Reference: 38 CFR 4.124a

Sources & Related Guides

What is the VA rating for Diseases of the Cranial Nerves?

Understand guidance under DC 8205-8412, covering 6 of the 12 cranial nerves, including trigeminal neuralgia (facial, glossopharyngeal, vagus, spinal accessory, hypoglossal), each with its own 3-tier paralysis table plus neuritis and neuralgia codes that dispatch into that same table, capped by 38 CFR 4.123 and 4.124.

Condition Overview & Clinical Scope

This range covers 6 of the 12 cranial nerves -- the trigeminal (5th), facial (7th), glossopharyngeal (9th), vagus/pneumogastric (10th), spinal accessory, external branch (11th), and hypoglossal (12th). The other 6 (I, II, III, IV, VI, VIII) are rated under the Organs of Special Sense instead, per the current text's own header note -- see the Eye Conditions and Hearing Loss guides for those. Each of the 6 covered nerves has its own 3-tier paralysis table (complete / incomplete-severe / incomplete-moderate), plus a neuritis code and a neuralgia code that carry no percentage of their own -- both dispatch into that same nerve's paralysis table, capped by the general provisions at 38 CFR 4.123 (neuritis) and 38 CFR 4.124 (neuralgia).

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Common Questions & FAQs

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Overview

About this condition

This range covers 6 of the 12 cranial nerves -- the trigeminal (5th), facial (7th), glossopharyngeal (9th), vagus/pneumogastric (10th), spinal accessory, external branch (11th), and hypoglossal (12th). The other 6 (I, II, III, IV, VI, VIII) are rated under the Organs of Special Sense instead, per the current text's own header note -- see the Eye Conditions and Hearing Loss guides for those. Each of the 6 covered nerves has its own 3-tier paralysis table (complete / incomplete-severe / incomplete-moderate), plus a neuritis code and a neuralgia code that carry no percentage of their own -- both dispatch into that same nerve's paralysis table, capped by the general provisions at 38 CFR 4.123 (neuritis) and 38 CFR 4.124 (neuralgia).

Regulatory authority: 38 CFR 4.124a, DC 8205-8412

This hub explains the published DC 8205-8412 criteria and common record language. It does not diagnose any of these conditions, infer missing severity or status documentation, determine service connection, or predict a VA decision. Bilateral involvement is disclosed only, never computed as a combined percentage: the current text states cranial nerve ratings are for unilateral involvement, and when bilateral, the two sides combine under 38 CFR 4.25 without the 38 CFR 4.26 bilateral factor. This hub resolves one side's tier and discloses that combination rule; it does not perform the Table I combination itself.

Percentage Guides

Understanding Your Percentage

Select a pathway to see what the published criteria ask about, what records may clarify it, and what should not be assumed.

50%

Highest listed pathway

Complete paralysis of the trigeminal, vagus, or hypoglossal nerve, and separately, trigeminal neuralgia specifically identified as tic douloureux.

What separates the next level: The 30 percent tier below describes a less advanced presentation for these same 3 nerves, or the complete-paralysis tier for the other 3 nerves.

Review CFR criteria, examples, and evidence
Official CFR language
DC 8205 (trigeminal), DC 8210 (vagus), and DC 8212 (hypoglossal) each rate complete paralysis at 50 percent. DC 8405 (trigeminal neuralgia) additionally reaches this same percentage via its tic douloureux exception -- the only neuralgia code in this range able to exceed its nerve's moderate cap.
Qualification explanation
For paralysis: a documented complete-paralysis finding for one of these 3 nerves. For neuralgia: a documented tic douloureux finding, trigeminal only.
Examples
Records documenting complete paralysis of the vagus nerve.; Records documenting trigeminal neuralgia specifically identified as tic douloureux.
Medical evidence
Neurology treatment records documenting the specific nerve, category, and severity or tic-douloureux finding
Functional impact examples
Complete loss of motor or sensory function attributable to the trigeminal, vagus, or hypoglossal nerve.
Common misconceptions
Trigeminal, vagus, and hypoglossal share this 50/30/10 percentage pattern; facial, glossopharyngeal, and spinal accessory instead share a 30/20/10 pattern -- confirm which pattern applies to the documented nerve before reading a percentage.
Related topics
trigeminal nerve; vagus nerve; hypoglossal nerve; tic douloureux
Source context
38 CFR 4.124a; 8205, 8210, 8212, 8405; Current Diseases of the Cranial Nerves table; RIN 2900-AQ73 proposes relabeling complete/incomplete criteria with objective language while preserving the current 3-tier structure and percentages, and adds a new sensory-neuropathy line (NHD-3, confirmed).

