VA Disability Rating for Facial Nerve Paralysis (DC 8207)
Diagnostic Code 8207 · 38 CFR §4.124a
What Is It?
The facial nerve (7th cranial nerve) controls the muscles of facial expression on each side of the face. Paralysis causes drooping of one side of the face, inability to close the eye, difficulty smiling, drooling, and loss of taste on part of the tongue. Bell's palsy — sudden facial paralysis often triggered by viral infection — is the most common cause. Veterans may develop facial nerve paralysis from Bell's palsy during service, skull fractures, ear surgery, brain tumors, or blast injuries. While many cases of Bell's palsy recover fully, some result in permanent facial weakness or involuntary movements (synkinesis) that remain disabling.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Complete paralysis of one side of the face with inability to close the eye, total loss of facial expression on that side, and drooling. |
| 20% | Severe incomplete paralysis with significant facial asymmetry, difficulty closing the eye, noticeable drooping, and functional impairment of facial expression. |
| 10% | Moderate incomplete paralysis with mild facial asymmetry, some difficulty with facial movements, and mild functional limitations. |
Evidence Needed
- Neurological examination documenting facial nerve function on both sides
- EMG/nerve conduction studies of the facial nerve
- Photographs showing facial asymmetry at rest and during facial movements
- Brain or temporal bone imaging if structural cause is suspected
- Service records documenting the onset of facial paralysis during service
- Ophthalmological evaluation if eye closure is affected
C&P Exam Tips
- Have the examiner photograph your face at rest and during specific movements (smiling, raising eyebrows, closing eyes tightly)
- Demonstrate all facial movements so the examiner can document asymmetry
- Report any difficulty eating, drinking, or managing saliva
- Describe any involuntary facial movements (synkinesis) that developed during recovery
- Report eye dryness or tearing problems from inability to blink properly
- Explain how facial asymmetry affects your social interactions and self-confidence
How to File
File under DC 8207 for paralysis of the 7th cranial nerve. Include neurological examination findings with photographs, EMG results, and documentation of the onset during service. If Bell's palsy occurred during service and left permanent residuals, the service connection is straightforward. If eye complications have developed, claim those separately under the appropriate eye code.
Common Mistakes
Assuming Bell Not claiming eye problems separately Not documenting with photographs
Frequently Asked Questions
Is Bell's palsy service-connected?
If Bell's palsy occurred during active duty, it can be service-connected. Bell's palsy is thought to be triggered by viral reactivation, which can be precipitated by the physical stress, fatigue, and immune suppression common during military service. If you have permanent residuals, file a claim.
What is synkinesis?
Synkinesis occurs when the facial nerve regenerates abnormally after paralysis. Nerve fibers reconnect to the wrong muscles, causing involuntary movements — for example, your eye may close when you try to smile. Synkinesis is a recognized residual of facial nerve paralysis and should be documented in your claim.