38 CFR Part 4 — 38 CFR § 4.124a
Neuralgia, eleventh (spinal accessory) cranial nerve — VA Diagnostic Code 8411
Neurological
Diagnostic code
8411
38 CFR § 4.124a lists the eleventh (spinal accessory, external branch) cranial nerve and then Diagnostic Code 8411 as “Neuralgia.” The row prints no percentage. Section 4.124 rates neuralgia on the same scale as the nerve, with a maximum equal to moderate incomplete paralysis. The paralysis scale for this nerve is DC 8211. Appendix B to Part 4 indexes “Neuralgia, eleventh cranial nerve.” The catalog slug is dc-8411-neuralgia-eleventh-cranial-nerve.
Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was last amended on 2026-08-27. On 2026-10-05 the titles list reports up to date as of 2026-10-02. Section 4.124a source note: 29 FR 6718, May 22, 1964, as amended at 40 FR 42540, Sept. 15, 1975; 41 FR 11302, Mar. 18, 1976; 43 FR 45362, Oct. 2, 1978; 54 FR 4282, Jan. 30, 1989; 54 FR 49755, Dec. 1, 1989; 55 FR 154, Jan. 3, 1990; 56 FR 51653, Oct. 15, 1991; 57 FR 24364, June 9, 1992; 70 FR 75399, Dec. 20, 2005; 73 FR 54705, Sept. 23, 2008; 73 FR 69554, Nov. 19, 2008; 76 FR 78824, Dec. 20, 2011; 79 FR 2100, Jan. 13, 2014. The § 4.123 and § 4.124 XML for this date print the neuritis and neuralgia paragraphs and do not print a Federal Register source note.
The rating criteria at each level
8411 Neuralgia — the row under the eleventh cranial nerve
Rating %: —
Criteria (verbatim). Neuralgia.
| Rating % | Criteria (verbatim) |
|---|---|
| — | Neuralgia. |
8211 Paralysis of the eleventh cranial nerve — the scale § 4.124 names
Rating %: 30
Criteria (verbatim). Complete
Rating %: 20
Criteria (verbatim). Incomplete, severe
Rating %: 10
Criteria (verbatim). Incomplete, moderate
| Rating % | Criteria (verbatim) |
|---|---|
| 30 | Complete |
| 20 | Incomplete, severe |
| 10 | Incomplete, moderate |
DC 8411 prints the word “Neuralgia.” and no number. The percentages above are the DC 8211 column. There is no Mild line and no Major or Minor column.
The DC 8211 note: Dependent upon loss of motor function of sternomastoid and trapezius muscles. That note is printed on the paralysis row. It is not reprinted on DC 8411.
The Diseases of the Cranial Nerves block says: Disability from lesions of peripheral portions of first, second, third, fourth, sixth, and eighth nerves will be rated under the Organs of Special Sense. The ratings for the cranial nerves are for unilateral involvement; when bilateral, combine but without the bilateral factor.
38 CFR § 4.124 says: “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.” On the DC 8211 scale, incomplete moderate is 10. That is the neuralgia maximum. Complete is 30 and incomplete severe is 20. Both are above that maximum. The tic douloureux sentence is not this nerve. DC 8211 is the paralysis row. DC 8311 prints “Neuritis.” and no percentage. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just. 38 CFR § 4.14 says the evaluation of the same disability under various diagnoses is to be avoided, and that the evaluation of the same manifestation under different diagnoses is to be avoided.
The cranial-nerve sentence says ratings are for unilateral involvement, and when bilateral, combine but without the bilateral factor. The eleventh nerve is not in the special-sense list. 38 CFR § 4.31 says that in every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. DC 8211’s lowest printed line is incomplete, moderate, at 10.
The 2026-10-01 text of 38 CFR § 3.309 does not contain “8411” or “spinal accessory.” This page does not add DC 8411 to a presumptive row.
Source: 38 CFR § 4.124a and 38 CFR § 4.124, Diagnostic Code 8411, eCFR full-text XML for 2026-10-01.
