A radiculopathy (sciatica) nexus letter for your VA claim, from your nerve and spine records

What the clinician looks for in your nerve records

Radiculopathy is pain, numbness or weakness from a pinched spinal nerve root, felt along that nerve in a leg or an arm; sciatica is the common name for it in the leg. For the flat $500, the clinician reviews your records for findings that place the symptoms at a nerve root and the spine condition behind it.

• A diagnosis of radiculopathy or sciatica, naming the side and, where the records say, the nerve root level.
• Exam findings: reflexes, strength and sensation testing in the affected limb, and a straight-leg raise test for the lower back.
• Nerve conduction studies or EMG reports, when they were done.
• Spine imaging, such as an MRI showing a disc herniation or narrowing that presses on a nerve root at a matching level.
• Your description of the symptoms in your records: where the pain or numbness travels, how often, and what it stops you from doing.
• The service-connected back or neck condition, with VA's decision letter if you have it.

Common service-connection routes for radiculopathy

Secondary service connection under 38 CFR 3.310 is the usual route. Sciatica and other leg radiculopathy commonly come from the lumbar spine, and arm radiculopathy from the cervical spine. When VA has connected the back or neck, a clinician may consider whether the nerve symptoms come from that same spine condition.

Direct service connection under 38 CFR 3.303 can fit when the nerve symptoms themselves were recorded in service, for example leg pain shooting below the knee after a lifting or landing injury.

If the spine condition is not yet service connected, the back or neck usually has to be connected first, or claimed at the same time; the back and neck pages cover that opinion.

Is there a DBQ for radiculopathy?

Yes. VA's public Peripheral Nerves DBQ records nerve findings, and the back and neck DBQs also ask about radiating nerve symptoms. Commander Health completes a DBQ for a flat $200 from your existing records. The licensed clinician completes and signs it only when the records hold the strength, reflex and sensation findings the form asks for.

A nexus letter and one DBQ together are $550. VA may still order its own exam, and VA decides the rating.

What it is not

• Physical conditions only: Commander Health does not write PTSD or other mental health opinions, or secondary opinions that run through a mental health condition.
• Not an exam or an appointment. There are no calls or video visits; the clinician works from your records, and any follow-up comes by email.
• Not a filing service. Commander Health does not file claims and is not a VSO, a law firm, or a VA-accredited representative. Free help filing a claim is available from a VA-accredited Veterans Service Organization.
• Not a guarantee. Clinical review never guarantees an outcome. A clinician signs only if your records support the opinion, and VA decides the claim.

Frequently asked questions

Is sciatica a separate claim from my back?

Usually, yes. VA rates radiculopathy separately from the spine, and each affected limb separately, so it is commonly claimed secondary to the back.

Do I need an EMG?

Not always. Exam findings and imaging can support the diagnosis. A nerve study helps when the records are unclear about which nerve is involved.

My arms go numb from my neck. Is that radiculopathy too?

It can be, at the cervical level. A clinician may consider arm radiculopathy secondary to a service-connected neck condition when the records show matching findings.

My back is not service connected yet. Can I still claim sciatica?

The sciatica opinion usually depends on the back. Claim the back first or at the same time; the free screen checks both before you pay.