VA Benefits for Jaw, Dental, and Oral Disabilities

Jaw Disabilities

Dental care and oral health may not be the first things to come to mind when you think about disabilities affecting veterans. They probably make you think of relatively minor issues that can be solved by simple procedures and routine self-care.

However, there are numerous more serious injuries and conditions related to oral health that may have been directly caused by veterans’ time in active service, made worse by their service, or are related to another service-connected condition. Such conditions can cause far more than just temporary discomfort, like cavities or gum disease, going so far as to negatively affect a veteran’s quality of life for the longterm.

In instances involving serious conditions like jaw injuries, loss or damage to your soft or hard palate, loss of several teeth, cancer, and other conditions affecting your ability to eat, VA provides monthly disability compensation, as long as your meet eligibility requirements that first and foremost assume that you can prove a service connection between your condition and your time in military service.

In general, disability-rated dental and oral conditions are those that cannot be ameliorated with simple dental care or procedures. Lost teeth that can be replaced, for instance, will not qualify for disability, whereas lost teeth that cannot be fit for replacements will qualify. The various conditions, their VA disability ratings, and your eligibility requirements are explored below, and may qualify for up to 100% disability in certain situations.

Also, on the topic of dental and oral conditions, it is worth mentioning that VA does, in fact, offer dental care benefits, and, depending on your situation, you may qualify to get most or all of your dental care provided through VA.

Proving a Service Connection for Dental and Oral Disabilities

Before diving into the conditions covered by VA, it is important to note that veterans must meet eligibility requirements before receiving disability compensation, starting with providing a service connection for your condition. A service connection means that your present condition resulted from your military service, whether your service directly caused it or simply made it worse. In these cases, you would be able to establish a direct service connection.

Another kind of service connection is secondary service connection, which you can seek by proving that your dental or oral condition is the result of another condition which has already been granted a direct service connection. If, for instance, your temporomandibular disorder (TMD) is the result of service-connected post-traumatic stress disorder (PTSD), then your condition may qualify on a secondary basis.

A service connection is found by providing three things: first, an in-service event, injury, or illness, second, a current diagnosis for your condition provided by a medical professional, and third, a nexus between the in-service event and your current diagnosis. VA will most likely schedule a Compensation & Pension (C&P) exam with you to help determine if your disability is service-connected.

VA Disability Ratings for Dental and Oral Conditions

Dental and oral conditions are rated for disability under 38 CFR § 4.150 of the Federal Register schedule of ratings. Ratings may be as low as 0% for conditions which cause minimal disfunction or discomfort, or which may be mostly alleviated by the fitting of a prosthesis. They may also go as high as 100% in instances where prostheses cannot be fitted or active cancer is present.

The following diagnostic codes, as found in the schedule of ratings, show the VA disability ratings for mandible (lower jaw) conditions, which are generally based on the amount of loss suffered, your ability to articulate your jaw, and the fitting of prostheses:

9000: Maxilla or mandible, chronic osteomyelitis, osteonecrosis or osteoradionecrosis of: rate as chronic osteomyelitis under diagnostic code 5000.
9001: Mandible, loss of, complete, between angles: 100%
9002: Mandible, loss of, including ramus, unilaterally or bilaterally:
- Loss of one half or more, involving temporomandibular articulation (not replaceable by prosthesis): 70%
- Loss of one half or more, involving temporomandibular articulation (replaceable by prosthesis): 50%
- Loss of one half or more, not involving temporomandibular articulation (not replaceable by prosthesis): 40%
- Loss of one half or more, not involving temporomandibular articulation (replaceable by prosthesis): 30%
- Loss of less than one-half, involving temporomandibular articulation (not replaceable by prosthesis): 70%
- Loss of less than one-half, involving temporomandibular articulation (replaceable by prosthesis): 50%
- Loss of less than one-half, not involving temporomandibular articulation (not replaceable by prosthesis): 20%
- Loss of less than one-half, not involving temporomandibular articulation (replaceable by prosthesis): 10%
9903: Mandible, nonunion of, confirmed by diagnostic imaging studies:
- Severe, with false motion: 30%
- Moderate, without false motion: 10%
9904: Mandible, nonunion of:
- Displacement, causing severe anterior or posterior open bite: 20%
- Displacement, causing moderate anterior or posterior open bite: 10%
- Displacement, not causing anterior or posterior open bite: 0%

Temporomandibular disorder (TMD), which may result from numerous conditions, causes disfunction and pain in the jaw joint and the in the muscles that control the jaw. Its ratings are oriented around your “interincisal range,” or more basically how much you can open your jaw, as well as what alterations you must make to your food so that you are able to eat. It is rated under Diagnostic Code 9905 as follows:

