Restless Leg Syndrome (RLS) is a condition that causes uncomfortable sensations in the legs. It can cause jittery, crawling, or aching feelings in the calf muscles and feet. Symptoms tend to get worse at night.

The VA determines ratings for RLS based on several factors. These include your symptoms, the severity of the problem, and its impact on your life.

Symptoms

Restless leg syndrome (RLS) symptoms include an uncontrollable urge to move the legs, especially at night. RLS is not dangerous, but it can interfere with sleep and impact daily life. RLS can be caused by medical conditions such as obstructive sleep apnea or spinal cord trauma, but it can also be associated with mental health disorders like PTSD.

The sensations of RLS are described as a pulling, creeping, or throbbing feeling in the legs that can range from irritating to painful. The sensations usually occur in one or both legs but can affect any body part. RLS can also cause discomfort during the daytime, but it is more noticeable at night and tends to get worse after sitting or lying down for a long time.

People with RLS may experience relief from the sensations by stretching or moving around. They can also take medication to help with their symptoms, such as a dopaminergic drug, such as pramipexole (Mirapex), ropinirole (Requip), or rotigotine (Neupro). Some people with RLS find that avoiding caffeine, alcohol, and nicotine improves their symptoms.

Medical History

RLS is a chronic condition that can cause sleep disturbances. This can affect the quality of a person’s life. The symptoms make it difficult for people to fall asleep or rest, leading to problems with mood, cognitive function, and energy levels. This can also result in frequent episodes of sleep deprivation, which are often disabling.

The assessment for a restless leg syndrome VA rating involves examining the severity of the condition’s impact on a veteran’s sleep quality and overall well-being, considering its effects on daily life and the resulting limitations it imposes.

Symptoms usually occur in both legs, are most severe when the person rests, and worsen at night. They improve with activity, such as walking or stretching, and are lessened by medication. Certain medical conditions, including pregnancy, a genetic predisposition, and iron deficiency, can cause RLS. It can also be a side effect of some medicines and treatments, such as some antidepressants, antipsychotics, and some cancer drugs.

The VA uses a rating scale and a self-administered version, sIRLS, to assess RLS symptoms. The severity of the symptoms is determined by comparing them to the average person’s response to the same questions.

Physical Examination

During the physical exam, your examiner will examine your legs, feet, and back for signs of injury or damage. They will also ask you about your symptoms and how they affect you.

The examiner will also use a template to guide their examination. For example, a template for the leg exam may include sections on your ability to walk, sit, and stand for long periods. The foot exam might include tests to check how well your feet touch the ground.

Doctors don’t know what causes most cases of restless leg syndrome. But they do know that it’s related to a problem with the brain chemical dopamine. Medications such as pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro) help some people control their RLS. Other treatments might include:

  • Reducing alcohol and tobacco use.
  • Apply heat or ice to your legs.
  • Taking an over-the-counter pain reliever such as acetaminophen.

A sedative or sleep-promoting medication might also work for some.

Tests

Like any other disability or injury the VA rates, RLS is based on symptoms and a physical exam. But no one test for this condition makes proving your eligibility difficult.

Other conditions can cause or worsen RLS. For example, some medications may make your symptoms more severe, including antidepressants, antipsychotic drugs, and some cold and allergy medicines. Other medicines may help lessen your symptoms, such as sleep aids and benzodiazepines.

Your doctor will also run blood tests, a neurological exam, and a sleep study to determine the severity of your symptoms and how they affect your day-to-day life. They will discuss your medical history, including any experiences you had during service. They will look at whether or not your RLS is tied to a service-connected health condition such as PTSD, obstructive sleep apnea, or diabetes. In these cases, you could be eligible for a secondary service connection that helps to prove your case.