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Charcot-Marie-Tooth Disease
✓ VERIFIED AGAINST 38 C.F.R.§ 4.124a (Neurological conditions and convulsive disorders) · reviewed 2026-05-15 · ClaimRecon Editorial Team
Charcot-Marie-Tooth Disease is rated by the U.S. Department of Veterans Affairs under DC 8520 of 38 CFR § 4.124a, DC 8520 across 5 severity tiers (10% / 20% / 40% / 60% / 80%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Hereditary motor and sensory neuropathy causing progressive muscle weakness and atrophy, primarily in the feet, legs, hands, and arms.
RATING CRITERIA (5 LEVELS)
10%
Mild incomplete paralysis — early-stage CMT with foot deformity (pes cavus / hammer toes) without significant motor weakness; intermittent paresthesia.
20%
Moderate incomplete paralysis — daily symptoms, mild ankle dorsiflexion weakness, absent ankle reflex, hand involvement (intrinsic wasting beginning).
40%
Moderately severe incomplete paralysis — constant symptoms, marked dorsiflexion weakness, foot drop with AFO use, hand intrinsic wasting (claw-hand deformity).
60%
Severe incomplete paralysis with marked muscular atrophy — "inverted-champagne-bottle" leg appearance (distal atrophy with preserved proximal bulk), bilateral foot drop, severe hand intrinsic loss, requires AFOs bilaterally and may use wheelchair for distance.
80%
Complete paralysis — total sciatic-distribution motor loss approaching wheelchair dependence; rare even in late-stage CMT but represented at this tier per the DC 8520 schedule.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria text quoted verbatim from 38 C.F.R. § 4.124a (Neurological conditions and convulsive disorders). Source verified 2026-05-15 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026