The Central Nervous System

Topics:

Central Nervous Rating System
Conditions of the Brain
Conditions of the Spinal Cord
Nervous System Diseases
Cancer and Tumors of the Nervous System
Epilepsy and Seizures
Migraine Headaches
Other Nervous System Conditions
DBQ for Nervous System Conditions
Principles that Apply

The Nervous System is divided over multiple pages: the Peripheral Nerves of the Upper Back and Arms, the Peripheral Nerves of the Low Back and Legs, the Cranial Nerves, and Traumatic Brain Injury (TBI). Finally, all other nervous conditions can be found on this page.

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

Additional compensation is given by the VA for loss of use of the arms, legs and a few other body systems. If your nerve condition is severe enough that the affected body part is unable to function at all, you may qualify. See the Special Monthly Compensation page to see if your particular condition qualifies.

The nervous system connects the brain to the rest of the body. Impulses travel up the nerves and spinal cord to the brain, and the brain then turns these impulses into ideas like pain, heat, etc. Similarly, the brain can send signals through the nerves to various parts of the body, telling it to raise the arm, point the toes, open and close the lungs to breathe, etc.

The nervous system is divided into two parts: the central nervous system, and the peripheral nervous system. The central nervous system consists of the brain, the spinal cord, and the cranial nerves. The peripheral nervous system is made up of all the nerves that travel from the spinal cord to the rest of the body.

We have divided the nervous system across five different pages: the peripheral nerves are split into two categories: Nerves of the Upper Back and Arms, and Nerves of the Low Back and Legs. The Cranial Nerves have their own page, as does Traumatic Brain Injury (TBI). All other nervous conditions can be found on this page.

The majority of nervous system conditions are rated on the symptoms they create. These symptoms could include mental illness (hallucinations and the like), trouble speaking, hearing, seeing, the inability to properly move the body, tremors, and more. For the VA, every symptom will be ratable, but for the DoD, since they only rate conditions that make a service member Unfit for Duty, they will only rate the symptoms that also make him unfit. Not every symptom a nerve condition causes will always be ratable for DoD Disability. If each symptom is not unfitting by itself, but the overall condition is, then only the worst symptom can be rated.

Note: There are a few times for these conditions that the VASRD uses vague terms like “severe.” The exact definition of terms like this is up to the opinion of the Rating Authorities, so unfortunately, we can’t really give you a more concrete definition than this. It may mean one thing to one person and something entirely different to someone else. What they are supposed to be keeping in mind when deciding ratings, however, is how much that condition affects your overall health and ability to work. If that is severely affected, then the Rating Authorities should consider it a “severe” condition. Hope that helps.



Central Nervous Rating System

This rating system is for the majority of brain and spinal cord conditions and nervous system diseases. Assigning Military Disability Ratings to these conditions can be very confusing. First, all these conditions are rated based on the symptoms or other conditions it causes. For example, if a brain condition causes the right arm to be paralyzed, then it would be rated on whichever peripheral nerve was damaged to cause the paralysis of that arm.

When rating the symptoms of a central nervous condition, the final code will look like this: 8007-5200. The first four-digit code defines the condition, and the second code tells how it is rated. So in this example, embolism of the blood vessels in the brain (code 8007) causes paralysis of the arm (code 5200), on which it is rated.

Some of these conditions have minimum required ratings. This means that no matter what symptom it is rated on, the LOWEST rating it can receive is the minimum. Just because a condition has a minimum rating noted, however, does not mean that every case of this condition can qualify for that minimum rating.

If the condition has ratable symptoms, then the minimum rating is always applied. If the only symptoms are ones that cannot be measured (like headaches, dizziness, fatigue, etc.—note that these symptoms are also not usually separately ratable), then that condition can qualify for the minimum rating under its code, but only as long as the diagnosis of the condition is definite and the symptoms are common for that condition.

For example, if a service member has been diagnosed with Parkinson’s disease, but the only symptom he has is diarrhea, then it would be pretty logical to say that the diarrhea was not caused by the Parkinson’s and so cannot be rated. In the absence of any ratable symptoms, the condition would be rated 0%.

If, however, a service member has been diagnosed with Parkinson’s disease, and the only symptom he has is dizziness (this can be caused by destruction of the brain’s ability to sense balance), he would qualify for the minimum rating under the Parkinson’s, code 8004, which is 30%. Got it?

