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Evidence checklist

Sixth Cranial Nerve Paralysis

DC 609038 CFR § 4.79Neurological

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 4 collected
Neuro-ophthalmology evaluation documenting lateral rectus weakness and diplopiaCritical

A neuro-ophthalmologist's evaluation documenting horizontal diplopia, esotropia, failure of abduction of the affected eye, and degree of lateral gaze limitation. The VA rates based on severity of diplopia and visual field loss.

Private provider · independent opinion
MRI brain/orbit with gadoliniumCritical

MRI to evaluate the sixth nerve course from pons to cavernous sinus to orbit, looking for compressive, demyelinating, or ischemic causes.

Private provider · independent opinion
Nexus opinion linking sixth nerve palsy to service (at least as likely as not)Critical

Medical opinion connecting sixth cranial nerve palsy to in-service TBI, elevated intracranial pressure, skull base fracture, or meningitis during service.

Private provider · independent opinion
Prism cover test and ocular motility measurement

Quantified ocular deviation measurement in prism diopters across the gaze field, documenting the extent of muscle paresis for rating purposes.

Private provider · independent opinion
02

Treatment records

0 of 1 collected
Treatment records (prism glasses, patching, strabismus surgery)

Records of Fresnel prism correction, occlusion patching for diplopia, or botulinum toxin injection and strabismus surgery.

VA or private records · written request
03

Lay statements

0 of 2 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Cranial Nerve ConditionsCritical

VA standardized form capturing diplopia severity, visual field limitation, and functional impact. A sixth (abducens) nerve palsy is not rated on the 82xx cranial nerve codes — 38 CFR 4.124a sends first, second, third, fourth, sixth and eighth nerve lesions to the Organs of Special Sense, so it is rated as diplopia under DC 6090.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forBuddy statement builderGuided VA Form 21-10210

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