VASRD Dental and Oral Conditions

When it’s time to retire or separate from the United States military, one very important part of that process is filing a medical claim (where appropriate) with the Department of Veterans Affairs for service-related medical issues. This claim is part of the future veteran’s ability to qualify care in the VA medical system.

The Department of Veterans Affairs uses a “schedule” of medical disability ratings as part of its’ process to evaluate veteran medical claims. This document covers a variety of conditions, injuries, and diagnoses broken down into separate categories based on regions of the human body.

The Veteran Affairs Schedule for Rating Disabilities (VASRD) includes a section on Dental and Oral Conditions that may qualify the veteran for VA compensation for conditions deemed to be service-connected.

Dental And Oral Conditions Are Unique

The Department of Veterans Affairs acknowledges that dental conditions are viewed and processed differently than other medical issues.

The VA official site reminds, “Dental benefits are not the same as other VA medical benefits. We look at many factors to decide who qualifies for VA dental care—and which dental care benefits each Veteran may receive.”

VA disability ratings for dental issues will depend on the nature, severity, and complexity of the issues. What follows below is a cross-section of conditions that may warrant VA benefits if the claim examiner finds the right conditions to be present.

Issues Related To The Mandible

There are multiple conditions related to the maxilla, mandible, and the range of articulation the patient has. These include, as described on the VA official site:

• Maxilla or mandible, chronic osteomyelitis, osteonecrosis or osteoradionecrosis
• Mandible, loss of, complete
• Mandible, loss of, including ramus, unilaterally or bilaterally
• Loss of one-half or more, Involving temporomandibular articulation

Another mandible condition is described as “malunion”, and yet another as “displacement”. These may be rated from 10% to 30% depending on circumstances.

The complete loss of a mandible is rated by the VA at 100%. The rating is lower in cases where a mandible may be replaced by a prosthesis and higher when such replacement is not possible.

Another mandible-related issue is described as Temporomandibular disorders (TMD), Johns Hopkins University describes TMD as “disorders of the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain”. These issues are rated by the VA up to 50% depending on the nature and severity of the condition.

The National Institute of Dental and Craniofacial Research classifies TMD as including:

• Myofascial pain or discomfort in the fascia, also known as the connective tissue covering the muscles, and/or and muscles that control jaw, neck and shoulder.
• Internal “derangement of the joint” including a dislocated jaw or displaced disk, or injury to the end of the jaw bone that articulates with the temporal skull bone.
• Degenerative joint disease such as osteoarthritis or rheumatoid arthritis in the jaw joint.

Medical Issues Related To The Hard Palate

The VA describes a “loss of hard palate” as a compensable medical issue. The loss of half of the soft palate or more, not replaceable with a prosthetic is VA-rated at 30%, with lower ratings from there depending on the amount of palate loss.

Medical Issues Related To Teeth And Maxilla

The loss of teeth “due to loss of substance of body of maxilla or mandible without loss of continuity” is a condition that can earn a VA disability rating as high as 40% for conditions where the loss of all teeth is documented. The scale gets lower depending on how many teeth are lost and whether or not they can be replaced with a prosthetic.

The loss of Maxilla, a major part of the anatomy of the face, is also compensable at a rating of 100% when not replaceable with a prosthetic.

The VA rating scale moves downward from there–in cases where half the maxilla or less has been lost, a rating up to 50% is possible but affected by whether or not a prosthetic can be used.

VA ratings for “nonunion” and “malunion” of the maxilla starts at roughly 30% but is affected by whether or not there is “false motion” present. VA ratings for nonunion and malunion maxilla conditions without false motion are closer to 10%.

Benign And Malignant Neoplasm

VA ratings for benign and malignant neoplasm can be as high as 100%. Neoplasm is defined by Cancer.gov as “An abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should”.

Neoplasms may be benign and not deemed cancerous, or be diagnosed as malignant which means cancer is present. Cancer.gov informs, “Benign neoplasms may grow large but do not spread into, or invade, nearby tissues or other parts of the body” where malignant neoplasms can affect any neighboring tissues or spread via the bloodstream.

VA ratings are only for malignant neoplasms (100%) and VA guidance for rating benign versions includes instructions for the VA rater to “Rate as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring”.

Due to the nature of malignant neoplasms, VA regulations for assigning a disability rating for this condition includes maintaining a 100% disability rating beyond the treatment phase for the condition.

Six months following any treatment for a malignant neoplasm, the patient will have the disability rating reviewed. VA rules include the following instructions for the VA rater:

“Any change in evaluation based upon that or any subsequent examination” shall be subject to the provisions of the VASRD including a requirement that in cases where there has been no recurrence of the neoplasm or metastasis, the VA rater must make a determination “…on residuals such as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring”.

Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News