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Conditions of the Brain

Code 8000: Chronic epidemic encephalitis is more commonly known as the sleeping sickness that is often found in Africa. It is technically the swelling of the brain caused by a virus or bacteria. Symptoms can include headache (code 8100), drowsiness, fever, nausea, paralysis of the eye muscles (code 6009), and weakness. If the encephalitis is active, it is rated 100%. This 100% rating continues for the first 3 months following the end of the active disease. It is then reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8004: Parkinson’s disease (a.k.a. paralysis agitans) is a condition where cells in the brain die, causing serious difficulties controlling bodily movements. This condition is degenerative, meaning it cannot be cured and gets progressively worse over time. Symptoms can include shaking, slowness, difficulty walking (this would be rated under one of the leg codes, depending on which best describes the exact problem, 5256, 5260-5261, 5250-5253), paralysis, dementia (9305), and other mental disorders. It is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8005: Bulbar palsy is a condition where all the cranial nerves are affected by an area of damaged tissues in the brain. This condition is always rated 100%.

Code 8007: Embolism of the blood vessels in the brain (a form of stroke) occurs when blood clots that form in other parts of the body move to the blood vessels in the brain, stopping the flow of blood to the brain. Symptoms can include paralysis, dementia (9305), and weakness. This condition is rated 100% while it is active and for the first 6 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8008: Thrombosis of the blood vessels in the brain (the most common kind of stroke) occurs when blood clots form in the brain’s blood vessels, restricting the flow of blood to the brain. Symptoms can include paralysis, dementia (9305), and weakness. This condition is rated 100% while it is active and for the first 6 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8009: Hemorrhage from the blood vessels in the brain (a form of stroke) occurs when a blood vessel in the brain bursts, causing bleeding into the brain that kills the surrounding brain cells. Symptoms can include paralysis, dementia (9305), and weakness. This condition is rated 100% while it is active and for the first 6 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8014: Meningovascular syphilis is an infection of the syphilis bacteria in the lining of the brain and the blood vessels in the brain. This occurs only after a syphilis infection has occurred elsewhere in the body. Symptoms can include headaches (8100), fatigue, dementia (9305), nerve paralysis, double vision (6009), and poor memory. It is rated on the Central Nervous Rating System.

Code 8020: Abscess of the brain is a collection of pus in the brain from an infection or injury to the brain. The pus puts pressure on the surrounding brain and can kill brain cells. Symptoms can include headaches (8100), dementia (9305), fatigue, nerve paralysis, seizures (8910-8911), and weakness. This condition is rated 100% while it is active and for the first 3 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8025: Myasthenia gravis is a condition where the immune system attacks the healthy tissues that allow the nerves to communicate with the muscles. Symptoms can include trouble breathing (6840-6841), weakness, nerve paralysis, difficulty eating (7203, 9901), fatigue, and double vision (6009). It is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8046: Cerebral arteriosclerosis occurs when the arteries in the brain stiffen and narrow, restricting the blood flow to the brain. To rate a condition under this code, clinical proof must be given that this condition is cerebral arteriosclerosis and not just retinal arteriosclerosis.

This code is rated on the Central Nervous Rating System with one difference. If the only symptoms of this condition are not measureable, like headache, dizziness, insomnia, etc., it is rated 10%, and no more, under code 9305, vascular dementia. Not quite sure why the code for dementia is used for the non-ratable symptoms, but it is. Everything else is the same, but there is no minimum rating for this condition.

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Conditions of the Spinal Cord

Code 8010: Myelitis is the swelling or infection of the tissues of the spinal cord. Symptoms can include fatigue, nerve paralysis, difficulty walking (this would be rated under one of the leg codes, depending on which best describes the exact problem, 5256, 5260-5261, 5250-5253), incontinence, and weakness. It is rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8011: Anterior poliomyelitis (a.k.a. polio) is an infectious disease that causes swelling in the spinal cord. Symptoms can include nerve paralysis, and muscle weakness. This condition is rated 100% while active and for the first 3 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8012: Hematomyelia occurs when blood vessels burst and bleed into the spinal cord, building pressure and killing the cells around it. Symptoms can include nerve paralysis, and muscle weakness. This condition is rated 100% for 6 months following the hemorrhage. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8015: Tabes dorsalis is a syphilis infection in the spinal cord that slowly kills the cells. Symptoms can include nerve paralysis, convulsive tics (8103, 8104 or epilepsy), vision problems, degenerative arthritis (5003), and mental disorders. It is rated on the Central Nervous Rating System.