30%

Next: 50% (trigeminal/vagus/hypoglossal only -- facial/glossopharyngeal/spinal accessory have no tier above this one)

Two different meanings share this percentage: complete paralysis of the facial, glossopharyngeal, or spinal accessory nerve, and separately, incomplete-severe paralysis (or organic-changes neuritis) of the trigeminal, vagus, or hypoglossal nerve.

What separates the next level: For facial/glossopharyngeal/spinal-accessory: the top tier for that nerve. For trigeminal/vagus/hypoglossal: one tier below complete, one above incomplete-moderate.

Review CFR criteria, examples, and evidence
Official CFR language
DC 8207 (facial), DC 8209 (glossopharyngeal), and DC 8211 (spinal accessory) each rate complete paralysis at 30 percent. DC 8205 (trigeminal), DC 8210 (vagus), and DC 8212 (hypoglossal) each rate incomplete, severe paralysis at 30 percent, and their corresponding neuritis codes (DC 8305, 8310, 8312) are capped at this same tier when documented with organic changes, per 38 CFR 4.123.
Qualification explanation
Depends entirely on which nerve and which category is documented -- the same percentage number reflects two structurally different findings here.
Examples
Records documenting complete paralysis of the facial nerve (e.g. complete Bell's palsy).; Records documenting incomplete, severe paralysis of the trigeminal nerve.; Records documenting neuritis of the vagus nerve with organic changes.
Medical evidence
Neurology treatment records documenting the specific nerve, category, and severity or organic-changes finding
Functional impact examples
Complete functional loss attributable to the facial, glossopharyngeal, or spinal accessory nerve, or severe-but-incomplete loss attributable to the trigeminal, vagus, or hypoglossal nerve.
Common misconceptions
These are two distinct findings that happen to share a percentage -- not the same clinical presentation. Confirm which nerve and category before comparing outcomes.
Related topics
facial nerve; glossopharyngeal nerve; spinal accessory nerve; neuritis; organic changes
Source context
38 CFR 4.124a / 4.123; 8205, 8207, 8209, 8210, 8211, 8212, 8305, 8310, 8312; Current text. RIN 2900-AQ73 proposes removing the separate neuritis codes outright.

20%

Next: 30%

Incomplete-severe paralysis (or organic-changes neuritis) of the facial, glossopharyngeal, or spinal accessory nerve.

What separates the next level: One tier below complete (30 percent for these 3 nerves), one above incomplete-moderate.

Review CFR criteria, examples, and evidence
Official CFR language
DC 8207, 8209, 8211 each rate incomplete, severe paralysis at 20 percent. Their corresponding neuritis codes (DC 8307, 8309, 8311) are capped at this same tier when documented with organic changes, per 38 CFR 4.123.
Qualification explanation
For paralysis: a documented severe-but-incomplete finding. For neuritis: a documented organic-changes finding (see NHD-1).
Examples
Records documenting incomplete, severe paralysis of the glossopharyngeal nerve.; Records documenting neuritis of the spinal accessory nerve with organic changes.
Medical evidence
Neurology treatment records documenting the specific nerve, category, and severity or organic-changes finding
Functional impact examples
Severe but incomplete functional loss attributable to the facial, glossopharyngeal, or spinal accessory nerve.
Common misconceptions
Neuritis never carries its own independent percentage in this range -- it always borrows from the same nerve's paralysis table.
Related topics
facial nerve; glossopharyngeal nerve; spinal accessory nerve; neuritis
Source context
38 CFR 4.124a / 4.123; 8207, 8209, 8211, 8307, 8309, 8311; Current text. RIN 2900-AQ73 proposes removing the separate neuritis codes outright.

10%

Next: 20% or 30%, depending on the nerve

The universal floor of this range: incomplete-moderate paralysis for every one of the 6 nerves, neuritis without documented organic changes, and neuralgia of every nerve except tic-douloureux-specific trigeminal neuralgia.

What separates the next level: The lowest compensable tier in this range -- there is no 0 percent row anywhere in DC 8205-8412.

Review CFR criteria, examples, and evidence
Official CFR language
All 6 paralysis codes (DC 8205, 8207, 8209, 8210, 8211, 8212) rate incomplete, moderate paralysis at 10 percent. All 6 neuritis codes are capped at this tier when not characterized by organic changes, per 38 CFR 4.123. All 6 neuralgia codes are capped at this tier (except DC 8405's tic douloureux exception), per 38 CFR 4.124.
Qualification explanation
For paralysis: a documented moderate, incomplete finding. For neuritis: documented without organic changes. For neuralgia: any documented finding other than trigeminal tic douloureux.
Examples
Records documenting incomplete, moderate paralysis of the spinal accessory nerve.; Records documenting glossopharyngeal neuralgia.
Medical evidence
Neurology treatment records documenting the specific nerve, category, and severity or status finding
Functional impact examples
Moderate, incomplete functional loss attributable to the specific nerve.
Common misconceptions
This is the only tier every one of the 18 codes in this range can reach -- it is the universal floor, not a rarely-used edge case.
Related topics
neuralgia; tic douloureux
Source context
38 CFR 4.124a / 4.124; 8205, 8207, 8209, 8210, 8211, 8212, 8305-8312, 8405-8412; Current text. RIN 2900-AQ73 proposes removing the separate neuralgia codes outright.

