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. 38 CFR 4.124a rates DC 8207 at 30 percent for complete paralysis, 20 percent for severe incomplete paralysis, and 10 percent for moderate incomplete paralysis, and its Note makes the rating dependent upon relative loss of innervation of facial muscles. The schedule prints no step for mild incomplete paralysis. The cranial nerve ratings are for one side; when both sides are involved, the ratings are combined but without the bilateral factor.

Rating Criteria

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, those residuals can be service connected. If eye complications have developed, ask whether they can be rated separately under the eye schedule.

Common Mistakes

• Assuming Bell's palsy cannot be claimed because it improved. If it began in service and left lasting facial weakness or synkinesis, those residuals can be claimed.
• Not asking about eye problems. If the eye cannot close fully, ask whether a resulting eye condition, such as corneal damage, can be rated separately from the facial nerve rating.
• Not documenting with photographs. Photographs of the face at rest and during movement can show the facial weakness the examiner weighs; the schedule rates DC 8207 on the relative loss of innervation of the facial muscles.

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.