Veterans who suffer from trigeminal neuralgia (TN) often find that the VA doesn’t always make it easy for them to get the benefits they need. Because the frequency, intensity, and duration of pain varies from person to person, TN may not be a disabling condition in and of itself. Claims are regularly denied because they say there is no objective basis for the diagnosis, there is no objective basis for a physician’s restrictions and limitations, or your inability to do your job has no causal association with your trigeminal neuralgia diagnosis or imposed constraints and limits.
Woods and Woods has helped thousands of veterans get VA disability benefits, including those diagnosed with TN. Understanding exactly what TN is and how it is diagnosed is key to taking the first step toward qualifying for benefits. Although TN might not qualify as a service-connected disability, it may be a secondary connection.
In this article about Trigeminal Neuralgia veteran’s benefits:
- What Is Trigeminal Neuralgia?
- What Causes Trigeminal Neuralgia?
- What Are The Symptoms Of Trigeminal Neuralgia?
- How Is Trigeminal Neuralgia Diagnosed?
- How Is A VA Service Connection Established For Trigeminal Neuralgia?
- Trigeminal Neuralgia VA Ratings
- The Main Impact of Trigeminal Neuralgia on Veterans
- Is It Possible To Receive A 100 Percent Disability Rating For Trigeminal Neuralgia?
- What If My VA Disability Claim Is Denied?
What Is Trigeminal Neuralgia?
Trigeminal neuralgia (TN), sometimes known as “tic douloureux,” is a painful chronic condition that affects the trigeminal or 5th cranial nerve of the face. The pain can be debilitating. It is a rather uncommon disorder, with approximately 12 new cases per 100,000 individuals diagnosed per year. Although it usually affects women in their forties and fifties, men, children, and young adults can also develop TN.
There are two types of trigeminal neuralgia, TN1 and TN2. The National Institutes of Health (NIH) describes TN1 as a neuropathic pain condition with extreme, sporadic, and sudden searing or shock-like face pain that lasts anywhere from a few seconds to a few minutes. With TN1, pain can come in rapid succession and last up to two hours. TN2 is less common and milder than TN2, with stabbing pain characterized by continuous throbbing. The level of pain can be both physically and mentally incapacitating, and both TN1 and TN2 can strike at the same time in the same person.
What Causes Trigeminal Neuralgia?
TN normally develops on its own; however, it can sometimes be brought on by dental treatments or facial trauma. A blood artery pressing against the trigeminal nerve, also known as vascular compression, may also trigger the condition. The rubbing of an artery against a nerve can wear away the coating, known as myelin, over time, leaving the nerve exposed and very sensitive.
Because the symptoms of untreated TN can be similar to those of dental disorders, patients with undiagnosed TN may first try a variety of dental procedures to relieve their discomfort.
TN may also be caused by a tumor or multiple sclerosis, both of which are uncommon. There is ongoing research to determine if postherpetic neuralgia, which is caused by shingles, is related to TN.
In this video from one of our VA disability lawyers, we explain how to service connect your disability that was caused by your military service.
What Are The Symptoms Of Trigeminal Neuralgia?
TN is most common in people who are over the age of 50. It is not thought to be passed down through genetics or run in families. Interestingly, it occurs more commonly on the right side of the face than the left.
Common symptoms of TN include:
- Episodes of sharp, stabbing pain in the cheek or jaw, similar to an electric shock.
- Spontaneous attacks catalyzed by anything touching the face or teeth can bring on the pain. This includes things like applying makeup, chewing, shaving, cleaning teeth, talking, drinking, eating, or touching a tooth or lip with the tongue. Even water striking the face or a slight breeze can cause painful episodes.
- Intervals of respite between episodes, which can last a few seconds to several minutes or longer.
- Multiple episodes that last days, weeks, months, or longer – some people have periods where they don’t feel any pain.
- A constant aching, burning sensation that may occur before trigeminal neuralgia develops into spasm-like pain.
- Pain in the cheek, jaw, gums, teeth, lips, sometimes the eye and forehead areas, or any area supplied by the trigeminal nerve.
- Pain that affects only one side of the face at a time, though it can occasionally affect both sides.
- Pain in one spot or spread in a wider pattern.
- More regular and intense attacks over time.
- Anxiety at the prospect of the pain reappearing.
How Is Trigeminal Neuralgia Diagnosed?
Because there are no specific diagnostic tests for TN and the symptoms are similar to those of other facial pain illnesses, it can be difficult to diagnose. When experiencing unusual, sharp pain around the nose, eyes, forehead, lips, scalp, or jaw, people should get medical attention immediately, especially if they have not recently had dental or other facial surgery. The patient should first consult with their primary care physician about the issue and, later on, the PCP may recommend the patient to a specialist.
How Is A VA Service Connection Established For Trigeminal Neuralgia?
A service connection for TN can be formed in a variety of methods, the most common of which is on a secondary basis. When a veteran’s pre-existing service-connected conditions aggravate or cause a non-service-connected condition, a secondary service connection is sometimes possible.
Secondary service-connected conditions are graded in the same way as direct service-connected conditions. To be eligible for secondary service connection for TN, a veteran must first be service-connected for another condition such as multiple sclerosis, a tumor or cyst, face trauma that occurred while serving, or another medical condition that damages your myelin sheaths.
If you’ve been diagnosed with TN and believe it’s due to your military service, you might be eligible for VA disability compensation. There are three key criteria you must meet in order to do so. The first step is to acquire a diagnosis from a certified medical practitioner; if you haven’t already, schedule an appointment as soon as is feasible. Your appointment doesn’t need to be with a VA nexus doctor to get this diagnosis.
