptoms of Drop Foot in Veterans

Here are the primary symptoms associated with foot drop in military veterans:

• Difficulty Lifting the Front of the Foot

• High-Stepping Gait (Steppage Gait)

• Foot Slapping the Ground

• Numbness or Tingling

• Weakness in the Lower Leg

• Pain or Discomfort

• Increased Risk of Falls

• Muscle Atrophy

• Altered Walking Mechanics

• Difficulty Performing Daily Activities

Foot Drop Risk Factors in Military Veterans

Military veterans may face unique risk factors for developing foot drop due to the demanding nature of military service, including physical strain, exposure to trauma, and other related conditions.

Here are some key risk factors specific to veterans:

1. Spinal and Nerve Injuries

Veterans are at higher risk of spinal and nerve injuries due to the physically demanding and sometimes hazardous conditions of military service. These injuries can result from direct trauma, such as falls, explosions, or vehicle accidents. Damage to the lumbar or sacral spine can compress or damage nerves that control foot movement, leading to foot drop. Chronic conditions like degenerative disc disease, common among veterans, can also contribute to nerve compression and foot drop.

2. Peripheral Neuropathy

Peripheral neuropathy, a condition where the peripheral nerves are damaged, is common in veterans, especially those exposed to Agent Orange or other toxic substances during service. This nerve damage can lead to foot drop, as the peroneal nerve, responsible for lifting the foot, is often affected.

3. Exposure to Toxins

Veterans exposed to environmental toxins such as Agent Orange, burn pits, and other hazardous chemicals may develop neurological disorders that increase the risk of foot drop. These toxins can cause nerve damage or exacerbate conditions like peripheral neuropathy, contributing to foot drop.

4. Traumatic Brain Injury (TBI)

TBI, common among veterans due to blasts and other combat-related incidents, can impact the brain’s ability to communicate with the nerves and muscles controlling the foot. Damage to specific areas of the brain that control motor function can result in weakness or paralysis, contributing to foot drop.

5. Chronic Conditions and Comorbidities

Many veterans suffer from chronic conditions such as diabetes and multiple sclerosis, which can contribute to nerve damage and the development of foot drop. These conditions can be exacerbated by the physical and emotional stress of military service, making veterans more susceptible to complications like foot drop.

6. Prolonged Immobility or Physical Stress

Military service often requires prolonged periods of immobility (e.g., long deployments with limited movement) or intense physical exertion, both of which can contribute to conditions like lumbar radiculopathy or compartment syndrome, increasing the risk of foot drop. Prolonged immobility can lead to nerve compression, while overuse can result in muscle and nerve injuries.

7. Post-Surgical Complications

Veterans who have undergone surgeries for back, hip, or knee injuries may develop foot drop as a postoperative complication. Surgical procedures can sometimes result in inadvertent nerve damage, particularly to the sciatic or peroneal nerves, leading to foot drop.

8. Combat-Related Injuries

Combat-related injuries, such as shrapnel wounds or blast injuries, can directly damage the nerves or muscles involved in foot movement. Even minor injuries to the legs or back during service can lead to complications like foot drop over time.

What are the VA Ratings for Foot Drop?

The VA rates foot drop, also called “drop foot,” primarily under Diagnostic Code 8521 for paralysis of the external popliteal (common peroneal) nerve in 38 CFR § 4.124a from 10% to 40% with breaks at 20% and 30% depending on the severity of symptoms and how those symptoms negatively impact your work, life, social functioning, and any functional impact or loss.

The rating depends on the severity of paralysis and its impact on the veteran’s functionality:

Diagnostic Code 8521 – External Popliteal (Common Peroneal) Nerve Paralysis:

• 10% VA Rating: Foot drop with mild incomplete paralysis. This rating is given when there is minimal loss of strength or sensory disturbance in the lower leg or foot, and the overall impact on movement is minor.

• 20% VA Rating: Foot drop with moderate incomplete paralysis. This level indicates more noticeable impairment, such as significant weakness, numbness, or partial loss of function in the affected foot. The veteran may have some difficulty lifting the foot but retains partial movement.

• 30% VA Rating: Foot drop with severe incomplete paralysis. This rating reflects severe loss of function, where there is considerable difficulty in moving the foot, and the veteran is unable to perform tasks such as lifting the foot or dorsiflexion of the ankle. The condition significantly impairs mobility and daily activities.

• 40% VA Rating: Foot drop with complete paralysis. This is the highest rating under this diagnostic code and is given when there is total paralysis of the peroneal nerve. The foot dangles and drops, and no active movement is possible below the knee. The veteran may require assistive devices like a brace or orthotic support to prevent tripping or falling.

Other Potential Diagnostic Codes for Foot Drop

Depending on the underlying cause and associated conditions, foot drop may also be evaluated under other diagnostic codes in 38 CFR § 4.124a:

• Diagnostic Code 8520 – Sciatic Nerve Paralysis: Used when foot drop is caused by severe radiculopathy or nerve compression in the spine. Ratings range from 10% for mild incomplete paralysis to 80% for complete paralysis, where the foot and leg are entirely paralyzed.

• Diagnostic Code 8524 – Internal Popliteal (Tibial) Nerve Paralysis: Applicable when the tibial nerve is affected, which can also cause foot drop. Ratings range from 10% to 40%, similar to the external popliteal nerve criteria.

• Diagnostic Code 8525 – Posterior Tibial Nerve Paralysis: Used for cases where the posterior tibial nerve is involved, affecting foot movement and stability. Ratings also range from 10% to 30%, based on the severity of paralysis.

Establishing Service Connection for Foot Drop

To receive a VA disability rating for foot drop, a veteran must establish a service connection, either as a primary condition or as a secondary condition linked to an existing service-connected disability.

Here’s how it works:

• Direct Service Connection: This applies if foot drop is directly related to an injury or event that occurred during military service, such as a combat injury or traumatic brain injury (TBI) that affected the nerves controlling foot movement.

• Secondary Service Connection: Foot drop may develop as a secondary condition to other service-connected disabilities, such as lumbar radiculopathy, peripheral neuropathy, or complications from spinal surgery. In these cases, a nexus letter from a medical professional can help establish the link between the primary disability and foot drop.

• Service Connection Via Aggravation: If a pre-existing condition, such as a mild nerve injury, worsens due to service-related activities or injuries, the veteran may qualify for an increased rating based on the aggravation of the condition. This also applies to primary disabilities that “aggravate” a non-service connected secondary condition.

How to Maximize Your VA Rating for Foot Drop

To ensure you receive the highest possible rating for foot drop:

• Document All Symptoms: Include detailed descriptions of how foot drop affects your daily activities, mobility, and quality of life. The more severe your symptoms, the higher the VA rating you’ll receive for foot drop.

• Obtain a Nexus Letter: If you’ve been out of the military for more than 12-months (and aren’t already service connected) or if your foot drop is a secondary condition, a strong nexus letter from a qualified healthcare provider can establish the connection to your primary service-connected disability.

• Consider Filing Claims for Secondary Conditions: If you develop additional issues like chronic back pain or hip problems due to foot drop, file separate claims for these conditions to potentially increase your combined disability rating.

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