Learn

Understand the details behind the criteria

Use these short guides to connect published terms with the records and observations that may clarify them.

Why this range only covers 6 of the 12 cranial nerves

The section's own header note routes the other 6 cranial nerves to different hubs entirely.

  • The current text states: "Disability from lesions of peripheral portions of first, second, third, fourth, sixth, and eighth nerves will be rated under the Organs of Special Sense."
  • Nerves I (olfactory) and II (optic) route to the Eye Conditions hub's scope.
  • Nerves III, IV, and VI (oculomotor, trochlear, abducens -- all eye-movement nerves) also route to the Eye Conditions hub's scope.
  • Nerve VIII (vestibulocochlear) routes to the Hearing Loss hub's scope.
  • Only V (trigeminal), VII (facial), IX (glossopharyngeal), X (vagus), XI (spinal accessory), and XII (hypoglossal) have their own codes in this DC 8205-8412 range.

Records to review: Neurology treatment records identifying the specific cranial nerve.

How neuritis and neuralgia borrow from the same nerve's paralysis table

Neither category has its own percentage anywhere in this range -- both are capped versions of the same nerve's paralysis table.

  • 38 CFR 4.123 (Neuritis, Cranial or Peripheral): capped at severe incomplete paralysis if organic changes are documented, or moderate incomplete paralysis if not. "Organic changes" is not itself defined (NHD-1).
  • 38 CFR 4.124 (Neuralgia, Cranial or Peripheral): capped at moderate incomplete paralysis for every nerve, except DC 8405 (trigeminal), where tic douloureux may reach complete paralysis (NHD-2 on whether this was meant to extend further).
  • This same dependency structure already governs the DC 8510-8519/8610-8619/8710-8719 (Peripheral Nerves, Upper Extremity) and DC 8521-8530/8621-8630/8721-8730 (Peripheral Nerves, Lower Extremity) ranges -- this hub is the third instance of the same pattern, not a novel mechanism.

Records to review: Neurology treatment records documenting organic-changes findings or a tic douloureux diagnosis.

How bilateral cranial nerve involvement is handled

Bilateral involvement is disclosed, not computed as a combined percentage.

  • The section's header note states: "The ratings for the cranial nerves are for unilateral involvement; when bilateral, combine but without the bilateral factor."
  • This means each side's tier is rated independently under this same table, then the two ratings combine under 38 CFR 4.25 (the standard combined-ratings table), without applying the 38 CFR 4.26 bilateral factor that some limb conditions receive.
  • This hub resolves one side's tier and discloses this combination rule; it does not perform the 38 CFR 4.25 Table I combination itself, matching the same disclosure-only pattern already used for Amputations' bilateral cases.

Records to review: Neurology treatment records documenting findings for both sides, if bilateral.

Evidence

Evidence that may clarify the published criteria

Neurology treatment records

Treatment records document the specific cranial nerve, category (paralysis, neuritis, or neuralgia), and severity or status finding.

A general cranial-nerve diagnosis without the specific nerve identified cannot resolve a tier.

Documented severity, organic-changes, or tic-douloureux findings

The specific fact each tier is built on -- a severity label for paralysis, an organic-changes finding for neuritis, or a tic-douloureux identification for trigeminal neuralgia.

A diagnosis alone, without the specific finding each category requires, cannot resolve which tier applies.

Personal and firsthand lay evidence

Plain descriptions can help characterize documented symptoms and functional impact.

Lay evidence can describe observed impact, but it should not invent measurements or diagnoses.

Official VA Forms & DBQs

Downloadable DBQs & Supporting Claim Forms

Take the public DBQ to your private physician or review it prior to your C&P examination.

Terminology

Plain-English terms

Diseases of the Cranial Nerves

Each of the 6 covered nerves has a 3-tier paralysis table, plus a neuritis code and a neuralgia code that borrow from that same table.

Covers clinically real conditions such as Bell's palsy (facial nerve) and trigeminal neuralgia, not academic edge cases.

Neurology treatment records

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Organic changes (neuritis)

Whether this finding is documented determines whether neuritis caps at the severe or moderate incomplete-paralysis tier.