Code 8024: Syringomyelia is a cyst that forms in the spinal cord. Symptoms can include headaches (8100), nerve paralysis, muscle weakness, and pain. It is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

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Nervous System Diseases

Code 8013: Cerebrospinal syphilis is an infection of the syphilis bacteria in the brain or spinal cord. This occurs only after a syphilis infection has occurred elsewhere in the body. Symptoms can include headaches (8100), fatigue, dementia (9305), nerve paralysis, double vision (6009), and poor memory. It is rated on the Central Nervous Rating System.

Code 8017: Amyotrophic lateral sclerosis (a.k.a. Lou Gherig’s Disease or ALS) is a degenerative disease that gets worse over time and affects the nerve cells in the brain and spinal cord that control voluntary (you tell the muscle to move—as opposed to involuntary: the heart beats regardless of the brain) muscle movement. Symptoms include loss of coordination, weakness, difficulty eating (7203, 9901), breathing (6840-6841), nerve paralysis, double vision (6009), and weight loss. The rating for any severity of ALS is 100%.

Code 8018: Multiple sclerosis (a.k.a. MS) is a degenerative disease that gets worse over time and causes the tissues surrounding the axons in the brain and spinal cord to swell, disconnecting the brain from the rest of the body. Symptoms get worse over time and include loss of coordination, weakness, difficulty eating (7203, 9901), muscle spasms or tics (8103-8104), difficulty breathing (6840-6841), nerve paralysis, double vision (6009), depression (9434), and other mental disorders. It is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8019: Cerebrospinal meningitis (a.k.a. Meningitis) is an infection that causes the tissues covering the brain and spinal cord to swell. Symptoms can include headaches (8100), fever, vomiting, irritability, low blood pressure or other cardiac involvement, seizures, and gangrene leading to amputation. This condition is rated 100% while it is active and for 3 months following the last treatment. After that period, it is reevaluated and rated on the Central Nervous Rating System. The minimum rating for this condition is 10%.

Code 8023: Progressive muscular atrophy is a degenerative disease that gets worse over time and interferes with the brain and spinal cord’s motor neurons’ ability to communicate information to the muscles. Symptoms can include serious loss of muscle mass (atrophy), weakness, and muscle spasms or tics (8103-8104). It is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8103: Convulsive tic is a condition where the nerves cause the muscles, predominantly in the face, arms, or legs, to spasm regularly. If it is severe, it is rated 30%. Moderate is rated 10%, and mild is rated 0%.

Code 8105: Sydenham’s Chorea (a.k.a. chorea minor) is a type of chorea disease caused by an infection of streptococci (rheumatic fever, rheumatic heart disease, etc). There are different kinds of Sydenham’s chorea, some more severe than others. The worst form is progressive grave, which is not treatable and gets worse over time.

If the condition is progressive grave, it is rated 100%. If the condition is severe, but it is not progressive grave, it is rated 80%. A moderately severe condition is rated 50%. A moderate condition is rated 30%. If the condition is mild, it is rated 10%.

Code 8106: Huntington’s Disease (a.k.a Huntington's chorea) is a type of chorea caused by a genetic abnormality. This kind of chorea normally does not become symptomatic until late adult life, and so is ratable by both the VA and the DoD. It is rated as Sydenham’s chorea under code 8105. The final code will be 8106-8105.

Code 8107: Athetosis is a condition where the fingers, legs, neck, and arms twitch uncontrollably. It is often the result of damage to the brain or conditions like cerebral palsy. It is rated as Sydenham’s chorea under code 8105. The final code will be 8107-8105.

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Cancer and Tumors of the Nervous System

Cancer is the growth of abnormal cells. These cells can be benign—they do not attack the good cells around them—or they can be malignant—they attack the cells around them.

Code 8002: Malignant cancer of the brain is rated 100% while it is active. This 100% rating will continue for the first 2 years after the last treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8003: Benign tumors of the brain are rated based on the Central Nervous Rating System, with a few differences. While they are active and receiving treatment they are rated at least 60%. Following treatment (usually surgery) the residual symptoms are rated separately. The minimum rating for the ratable symptoms is 10%.

