Bell's Palsy (Facial Nerve Paralysis)
Bell's palsy is paralysis of the facial nerve (VII cranial nerve, also called the seventh nerve), which controls the muscles that allow facial expressions. It can cause partial or total inability to move the face on one or both sides. Under the VA rating schedule, the facial nerve is one of 6 cranial nerves that can be rated individually. Separate evaluations are possible for each side affected (left and right). However, cranial nerves are NOT eligible for the bilateral factor. The condition can be rated under paralysis (DC 8207), neuritis (DC 8307), or neuralgia (DC 8407) - whichever is the primary disability - but only one category may be assigned.
VA Rating Levels
Incomplete paralysis - moderate. Some difficulty with facial expressions but not total loss.
Incomplete paralysis - severe. Significant difficulty with facial muscle control.
Complete paralysis. Cannot make any facial expressions on the affected side.
Exam Tips & Key Evidence
- →The nerve can be rated under paralysis, neuritis, or neuralgia - but only one category is allowed. Paralysis (DC 8207) generally offers the highest ratings and is the most commonly used category.
- →Veterans can potentially receive separate evaluations for each side of the face, since there is a pair of facial nerves. Each side can be rated individually.
- →Cranial nerves are NOT eligible for the bilateral factor, unlike peripheral nerves of the arms and legs.
- →If the condition affects only range of motion (like jaw movement), the veteran may alternatively be rated under the applicable musculoskeletal schedule if it yields a higher rating. However, you cannot receive both a nerve rating AND a ROM rating for the same limitation.
- →If the veteran also has a musculoskeletal issue that can be attributed to the nerve condition's ROM limitation, separate ratings for both may be possible.
- →This is a presumptive condition if diagnosed within one year of separation and severity warranted at least 10% within that time.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.124a, DC 8207/8307/8407