Trigeminal Neuralgia

DC 8205Neurological38 CFR 4.124a, DC 8205 — Trigeminal (Fifth Cranial) Nerve Paralysis

Severe, shock-like facial pain caused by irritation of the trigeminal nerve. Even light touch to the face, eating, or talking can trigger episodes of intense pain. The VA rates it based on the severity of nerve involvement.

Rating Levels

You have complete paralysis of the trigeminal nerve. This is the maximum rating.

What the VA looks for

Complete loss of sensation in trigeminal distribution
Severe, debilitating facial pain
Loss of motor function of muscles of mastication
Unable to chew or has significant difficulty eating

Common Pitfalls

⚠Not describing the intensity and frequency of pain episodes — trigeminal neuralgia is called the "suicide disease" because of the severe pain. Make sure your records reflect this severity.
⚠Not documenting triggers — eating, talking, wind on face, brushing teeth. This shows how the condition limits daily activities.
⚠Not reporting weight loss or nutritional problems from avoiding eating due to pain — this supports the functional impact of your condition.
⚠Not connecting trigeminal neuralgia to a TBI, dental procedure, or other in-service event that caused or aggravated the nerve damage.
⚠Not filing for secondary depression or anxiety — chronic severe pain commonly causes mental health conditions.

Related DBQ Forms

DBQ Cranial Nerves Diseases

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…