Claim Raven explanation
What this means
Neuralgia is generally evaluated on the scale for the affected nerve. This section describes the typical intermittent pain pattern and the limit that ordinarily applies to its evaluation.
The rule identifies an exception for trigeminal neuralgia, also called tic douloureux. Other nerve diagnoses can follow different rules, so the medical classification should be clear before comparing rating levels.
How this helps your claim
This helps you understand how VA distinguished neuralgia from other nerve impairment. Use the nerve distribution, diagnosis, and findings in the record rather than assuming all radiating pain has the same evaluation.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Find the diagnosed condition and the nerve involved.
- Review the pattern, persistence, and documented functional effects of the pain.
- Compare the code and any applicable exception with VA's explanation.
Keep neuralgia distinct from other nerve diagnoses
The regulation describes neuralgia and its usual evaluation limit, with a particular exception for trigeminal neuralgia. Other nerve conditions can follow different provisions. Read the clinician's diagnosis and distribution of symptoms rather than assuming all nerve pain receives the same treatment.
Use the affected nerve's scale only after identifying the applicable classification. Intermittent pain, weakness and sensory findings should be accurately attributed where the medical evidence supports that distinction. An additional symptom does not automatically change neuralgia into another diagnosis or remove the rule's limit.
Can I use the trigeminal exception for another painful nerve?
No. The exception is specific. A painful condition elsewhere must be considered under its own applicable diagnosis and nerve provisions. The fact that pain is intense does not justify borrowing a different nerve's exception or relabeling the medical condition.
Official regulatory text
38 CFR § 4.124
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.124 Neuralgia, cranial or peripheral.
Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected nerve.
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
Ready to review your own document? Start your free claim review.