What the words mean in your records
Moderate is 10 on this scale
Section 4.124 stops neuralgia at moderate incomplete paralysis. DC 8211 prints that line at 10. Incomplete severe is 20. Complete is 30.
The muscles stay on the paralysis note
Sternomastoid and trapezius are named in the DC 8211 note. The DC 8411 cell is only the word “Neuralgia.”
No mild line
DC 8211 does not print Mild. The wholly-sensory sentence is in the peripheral-nerve block, not in this cranial-nerve block.
Evidence that speaks to each level
The DC 8411 row
What the rater needs to see. Neuralgia of the eleventh cranial nerve, of typical distribution so as to identify the nerve.
Where that usually lives. The neurological examination that identifies this nerve.
Incomplete, moderate — 10
What the rater needs to see. The moderate incomplete line. Section 4.124 stops neuralgia at that line.
Where that usually lives. The same examination. Complete, 30, and incomplete severe, 20, are the DC 8211 paralysis lines above the neuralgia maximum.
VA’s public DBQ list, checked October 5, 2026, names “Cranial Nerve Conditions” under Neurological. The file is Cranial Nerve Conditions.
The exam form
DC 8411 prints no percentage. Section 4.124 and DC 8211 are the scale. This page does not say the form replaces that text.
Related codes and how they interact
Paralysis of this nerve is DC 8211.
That row prints 30, 20, and 10, and the note about the sternomastoid and trapezius muscles. Neuralgia does not reprint those percentages on its own row.
Secondary conditions and presumptions
Section 3.309 does not contain “8411” or “spinal accessory.” This page does not add DC 8411 to a presumptive row.
A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.
Short answers
What is the VA rating for neuralgia of the eleventh cranial nerve?
Under 38 CFR § 4.124a, Diagnostic Code 8411 prints “Neuralgia.” and no percentage. Section 4.124 caps that neuralgia at moderate incomplete paralysis. On Diagnostic Code 8211, incomplete moderate is 10 percent. Education only. VA decides on the evidence.
Does a bilateral rating use the bilateral factor?
The cranial-nerve sentence says that when involvement is bilateral, combine but without the bilateral factor.
FAQ
How does VA rate eleventh-cranial neuralgia under DC 8411?
The DC 8411 row prints “Neuralgia.” and no percentage. Section 4.124 caps neuralgia at moderate incomplete paralysis. On DC 8211 that line is 10 percent. Education only.
Does DC 8411 print the muscle note?
No. The note about loss of motor function of the sternomastoid and trapezius muscles is printed under DC 8211. The DC 8411 cell is “Neuralgia.”
Is tic douloureux this code?
No. Section 4.124’s complete-paralysis exception is tic douloureux, or trifacial neuralgia. It is not the eleventh cranial nerve.
Next steps
- Read the decision for DC 8411 or DC 8211, and whether the evaluation stopped at moderate.
- The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
- Other neurological codes are on the neurological diagnostic-code index. The category page is neurological conditions.
Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.
Other codes in this body system
Nearby catalog entries in Neurological, ordered by diagnostic code number. All Neurological codes
- DC 8207Seventh (facial), paralysis
- DC 8209Ninth (glossopharyngeal), paralysis
- DC 8210Tenth (pneumogastric, vagus), paralysis
- DC 8211Eleventh (spinal accessory, external branch), paralysis
- DC 8212Twelfth (hypoglossal), paralysis
- DC 8305Neuritis, fifth cranial nerve
- DC 8307Neuritis, seventh cranial nerve
- DC 8309Neuritis, ninth cranial nerve
- DC 8310Neuritis, tenth cranial nerve
- DC 8311Neuritis, eleventh cranial nerve
- DC 8312Neuritis, twelfth cranial nerve
- DC 8405Neuralgia, fifth cranial nerve
- DC 8407Neuralgia, seventh cranial nerve
- DC 8409Neuralgia, ninth cranial nerve
- DC 8410Neuralgia, tenth cranial nerve
- DC 8412Neuralgia, twelfth cranial nerve
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 8411 • va.gov
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.