EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Nystagmus
DC 6091 | 38 CFR § 4.79, DC 6091 |
Nystagmus is rated by the U.S. Department of Veterans Affairs under DC 6091 of 38 CFR § 4.79, DC 6091 across 3 severity tiers (40%+ -- Severe limitation or ankylosis / 20% -- Moderate limitation / 10% -- Mild limitation or painful motion). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Involuntary, repetitive, rhythmic eye movements that may be horizontal, vertical, or rotary. May be congenital or acquired. Acquired nystagmus in veterans often results from vestibular disorders, TBI, multiple sclerosis, or medication side effects. Causes oscillopsia (perception that the visual world is moving).
RATING CRITERIA (3 LEVELS)
40%+ -- Severe limitation or ankylosis
Severe limitation of motion or ankylosis of the affected joint. Specific percentages depend on the joint and whether dominant/non-dominant.
20% -- Moderate limitation
Moderate limitation of motion with significant functional impairment. DeLuca factors may increase the effective rating.
10% -- Mild limitation or painful motion
Mild limitation of motion, or X-ray evidence of arthritis with painful motion under DC 5003.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026