Bulbar Palsy

DC 8005Neurological38 CFR 4.124a, DC 8005

A condition affecting the motor nerves of the brainstem (bulbar region), causing progressive difficulty with speech, swallowing, and breathing. The VA rates bulbar palsy based on the severity of speech, swallowing, and respiratory impairment.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 8005

Rating range

60% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.124a, DC 8005. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your bulbar palsy is so severe that you cannot speak, cannot swallow safely, and have significant respiratory compromise. You depend on others for feeding and may need ventilatory support.

What the VA looks for

Complete loss of intelligible speech
Total dependence on tube feeding
Respiratory failure requiring BiPAP or mechanical ventilation
Recurrent aspiration pneumonia
Constant care and supervision required

Common Pitfalls

⚠Not getting a comprehensive speech-language pathology evaluation — this specialist testing documents the severity of dysarthria and dysphagia far more accurately than a general neurological exam.
⚠Not documenting aspiration events — aspiration pneumonia and choking episodes are critical evidence of swallowing severity and directly support higher ratings.
⚠Not connecting bulbar palsy to its underlying cause — it can result from ALS, stroke, brainstem tumors, or other service-connected conditions, and establishing this link is essential for service connection.
⚠Not filing for respiratory impairment separately — bulbar palsy often causes respiratory muscle weakness that may warrant a separate rating under the respiratory system.

Related DBQ Forms

DBQ Central Nervous System and Neuromuscular Diseases
DBQ Cranial Nerves Diseases

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 8005

Rating range

60% – 100%

Rating levels

Rating Levels

Your bulbar palsy is so severe that you cannot speak, cannot swallow safely, and have significant respiratory compromise. You depend on others for feeding and may need ventilatory support.

What the VA looks for

Complete loss of intelligible speech
Total dependence on tube feeding
Respiratory failure requiring BiPAP or mechanical ventilation
Recurrent aspiration pneumonia
Constant care and supervision required

Common Pitfalls

⚠Not getting a comprehensive speech-language pathology evaluation — this specialist testing documents the severity of dysarthria and dysphagia far more accurately than a general neurological exam.

⚠Not documenting aspiration events — aspiration pneumonia and choking episodes are critical evidence of swallowing severity and directly support higher ratings.

⚠Not connecting bulbar palsy to its underlying cause — it can result from ALS, stroke, brainstem tumors, or other service-connected conditions, and establishing this link is essential for service connection.

⚠Not filing for respiratory impairment separately — bulbar palsy often causes respiratory muscle weakness that may warrant a separate rating under the respiratory system.