If you’ve filed a VA disability claim for Restless Leg Syndrome (RLS), chances are you’ll be scheduled for an in-person Compensation and Pension (C&P) exam with a third-party medical provider contracted by the VA.
This exam is one of the most important moments in the entire VA claim process. The examiner’s findings often carry more weight than years of treatment records, especially when RLS is rated by analogy rather than under its own diagnostic code.
“Restless Leg Syndrome claims are won or lost based on symptom severity and functional loss, not just the diagnosis,” said Brian Reese, VA disability expert.
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Understanding what to expect and how to prepare can make a measurable difference in how accurately your condition is rated.
How the VA Rates Restless Leg Syndrome?
There is no standalone diagnostic code for Restless Leg Syndrome under 38 CFR § 4.124a. Instead, the VA rates RLS by analogy under Diagnostic Code (DC) 8620, which covers neuritis of the sciatic nerve.
VA ratings for RLS range from 10% to 80%, depending on whether paralysis is incomplete or complete and how severe the functional loss is.
VA Rating Criteria for Restless Leg Syndrome
| VA Rating | Severity Level | Description |
|---|---|---|
| 10% | Mild | Sensory symptoms with minimal functional loss |
| 20% | Moderate | Persistent symptoms affecting daily function |
| 40% | Moderately Severe | Significant disruption to sleep and mobility |
| 60% | Severe | Major functional impairment |
| 80% | Complete Paralysis | Foot drop, no active movement below the knee |
“Most veterans fall between 20% and 60%, depending on how badly RLS interferes with sleep, work, and mobility,” Reese explained.
Purpose of a VA C&P Exam for Restless Leg Syndrome
An in-person RLS C&P exam focuses on three core elements:
1. Diagnosis Confirmation
The examiner determines whether your RLS diagnosis conforms to accepted medical standards.
2. Nexus for Service Connection
The examiner provides a medical opinion on whether your RLS was:
- Caused by service
- Aggravated by service
- Secondary to another service-connected condition (such as sleep apnea, PTSD, or neuropathy)
3. Symptom Severity and Functional Impact
This is where most ratings are decided.
“Frequency, severity, and duration plus real-world impact are what VA raters care about most,” said Reese.
What to Expect at Your RLS C&P Exam?
1. Review of Medical History
The examiner reviews your VA and private medical records, including:
- Neurology notes
- Sleep studies
- Medication history
- Prior diagnoses
You are not required to bring records, but having copies can help clarify gaps.
2. History and Symptom Onset
You’ll be asked when symptoms started and whether service factors played a role, such as:
- Irregular sleep schedules
- Stress and deployments
- Physical overexertion
“RLS often develops or worsens during service because of chronic sleep disruption,” Reese explained.
3. Discussion of RLS Symptoms
Expect detailed questions about:
- Urge to move legs
- Tingling or crawling sensations
- Worsening symptoms at rest or night
- Relief with movement
Your rating depends on how often symptoms occur and how disruptive they are.
4. Impact on Work, Life, and Social Functioning
This section is critical.
You may be asked how RLS affects:
- Sleep quality
- Concentration at work
- Ability to sit still
- Social activities
“Veterans who clearly explain how RLS destroys their sleep often receive higher ratings,” Reese said.
5. Physical Examination
The examiner may assess:
- Leg movement
- Muscle strength
- Reflexes
- Sensory responses
Even though RLS is neurological, physical findings still matter.
6. Completion of the DBQ
All findings are documented on the Peripheral Nerve Conditions DBQ, which is sent to the VA rater.
“If it’s not written on the DBQ, the VA can’t legally consider it,” Reese emphasized.
Common Questions Asked During an RLS C&P Exam
You may be asked about:
- Diagnosis and ICD code
- Symptom frequency and severity
- Sleep disruption
- Muscle strength (0–5 scale)
- Sensory changes
- Reflex testing
- Gait abnormalities
- Assistive device use
- Functional impairment at work
Answer honestly and consistently.
How to Prepare for Your RLS C&P Exam?
1. Gather Medical Records
Review neurology notes, sleep studies, and medications so you understand your condition clearly.
2. Keep a Symptom Diary
Track:
- Nightly symptoms
- Sleep interruptions
- Daytime fatigue
- Flare-ups
“A symptom log prevents veterans from underreporting on exam day,” Reese explained.
3. List Functional Limitations
Examples include:
- Trouble sitting through meetings
- Reduced productivity
- Chronic exhaustion
- Emotional distress
4. Review the Peripheral Nerve DBQ
Knowing what examiners must document helps you stay focused.
5. Be Honest and Detailed
Do not minimize symptoms.
“This is not the time to tough it out,” Reese said. “The VA can only rate what you explain.”
Examples of RLS Impacts
Work Impacts
- Reduced concentration
- Increased absenteeism
- Limited job options
Life Impacts
- Social withdrawal
- Anxiety and depression
- Chronic sleep deprivation
Functional Impacts
- Inability to remain still
- Weakness and fatigue
- Reduced endurance
What Happens After the Exam?
After the exam:
- DBQ is submitted
- VA rater reviews evidence
- Claim is approved, denied, or deferred
- Decision letter explains why
FAQs
Is a C&P exam required for RLS claims?
Yes, especially for initial or increased-rating claims.
Can RLS be rated as secondary?
Yes. Common secondary links include sleep apnea and PTSD.
What rating do most veterans receive for RLS?
Most fall between 20% and 60%, depending on severity.
Should I bring records to the exam?
Optional, but helpful if clarification is needed.
What matters most for my rating?
Functional impact on sleep, work, and daily life.
