EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Trigeminal Neuralgia (Dental/Facial)
DC 8205 | 38 CFR § 4.124a, DC 8205 |
Trigeminal Neuralgia (Dental/Facial) is rated by the U.S. Department of Veterans Affairs under DC 8205 of 38 CFR § 4.124a, DC 8205 across 4 severity tiers (50% / 30% / 20% / 10%). 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
Severe, sudden, shock-like facial pain along the trigeminal nerve distribution. Can be triggered by eating, talking, or touching the face. Often misdiagnosed as dental pain. May result from dental procedures, facial trauma, or compression of the nerve.
RATING CRITERIA (4 LEVELS)
50%
Complete paralysis of the fifth (trigeminal) cranial nerve. (Verbatim § 4.124a DC 8205.) Per § 4.124a Note: "Dependent upon relative degree of sensory manifestation or motor loss." Total loss of trigeminal sensory + motor function on the affected side; severe disabling tic douloureux (trigeminal neuralgia) per the explicit note may be rated up to this complete level.
30%
Incomplete paralysis, severe. (Verbatim § 4.124a DC 8205.) Severe sensory loss or motor weakness in trigeminal distribution; severe tic douloureux with frequent / disabling attacks; per DC 8305 (Neuritis), severe = 30%.
20%
Moderate incomplete paralysis (DC 8305 neuritis moderate = 20%) or severe neuralgia (DC 8405 neuralgia severe = 20%). Moderate sensory disturbance / weakness in trigeminal distribution; moderate-severity tic douloureux.
10%
Incomplete paralysis, moderate. (Verbatim § 4.124a DC 8205.) Mild sensory disturbance in trigeminal distribution; mild tic douloureux; per DC 8305 (Neuritis) or DC 8405 (Neuralgia), mild = 10%. Per § 4.123 / § 4.124, pure sensory neuralgia rates lower than motor paralysis at equivalent severity.
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.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026