Trigeminal Neuralgia
Trigeminal neuralgia involves the trigeminal nerve (V cranial nerve, also called the fifth nerve), which provides sensation to the face and controls chewing and biting. This condition causes severe, stabbing facial pain and can affect jaw function. The VA rates it under paralysis (DC 8205), neuritis (DC 8305), or neuralgia (DC 8405). Separate evaluations are possible for each side affected. If only jaw range of motion is impacted (without other nerve symptoms), the veteran may instead be rated under temporomandibular disorder (DC 9905). Cranial nerves are NOT eligible for the bilateral factor.
VA Rating Levels
Incomplete paralysis - moderate. Noticeable pain and some difficulty with facial sensation or chewing.
Incomplete paralysis - severe. Significant pain and substantially impaired facial sensation or jaw function.
Complete paralysis. Unable to move the jaw at all and there is no sensation in the face.
Exam Tips & Key Evidence
- →If only jaw range of motion is affected without other nerve symptoms, the VA may rate the condition under temporomandibular disorder (TMJ, DC 9905) instead. Compare both schedules to understand which could yield a higher rating.
- →Rated under one category only - paralysis, neuritis, or neuralgia - whichever is the primary disability. Paralysis generally gives the highest evaluation.
- →Veterans can receive separate evaluations for the left and right sides if both are affected, since there is a pair of trigeminal nerves.
- →Cranial nerves are NOT eligible for the bilateral factor, unlike peripheral nerves in the arms and legs.
- →This is a presumptive condition if diagnosed within one year of separation and the severity warranted at least 10% within that time.
- →If the nerve condition also causes a musculoskeletal ROM issue that can be attributed to a separate musculoskeletal diagnosis, the veteran may be able to get separate ratings for both the nerve and the ROM.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.124a, DC 8205/8305/8405