Vocal Cord Paralysis

DC 6519Respiratory38 CFR 4.97, DC 6519

Paralysis of one or both vocal cords, causing hoarseness, breathing difficulty, or loss of voice. The VA rates based on the severity of voice impairment and associated symptoms.

Rating Levels

You are constantly unable to speak above a whisper, or you are completely unable to communicate by speech.

What the VA looks for

Documented inability to speak above a whisper
Complete loss of voice (aphonia) confirmed by ENT
Laryngoscopy showing bilateral vocal cord paralysis or fixation
Impact on occupational and daily communication documented

Common Pitfalls

⚠Not getting a laryngoscopy to document the extent of vocal cord dysfunction — the VA needs objective evidence of paralysis, not just a report of hoarseness.
⚠Not documenting the impact on communication ability, especially for veterans whose jobs require speaking — describe how voice loss affects your work and daily life.
⚠Not connecting to in-service intubation injuries, neck surgery, or thyroid procedures that may have damaged the laryngeal nerve.
⚠If breathing is significantly impaired, consider whether a higher rating is available under pulmonary function criteria rather than just the voice-based criteria.

Related DBQ Forms

DBQ Respiratory Conditions (Other than Tuberculosis and Sleep Apnea)

View evidence checklist →See secondary conditions →

Condition Rating Guides

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