Hypoglossal Nerve Paralysis (Cranial Nerve XII)

DC 8212Neurological38 CFR 4.124a, DC 8212

Damage to the twelfth cranial nerve, which controls tongue movement. Causes the tongue to deviate to the weak side, difficulty speaking clearly, and problems chewing and swallowing food. Can result from surgery, trauma, tumors, or stroke.

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 8212

Rating range

10% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.124a, DC 8212. 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

Complete paralysis — you have total loss of tongue movement on one side with severe speech impairment, marked swallowing difficulty, and complete tongue atrophy.

What the VA looks for

Complete loss of tongue movement on affected side
Severe tongue atrophy with fasciculations
Speech largely unintelligible without compensation
Severe dysphagia requiring significant dietary modification
Aspiration risk documented

Common Pitfalls

⚠Not documenting speech impairment with a speech-language pathology evaluation — an SLP assessment provides objective evidence of dysarthria severity that strengthens your rating claim.
⚠Failing to document swallowing difficulty with a formal swallow study — a modified barium swallow or FEES study provides objective evidence of dysphagia and aspiration risk.
⚠Not filing for secondary conditions — hypoglossal nerve paralysis can cause aspiration pneumonia risk, weight loss from difficulty eating, and depression from speech impairment.
⚠Not connecting the nerve damage to a specific in-service event — document the surgery, intubation injury, trauma, or other event that caused the nerve damage.

Related DBQ Forms

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 8212

Rating range

10% – 30%

Rating levels

Rating Levels

Complete paralysis — you have total loss of tongue movement on one side with severe speech impairment, marked swallowing difficulty, and complete tongue atrophy.

What the VA looks for

Complete loss of tongue movement on affected side
Severe tongue atrophy with fasciculations
Speech largely unintelligible without compensation
Severe dysphagia requiring significant dietary modification
Aspiration risk documented

Common Pitfalls

⚠Not documenting speech impairment with a speech-language pathology evaluation — an SLP assessment provides objective evidence of dysarthria severity that strengthens your rating claim.

⚠Failing to document swallowing difficulty with a formal swallow study — a modified barium swallow or FEES study provides objective evidence of dysphagia and aspiration risk.

⚠Not filing for secondary conditions — hypoglossal nerve paralysis can cause aspiration pneumonia risk, weight loss from difficulty eating, and depression from speech impairment.

⚠Not connecting the nerve damage to a specific in-service event — document the surgery, intubation injury, trauma, or other event that caused the nerve damage.