Diagnostic Code 5325 · 38 CFR §4.73
DC 5325 covers injury to the muscles of facial expression — the platysma, frontalis, orbicularis oculi, orbicularis oris, zygomaticus, levator labii superioris, and the other small superficial muscles that move the face. These muscles are innervated by the facial nerve (cranial nerve VII), but the diagnostic code captures the muscle injury itself rather than nerve damage, which has its own codes under the cranial nerve schedule. Combat-relevant mechanisms include shrapnel and fragment wounds, gunshot injuries crossing the face, blast injuries with extensive facial soft-tissue damage, and surgical residuals from reconstruction of those wounds. The rating reflects both the loss of facial muscle function (drooping, asymmetry, inability to close the eye fully, difficulty controlling food in the mouth) and the disfigurement that often accompanies the injury. Disfigurement of the head, face, or neck is rated under DC 7800 separately and frequently produces a higher rating than DC 5325 alone, so veterans with significant cosmetic residuals should be evaluated under both codes.
| Rating | Criteria |
|---|---|
| 0% | Slight injury — minor wound healing with no facial asymmetry, no muscle weakness, and no functional impairment. |
| 10% | Moderate injury — visible scarring with mild facial muscle weakness, slight asymmetry on smiling or eye closure, or minor difficulty with food management. |
| 30% | Moderately severe injury — definite facial asymmetry at rest, inability to fully close one or both eyes (lagophthalmos), difficulty with speech or food control, OR significant disfigurement that the rater may evaluate under DC 7800 if higher. |
| 50% | Severe injury — pronounced facial paralysis or muscle loss, inability to close the eye completely (risking corneal exposure injury), inability to control oral secretions, marked disfigurement, OR functional impairment severe enough to interfere with speech and feeding; DC 7800 disfigurement evaluation typically rates higher at this level and should be applied. |
A current physical examination documenting facial muscle function — symmetry at rest, ability to smile, ability to close each eye, ability to whistle, ability to control food in the mouth — is the core evidence. Photographs in repose and during attempted movement document the asymmetry. Imaging (CT or MRI of the face) characterizes the underlying tissue defect and any retained foreign bodies. EMG and nerve conduction studies of the facial muscles distinguish muscle injury from underlying facial nerve damage; both can coexist after combat trauma. Original surgical and trauma records establish the in-service event and the immediate-postoperative state. Records of any subsequent reconstructive surgery — facial nerve graft, fascial sling, gold weight implant for the eye, soft-tissue reconstruction — document the disease course.
No — DC 5325 captures muscle injury specifically. Facial nerve (cranial nerve VII) damage is rated under DC 8207 within the cranial nerve schedule. After combat trauma, both can coexist: the muscle itself is torn or scarred, AND the nerve supply is interrupted. The two codes can be combined when both findings are documented, because they evaluate different anatomical structures. EMG and nerve conduction studies distinguish the contributions.
DC 7800 (disfigurement of the head, face, or neck) is rated by counting the number of "characteristics of disfigurement" (scar length, scar width, contour distortion, abnormal pigmentation, etc.) and has a rating ceiling of 80%. DC 5325 caps at 50%. For most veterans with visible facial muscle injury, the disfigurement evaluation under DC 7800 produces a higher rating, and the principle is that the rater applies the higher code rather than stacking the two.
The blast or shrapnel injury itself is a direct in-service traumatic event that supports direct service connection without needing the PACT Act presumptives. The PACT Act framework applies primarily to toxic exposure conditions (respiratory cancers, rare cancers, certain reproductive conditions) rather than acute traumatic injuries. For combat trauma, the standard nexus pathway through service treatment records is sufficient and usually faster.