A genuinely undefined regulatory term (NHD-1) -- this hub discloses the ambiguity rather than resolving it.

Neurology treatment records documenting reflex loss, muscle atrophy, sensory disturbance, or constant pain

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TDIU

Even if the schedular rating for Diseases of the Cranial Nerves does not reach 100 percent, TDIU may still provide a pathway to compensation at the 100 percent rate, based on unemployability from this and/or other service-connected disabilities combined.

A lower schedular percentage does not by itself foreclose TDIU eligibility -- this hub computes only the schedular percentage for this specific condition and does not determine TDIU eligibility.

Employment history; vocational impact documentation; occupational impairment

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Common Questions

Questions veterans commonly ask

How does VA rate this range of conditions?

Each of the 6 covered cranial nerves has its own 3-tier paralysis table. Neuritis and neuralgia of the same nerve carry no percentage of their own -- both dispatch into that nerve's paralysis table, capped by 38 CFR 4.123 and 38 CFR 4.124 respectively.

Why isn't my cranial nerve in this hub?

This range covers only 6 of the 12 cranial nerves. The other 6 (I, II, III, IV, VI, VIII) are rated under the Organs of Special Sense instead, per the current text's own header note -- see the Eye Conditions and Hearing Loss guides.

How does neuritis or neuralgia get rated if it has no percentage of its own?

Both borrow from the affected nerve's own paralysis table. Neuritis caps at severe or moderate incomplete paralysis depending on whether organic changes are documented (an undefined term, NHD-1). Neuralgia caps at moderate incomplete paralysis, except trigeminal neuralgia identified as tic douloureux, which can reach complete paralysis (NHD-2).

What happens if my condition is bilateral?

The current text says cranial nerve ratings are for one side; when bilateral, the two sides combine under 38 CFR 4.25 without the 38 CFR 4.26 bilateral factor. This hub discloses that rule but does not perform the combination itself.

If my schedular rating for Diseases of the Cranial Nerves is below 100%, can I still be compensated at the 100% rate?

Possibly, through TDIU (Total Disability rating based on Individual Unemployability, 38 CFR 4.16) -- a separate pathway to 100 percent compensation based on unemployability, from this and/or other service-connected disabilities combined, independent of whether the schedular rating itself reaches 100 percent. This hub computes only the schedular percentage and does not determine TDIU eligibility.

What separates the 50% rating from adjacent levels?

The 30 percent tier below describes a less advanced presentation for these same 3 nerves, or the complete-paralysis tier for the other 3 nerves.

What separates the 30% rating from adjacent levels?

For facial/glossopharyngeal/spinal-accessory: the top tier for that nerve. For trigeminal/vagus/hypoglossal: one tier below complete, one above incomplete-moderate.

What separates the 20% rating from adjacent levels?

One tier below complete (30 percent for these 3 nerves), one above incomplete-moderate.

What separates the 10% rating from adjacent levels?

The lowest compensable tier in this range -- there is no 0 percent row anywhere in DC 8205-8412.

Related Conditions

Continue learning through connected topics

Eye Conditions

Cranial nerves I, II, III, IV, and VI are rated under Eye Conditions instead, per this range's own header note.

Hearing Loss

Cranial nerve VIII is rated under Hearing Loss instead, per this range's own header note.

Combined Ratings

Bilateral involvement and any other combined disabilities involve combined-rating math, educational context only.

Ready when you are

Compare documented cranial nerve findings

Use the documented specific cranial nerve, category (paralysis, neuritis, or neuralgia), and severity already noted in your records. Do not upload records or enter Social Security numbers, claim numbers, full dates of birth, or other sensitive identifiers. RatingScope does not infer missing findings.

Informational guidance only. RatingScope does not predict, decide, or guarantee VA outcomes.

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Secondary conditions

Conditions commonly connected to Diseases of the Cranial Nerves

No commonly documented secondary connections are tracked for Diseases of the Cranial Nerves yet.

Educational Guides & Evidence Resources

In-depth analysis of DBQ forms, medical evidence thresholds, and rating schedules for Diseases of the Cranial Nerves.

Diplopia and Eye Muscle Function VA Rating: DC 6090 Ocular Motility Guide

Understand how the VA rates double vision and extraocular muscle paralysis under 38 CFR 4.78 and DC 6090, quadrant weights, and visual acuity conversion.

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Related Tools

Compare a percentage level and combined-rating math, or review evidence context.

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VA Math & Combined Ratings

Understand the whole-person method, final rounding, and bilateral limits, then calculate how percentages combine.

Open VA Math guide

Evidence Center

Understand common evidence categories and what they can clarify without treating them as a checklist.

Open Evidence Center