VA Disability Rating for Central Nystagmus (DC 6016)
Diagnostic Code 6016 · 38 CFR §4.79
What Is It?
Central nystagmus is a condition causing involuntary, rhythmic eye movements that originate from dysfunction in the brain or brainstem rather than the eye itself. The constant eye movement makes it difficult to focus on objects, causing blurred vision, reduced visual acuity, and difficulty reading. In veterans, central nystagmus may result from traumatic brain injury, brainstem stroke, multiple sclerosis, or toxic exposures during service. The condition can be constant or triggered by certain head positions or eye movements. The VA assigns a flat 10% rating under DC 6016, but additional ratings for visual impairment caused by the nystagmus can be evaluated separately.
Rating Criteria
| Rating | Criteria |
|---|---|
| 10% | Central nystagmus receives a flat 10% rating under DC 6016. Additional disability from the visual impairment it causes is rated separately under the visual acuity or visual field codes. |
Evidence Needed
An ophthalmology or neurology examination confirming central nystagmus is essential. A description of the nystagmus pattern (direction, amplitude, conditions that worsen it), visual acuity testing showing impact on vision, brain imaging if the cause is suspected to be structural, and documentation of the service-connected cause (TBI, brainstem injury, etc.) all strengthen your claim.
C&P Exam Tips
The examiner should document the nystagmus with specific description of direction and amplitude. Have visual acuity tested with and without correction. Describe how the involuntary eye movements affect reading, focusing, and daily tasks. Connect the nystagmus to its cause such as TBI, brainstem injury, or toxic exposure. Mention if certain positions or movements worsen the nystagmus.
How to File
File under DC 6016 for the nystagmus itself (10% flat rate). Separately file for any visual acuity loss the nystagmus causes, and for the underlying condition (TBI, brainstem injury) under its own diagnostic code. The combined rating from multiple codes is typically much higher than any single code.
Common Mistakes
Filing only under the nystagmus code without claiming the visual acuity loss separately is the most common mistake. Not connecting the nystagmus to an underlying service-connected condition like TBI, overlooking balance problems and headaches as related ratable conditions, and not requesting the higher rating available through visual acuity impairment codes are other frequent errors.
Frequently Asked Questions
Why is central nystagmus only rated at 10%?
DC 6016 provides a flat 10% for the nystagmus itself. However, the VA also rates the visual impairment it causes (the reduced visual acuity from inability to focus) under separate codes. Combined with ratings for the underlying cause (TBI, etc.), the total compensation can be significantly higher than 10%.
What is the difference between central and peripheral nystagmus?
Central nystagmus comes from brain or brainstem dysfunction and is typically constant and multi-directional. Peripheral nystagmus comes from inner ear problems and is usually temporary, unidirectional, and associated with vertigo. The distinction matters for determining the service-connected cause.