Interincisal range:

- 0 to 10 millimeters (mm) of maximum unassisted vertical opening.
  - With dietary restrictions to all mechanically altered foods: 50%
  - Without dietary restrictions to mechanically altered foods: 40%
- 11 to 20 mm of maximum unassisted vertical opening.
  - With dietary restrictions to all mechanically altered foods: 40%
  - Without dietary restrictions to mechanically altered foods: 30%
- 21 to 29 mm of maximum unassisted vertical opening.
  - With dietary restrictions to full liquid and pureed foods: 40%
  - With dietary restrictions to soft and semi-solid foods: 30%
  - Without dietary restrictions to mechanically altered foods: 20%
- 30 to 34 mm of maximum unassisted vertical opening.
  - With dietary restrictions to full liquid and pureed foods: 30%
  - With dietary restrictions to soft and semi-solid foods: 20%
  - Without dietary restrictions to mechanically altered foods 10%
- Lateral excursion range of motion: 0 to 4 mm: 10%

Condyloid process, coronoid process, and hard palate disabilities are rating under the following diagnostic codes.

- - - 9908: Condyloid process, loss of, one or both sides: 30%
    - 9909: Condyloid process, loss of, one or both sides
      - Bilateral: 20%
      - Unilateral: 10%
    - 9911: Hard palate, loss of:
      - Loss of half or more, not replaceable by prosthesis: 30%
      - Loss of less than half, not replaceable by prosthesis: 20%
      - Loss of half or more, replaceable by prosthesis: 10%
      - Loss of less than half, replaceable by prosthesis: 0%

Lost teeth ratings are handled in the following diagnostic codes. These disability ratings revolve around teeth that are lost due to “loss of substance of body” of your maxilla or mandible, and for which prostheses cannot be fitted. Importantly, VA stipulates that these only apply to situations where bone loss is caused by trauma or disease like osteomyelitis, and not periodontitis, which is a not a VA rated disability.

9913: Teeth, loss of, due to loss of substance of body of maxilla or mandible without loss of continuity:

- - - - Where the lost masticatory surface cannot be restored by suitable prosthesis:
        
        Loss of all teeth: 40%
        
        Loss of all upper teeth: 30%
        
        Loss of all lower teeth: 30%
        
        All upper and lower posterior teeth missing: 20%
        
        All upper and lower anterior teeth missing: 20%
        
        All upper anterior teeth missing: 10%
        
        All lower anterior teeth missing: 10%
        
        All upper and lower teeth on one side missing: 10%
      - Where the loss of masticatory surface can be restored by suitable prosthesis: 0%

Maxilla (upper jaw) conditions, are rated under the following diagnostic codes. Ratings are similar to those for the mandible, and are based on amount of loss, range of motion, and replaceability with prostheses:

- - - - 9914: Maxilla, loss of more than half:
        
        Not replaceable by prosthesis: 100%
        
        Replaceable by prosthesis: 50%
      - 9915 Maxilla, loss of half or less:
        
        Loss of 25 to 50 percent:
        
        Not replaceable by prosthesis: 40%
        
        Replaceable by prosthesis: 30%
        
        Loss of less than 25 percent:
        Not replaceable by prosthesis: 20%
        Replaceable by prosthesis: 0%
        
        9916 Maxilla, malunion or nonunion of:
        
        Nonunion,
        
        With false motion: 30%
        
        Without false motion: 10%
        
        Malunion,
        
        With displacement, causing severe anterior or posterior open bite: 30%
        
        With displacement, causing moderate anterior or posterior open bite: 10%
        
        With displacement, causing mild anterior or posterior open bite: 0%

Neoplasms are rated according to the following two diagnostic codes, and are based around the severity of the neoplasm.

- - - - 9917: Neoplasm, hard and soft tissue, benign: Rate as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring.
        
        9918 Neoplasm, hard and soft tissue, malignant: 100%

The 100% rating for neoplasm follows VA’s general rule of rating cancers that are being actively treated at 100% for a period of six months beyond the cessation of treatment. Following that period, VA will adjust your rating based on your current condition.

Assistance With Your Claim

Dental and oral disabilities make up a compact section of the VA’s schedule of disability ratings, but there is no denying the seriousness of the included injuries and conditions. Suffering from any of the conditions described above can significantly impact the quality of a veteran’s life, and those who are eligible for VA disability compensation will not want to pass it up.

If you have been denied a claim and need to file an appeal, or want to make sure your first claim is as strong as possible before you submit it for disability compensation, reach out to VA Disability Group PLLC right now. You can contact us at 844-VET-LAWS or fill out our online form to start the process and get the compensation you deserve.