You’ll need to be able to point to a specific occurrence in your service record that triggered your TN once you’ve received a diagnosis. Finally, you must establish a medical link between the first or related occurrence and your diagnosis. You’ll be able to prove the link between your military service and your medical condition once you have these three criteria met.
The Nexus Letter is like the missing link to a successful VA disability compensation claim. In this video, one of our veteran’s disability lawyers explains the importance of the Nexus Letter.
Trigeminal Neuralgia VA Ratings
The amount of tax-free compensation you receive each month from the VA is determined by your disability rating. For example, a 10% rating will earn you $165.92 per month, while a 100% rating will earn you $3,621.95 per month. If you have a rating of 30% or more, your dependents will qualify you for more compensation.
TN disability ratings are listed under the broader rating category of “Diseases of the Cranial Nerves.” Ratings specific to TN fall under issues concerning the fifth (trigeminal) cranial nerve. Typically, ratings are assigned based on the degree of sensory or motor loss. Complete paralysis, for example, is rated at 50 percent. Incomplete paralysis, whether severe or moderate, is rated at either 30 or 10 percent.
The loss of function of the affected body part is used to rate all nerve disorders, including TN, and there are three different categories in which nerve injury can be classified: paralysis, neuritis, or neuralgia. Once the nerve injury is classified under one of them, the nerve damage will be scored under that category or based on limited motion, whichever provides the greater disability rating.
If limited motion is caused by nerve damage, only one rating can be issued, either under a nerve diagnostic code or under limited motion. However, if the restricted motion is not due to nerve damage, it can be assessed separately from the nerve diagnostic code.
The Main Impact of Trigeminal Neuralgia on Veterans
Paralysis is the most severe condition, in which the nerve ceases to function completely, resulting in full or partial paralysis. A rating of complete paralysis is assigned when the nerve is entirely paralyzed and the affected bodily portion is unable to function at all. An incomplete, severe rating, on the other hand, is assigned when the nerve is partially paralyzed and symptoms such as inadequate blood circulation and muscle atrophy severely limit the body part’s ability to operate. An incomplete, moderate rating is given when the nerve isn’t fully paralyzed and there is numbness, tingling, moderate pain, or other symptoms that make it difficult to use the body part. Finally, when the nerve is not entirely paralyzed and the affected body portion experiences tingling or minor pain only, an incomplete, mild rating is given.
Neuritis from Trigeminal Neuralgia
Neuritis is the second nerve condition category and is classified when the nerve is still functional, but it is swollen, inflamed, and painful. VA disability ratings are based on whether the neuritis is categorized as severe, moderate, or mild. A severe rating is given when three symptoms are present and limit function severely: loss of sensation, muscle atrophy, and loss of reflexes. If only one or more of those three symptoms are present, but they significantly interfere with the body part’s ability to function, a moderate rating is given. A mild rating is assigned when, although one or more of the three symptoms are present, they do not significantly interfere with the body part’s ability to function.
Neuralgia, the third nerve condition category, is classified when acute pain caused by an inflamed or injured nerve occurs. Disability ratings for neuralgia are based on whether they are classified as moderate or mild. A moderate rating is given when there is numbness, tingling, moderate to severe pain, or other symptoms that significantly interfere with the body part’s ability to function. A mild rating is assigned when only tingling or mild pain is present in the affected body part.
The VA will assign you a particular rating based on the severity of your symptoms if you are eligible for VA disability compensation. The VA assigns a percentage to your disability, ranging from 10 percent to 100 percent, depending on how much your disease interferes with your ability to function normally. They’ll also consider whether you have children, parents, or a dependent spouse, as well as whether you have more than one qualifying condition.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
Is It Possible To Receive A 100 Percent Disability Rating For Trigeminal Neuralgia?
Individual unemployability is a classification that the VA created to give veterans the equivalent pay of a 100% rating when you can’t work but can’t get a 100% rating either. If you have multiple ratings that add up to enough and you can’t work, you should try to get TDIU.
Veterans who can’t hold down a steady job that supports them financially (known as substantially gainful employment) because of their service-connected disabilities are eligible for TDIU if they have:
- At least one service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
As a result, if a veteran’s TN causes such significant pain that they may have difficulty finding and keeping a job, they may be entitled to TDIU. This alternative to a 100 percent rating is necessary because achieving the maximum rating for TN on its own, based on the criteria used, can be challenging.
Our Ultimate Guide to 100% TDIU
The big deal about TDIU is that you can jump from a 70% rating to 100% without your conditions getting worse. Read more about it here.
What If My VA Disability Claim Is Denied?
In some situations, VA disability compensation claims are denied. Don’t panic if this happens; you still have a few options for appealing the decision.
It is always wise to employ an experienced veteran affairs attorney to assist you with your first application, as well as any appeals you may need to make. They will be able to assist you in compiling all of the necessary documentation for your diagnostic and service record in order to establish a link between the two. We can also assist you with the appeals process to ensure that you receive the greatest compensation possible.
If you have been diagnosed with TN and believe you are entitled to compensation from the VA, call us.
At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.
Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.
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Frequently Asked Questions
Yes, if you can prove that your chronic pain is service-connected. Sometimes the VA gives ratings based on the cause of pain. Other times, the actual pain and it’s impact on your ability to work is what gets the rating. The VA has to give you whichever grants you more money, and a VA disability lawyer like us can make sure they give you the right ratings.
No, TN often takes years to set in and can be caused by another service-connected injury that worsens with age. Call our office at (866)232-5777 and let’s see if your service-connected disability caused TN. Most VA disabilities show up long after you’ve been discharged.