Neuromyelitis Optica (Devic's Disease)

DC 8018Neurological38 CFR 4.124a, DC 8018 (by analogy)

An autoimmune condition that attacks the optic nerves and spinal cord, causing episodes of vision loss and limb weakness or paralysis. Similar to multiple sclerosis but tends to be more severe in its attacks and targets specific areas of the nervous system.

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 8018

Rating range

30% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.124a, DC 8018 (by analogy). 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

Totally disabling — your NMO has caused severe bilateral vision loss or blindness and significant paralysis, rendering you unable to work or care for yourself.

What the VA looks for

Bilateral blindness or near-blindness
Severe paralysis of extremities
Complete bladder and bowel incontinence
Wheelchair-dependent or bedridden
Unable to perform activities of daily living

Common Pitfalls

⚠NMO being misdiagnosed as multiple sclerosis — the treatments are different, and correct diagnosis affects the medical evidence. Request aquaporin-4 antibody testing to confirm the diagnosis.
⚠Not filing separate ratings for vision loss and neurological deficits — NMO attacks both the optic nerves and spinal cord. Vision loss should be rated under the eye codes (DC 6061-6079) in addition to the neurological rating.
⚠Failing to document the relapsing nature — NMO attacks can cause sudden, severe disability. Keep records of each attack including hospitalization, treatment, and residual deficits.
⚠Not documenting the need for immunosuppressive medications — ongoing treatment with rituximab, azathioprine, or similar medications demonstrates the chronic, severe nature of the condition and supports higher ratings.

Related DBQ Forms

DBQ Central Nervous System and Neuromuscular Diseases
DBQ Eye Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Neuromyelitis Optica (Devic's Disease)

How the VA rates this condition

Diagnostic code

DC 8018

Rating range

30% – 100%

Rating levels

Rating Levels

Totally disabling — your NMO has caused severe bilateral vision loss or blindness and significant paralysis, rendering you unable to work or care for yourself.

What the VA looks for

Bilateral blindness or near-blindness
Severe paralysis of extremities
Complete bladder and bowel incontinence
Wheelchair-dependent or bedridden
Unable to perform activities of daily living

Common Pitfalls

⚠NMO being misdiagnosed as multiple sclerosis — the treatments are different, and correct diagnosis affects the medical evidence. Request aquaporin-4 antibody testing to confirm the diagnosis.

⚠Not filing separate ratings for vision loss and neurological deficits — NMO attacks both the optic nerves and spinal cord. Vision loss should be rated under the eye codes (DC 6061-6079) in addition to the neurological rating.

⚠Failing to document the relapsing nature — NMO attacks can cause sudden, severe disability. Keep records of each attack including hospitalization, treatment, and residual deficits.

⚠Not documenting the need for immunosuppressive medications — ongoing treatment with rituximab, azathioprine, or similar medications demonstrates the chronic, severe nature of the condition and supports higher ratings.