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.

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 6519

Rating range

10% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6519. 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

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 →C&P exam prep guide →See secondary conditions →

Related Conditions

Conditions commonly associated with Vocal Cord Paralysis or rated under the same body system.

Obstructive Sleep Apnea

DC 6847·Respiratory

Bronchial Asthma

DC 6602·Respiratory

Chronic Obstructive Pulmonary Disease (COPD)

DC 6604·Respiratory

Allergic Rhinitis

DC 6522·Respiratory

Chronic Sinusitis

DC 6510·Respiratory

Pulmonary Embolism (Residuals)

DC 6817·Respiratory

Sarcoidosis

DC 6846·Respiratory

Bronchiectasis

DC 6601·Respiratory

Condition Rating Guides

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

How the VA rates this condition

Diagnostic code

DC 6519

Rating range

10% – 60%

Rating levels

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.