Small Fiber Neuropathy

DC 8620Neurological38 CFR 4.124a, DC 8620

A condition affecting the small nerve fibers that transmit pain and temperature sensations and control autonomic functions. Causes burning pain, tingling, and numbness, typically starting in the feet. Often missed on standard nerve conduction studies.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 8620

Rating range

10% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.124a, DC 8620. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Complete neuritis — your small fiber neuropathy causes severe, constant pain and widespread autonomic dysfunction rendering you unable to function normally.

What the VA looks for

Severe constant pain refractory to all treatments
Widespread autonomic dysfunction affecting multiple organ systems
Unable to walk without assistance due to pain and sensory loss
Significant impact on all activities of daily living
Pain management specialist documentation of intractable neuropathic pain

Common Pitfalls

⚠Relying on standard nerve conduction studies (NCS) alone — small fiber neuropathy typically produces normal NCS results because these tests measure large fibers. A skin punch biopsy measuring intraepidermal nerve fiber density is the diagnostic gold standard.
⚠Not documenting autonomic symptoms — small fiber neuropathy affects autonomic nerves controlling sweating, heart rate, blood pressure, and digestion. These symptoms are often overlooked but support a higher rating.
⚠Failing to establish a service-connected cause — common military-related causes include toxic exposures (burn pits, Agent Orange, solvents), diabetes, and autoimmune conditions triggered during service.
⚠Not keeping a detailed pain diary — documenting the daily frequency, intensity, and functional impact of burning pain episodes provides critical evidence for your rating.

Related DBQ Forms

DBQ Peripheral Nerves Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 8620

Rating range

10% – 60%

Rating levels

Rating Levels

Complete neuritis — your small fiber neuropathy causes severe, constant pain and widespread autonomic dysfunction rendering you unable to function normally.

What the VA looks for

Severe constant pain refractory to all treatments
Widespread autonomic dysfunction affecting multiple organ systems
Unable to walk without assistance due to pain and sensory loss
Significant impact on all activities of daily living
Pain management specialist documentation of intractable neuropathic pain

Common Pitfalls

⚠Relying on standard nerve conduction studies (NCS) alone — small fiber neuropathy typically produces normal NCS results because these tests measure large fibers. A skin punch biopsy measuring intraepidermal nerve fiber density is the diagnostic gold standard.

⚠Not documenting autonomic symptoms — small fiber neuropathy affects autonomic nerves controlling sweating, heart rate, blood pressure, and digestion. These symptoms are often overlooked but support a higher rating.

⚠Failing to establish a service-connected cause — common military-related causes include toxic exposures (burn pits, Agent Orange, solvents), diabetes, and autoimmune conditions triggered during service.

⚠Not keeping a detailed pain diary — documenting the daily frequency, intensity, and functional impact of burning pain episodes provides critical evidence for your rating.