Code 8021: Malignant cancer of the spinal cord is rated 100% while it is active. This 100% rating will continue for the first 2 years after the last treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on the Central Nervous Rating System. The minimum rating for this condition is 30%.

Code 8022: Benign tumors of the spinal cord are rated based on the Central Nervous Rating System, with a few differences. While they are active and receiving treatment they are rated at least 60%. Following treatment (usually surgery) the residual symptoms are rated separately. The minimum rating for the ratable symptoms is 10%.

Code 8540: Malignant cancer of the nerves is rated 100% while it is active. This 100% rating will continue for the first 6 months following the last treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on any lasting nerve damage. Find the nerve that is damaged on either the Nerves of the Upper Back and Arms page, Nerves of the Lower Back and Legs page, or The Cranial Nerves page.

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Epilepsy and Seizures

Epilepsy is a condition defined by repeated seizures. There are numerous kinds of epilepsies, many of them with unknown causes. There is no cure for epilepsy, although some childhood forms of epilepsy can be outgrown. There are medications to treat it, but these medications can only treat the symptoms of the seizures, not cure the condition.

Seizures are defined as a period of abnormal electrical activity in the brain. This can occur in the entire brain, or just in sections of the brain. This electrical activity causes the body to act uncontrollably and often unconsciously, or the brain to sense things that are not there (hallucinations). Just as there are many kinds of epilepsy, seizures can cause hundreds of different symptoms. Common symptoms can include unconsciousness, severe shaking of the body, falling down, drooling, mumbling, hallucinations, vomiting, sweating, fear, anger, confusion, inappropriate behavior (pulling down your pants in public, etc.), and more. These symptoms can happen in combinations or just one at a time. The individual experiencing a seizure will almost never remember anything that occurred during the seizure. Sometimes, it may not be obvious that a person is having a seizure since they may look and interact fairly normally, but they are not in control of their actions and will not remember anything during the time of the seizure after they regain conscious control.

Often a mental disorder is also present with epilepsy. If mental disorder symptoms, like hallucinations, depression, etc., are only experienced during a seizure, then they are not ratable separately. If, however, the mental illness is present between seizures, it can be rated separately. See the Mental Disorders page for conditions and ratings. Note: Personality disorders are not usually ratable. However, if the personality disorder is present along with epilepsy, it is rated as dementia (code 9326).

To rate a condition as epilepsy, a physician must have witnessed a seizure and performed neurological testing. If a physician has not seen a seizure, the condition cannot be rated as epilepsy. In addition to the neurological testing, it is vital that the physician records the severity of the seizures as well as how often they occur. It is also important for the physician to note any occupational impairment. Does the condition interfere with the individual’s ability to work? Make sure this information is documented in order to get a proper rating.

Note: The VA and the DoD interpret the kind of seizures that are used for rating differently. For the VA, it does not matter whether the seizures occur during the day or night for rating purposes. They do distinguish, however, that if a seizure occurs after drinking alcohol or not taking the prescribed medicine, then it cannot be included in the total for rating purposes. On the other hand, the DoD does not count seizures that occur while sleeping for rating purposes. Those cannot count toward a DoD rating.

For rating purposes, there are three different categories to consider.

Major seizures affect the entire brain. In the majority of cases, the individual loses consciousness and shakes uncontrollably.

Minor seizures affect only portions of the brain. They cause only brief interruptions in conscious control with symptoms like mumbling, rocking, or slight twitching of the muscles, or falling down.

All epileptic conditions are rated on the following system:

Major Seizures

Minor Seizures

Rating

12 or more in the past year

 

100%

4-11 in the past year

11 or more per week

80%

3 in the past year

9-10 per week

60%

2 in the past year

5-8 per week

40%

1 in the past 2 years

2 in the past 6 months

20%

the epilepsy requires constant medication to control seizures or there is a definite diagnosis of epilepsy with history of seizures

10%


If the condition has both major and minor seizures, then rate the ones that give the higher rating.

Code 8910: Grand mal epilepsy is a condition where the seizures affect the entire brain, causing loss of consciousness and severe jerking/twitching of the body. This is rated as major seizures.

Code 8911: Petit mal epilepsy is a condition where the seizures cause short periods of loss of mental control or disconnect from reality. This is rated as minor seizures.

Code 8912: Three different kinds of epilepsy are rated under this code. All of them only affect one part of the brain at a time. Focal motor epilepsy consists of seizures that cause muscles in only certain areas to jerk, depending on which part of the brain is affected. Jacksonian epilepsy is similar to focal motor epilepsy, but it travels from one part of the brain to another. Symptoms reflect this travel, starting at one point in the body and moving to others. Sensory epilepsy consists of seizures that cause hallucinations of the senses—sight, smell, taste, etc. Again, this will only affect one sense at a time depending on what part of the brain is affected. These are rated as minor seizures.

Code 8913: Diencephalic epilepsy (a.k.a. automatic epilepsy or vasomotor epilepsy) is a condition where the seizures affect numerous parts of the brain at the same time, but not the entire brain. During a seizure, repetitive movements will occur that may seem normal or purposeful, although they are done unconsciously. Along with the movements, the individual will experience extremely strong bursts of emotion like fear or anxiety. It is also common for them to experience hallucinations. This condition is rated as minor seizures unless there are also major seizures. In this case, rate the type of seizure that interferes the most will daily living.

Code 8914: Psychomotor epilepsy is a condition where the seizures cause the individual to act in abnormal ways, almost like they were drunk. They are separated from conscious control, often experiencing hallucinations and amnesia. During a seizure, the individual could commit acts that they might never do under conscious control like violence, crime, etc. Passing out and jerking the body rarely happens with psychomotor epilepsy, but if it does, then the condition can be rated as major seizures. If the seizures are brief episodes of hallucinations, bad judgment, uncontrolled twitching, extreme moods, or abnormal acts, then it is rated as minor seizures.

Code 8108: Narcolepsy is not an actual epileptic condition caused by abnormal electrical activity in the brain. Instead, it is a sleep disorder where the individual experiences abnormal sleep patterns. Daytime symptoms can include severe drowsiness, sudden muscle weakness that can cause drooping of the limbs and head or falling, impaired vision and speech, and momentary paralysis. Although this is not technically an epileptic condition, it is rated as petit mal epilepsy (code 8911). The final code for this condition will be 8108-8911.

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Migraine Headaches

Code 8100: Migraine headaches are a type of headache caused by the swelling of the blood vessels in the brain. They are often more severe than other kinds of headaches (stress, sinus, etc.), and so interfere more with the individual’s ability to work and function in daily life. If another kind of headache interferes significantly with daily life, it can also be rated here.

Two things are taken into account when rating migraines: frequency (how often they occur) and severity (how bad they are). To receive a proper rating, it is essential that the physician records these clearly along with how they affect the individual’s ability to work and function.

The term “prostrating” means that the individual must stop all activity, take medication, and either seek medical attention or seclude himself for the rest of the day. The individual is unable to perform any occupational or daily activities either because of the migraine itself or because the migraine medication makes him too drowsy, etc.

The ratings for migraines only go up to 50%. The Rating Authorities, however, can give a higher rating if the case is so severe that 50% doesn’t truly reflect the disability. It is completely up to the Rating Authorities, however, exactly what makes a condition severe enough to warrant a higher rating.

Frequency

Severity

Rating

2 or more times per month

Prostrating

50%

Once a month

Prostrating

30%

Once every 2 months and prostrating

10%

Once every 3 months or less

Prostrating

0%


If the condition does not make occupational activity impossible, then it cannot be rated more than 0%.

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Other Nervous System Conditions

All other nervous system conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom-line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQ for Nervous System Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for nervous system conditions: Parkinson's DBQ, Amyotrophic Lateral Sclerosis DBQ, Narcolepsy DBQ, Headache DBQ, Multiple Sclerosis DBQ, Seizure Disorders DBQ, and Nervous System Condition/Diseases (Other) DBQ.

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Principles that Apply

Pyramiding: A single condition can only be rated once! However, if a mental disorder or another condition exists that is additional to the nervous condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

For mental and psychiatric conditions, please see the Mental Disorders page. For conditions of the nerves, see the Nerves of the Upper Back and Arms, the Nerves of the Low Back and Legs, and The Cranial Nerves pages. For TBI, see the Traumatic Brain Injury (TBI) page.

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