38 C.F.R. § 4.150

Schedule of ratings—dental and oral conditions

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Rating
Note (1): For VA compensation purposes, diagnostic imaging studies include, but are not limited to, conventional radiography (X-ray), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), radionuclide bone scanning, or ultrasonography
Note (2): Separately evaluate loss of vocal articulation, loss of smell, loss of taste, neurological impairment, respiratory dysfunction, and other impairments under the appropriate diagnostic code and combine under § 4.25 for each separately rated condition
9900 Maxilla or mandible, chronic osteomyelitis, osteonecrosis or osteoradionecrosis of:
Rate as osteomyelitis, chronic under diagnostic code 5000.
9901 Mandible, loss of, complete, between angles100
9902 Mandible, loss of, including ramus, unilaterally or bilaterally:
Loss of one-half or more,
Involving temporomandibular articulation
Not replaceable by prosthesis70
Replaceable by prosthesis50
Not involving temporomandibular articulation.
Not replaceable by prosthesis40
Replaceable by prosthesis30
Loss of less than one-half,
Involving temporomandibular articulation.
Not replaceable by prosthesis70
Replaceable by prosthesis50
Not involving temporomandibular articulation.
Not replaceable by prosthesis20
Replaceable by prosthesis10
9903 Mandible, nonunion of, confirmed by diagnostic imaging studies:
Severe, with false motion30
Moderate, without false motion10
9904 Mandible, malunion of:
Displacement, causing severe anterior or posterior open bite20
Displacement, causing moderate anterior or posterior open bite10
Displacement, not causing anterior or posterior open bite0
9905 Temporomandibular disorder (TMD):
Interincisal range:
0 to 10 millimeters (mm) of maximum unassisted vertical opening.
With dietary restrictions to all mechanically altered foods50
Without dietary restrictions to mechanically altered foods40
11 to 20 mm of maximum unassisted vertical opening.
With dietary restrictions to all mechanically altered foods40
Without dietary restrictions to mechanically altered foods30
21 to 29 mm of maximum unassisted vertical opening.
With dietary restrictions to full liquid and pureed foods40
With dietary restrictions to soft and semi-solid foods30
Without dietary restrictions to mechanically altered foods20
30 to 34 mm of maximum unassisted vertical opening.
With dietary restrictions to full liquid and pureed foods30
With dietary restrictions to soft and semi-solid foods20
Without dietary restrictions to mechanically altered foods10
Lateral excursion range of motion:
0 to 4 mm10
Note (1): Ratings for limited interincisal movement shall not be combined with ratings for limited lateral excursion
Note (2): For VA compensation purposes, the normal maximum unassisted range of vertical jaw opening is from 35 to 50 mm
Note (3): For VA compensation purposes, mechanically altered foods are defined as altered by blending, chopping, grinding or mashing so that they are easy to chew and swallow. There are four levels of mechanically altered foods: full liquid, puree, soft, and semisolid foods. To warrant elevation based on mechanically altered foods, the use of texture-modified diets must be recorded or verified by a physician
9908 Condyloid process, loss of, one or both sides30
9909 Coronoid process, loss of:
Bilateral20
Unilateral10
9911 Hard palate, loss of:
Loss of half or more, not replaceable by prosthesis30
Loss of less than half, not replaceable by prosthesis20
Loss of half or more, replaceable by prosthesis10
Loss of less than half, replaceable by prosthesis0
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 teeth40
Loss of all upper teeth30
Loss of all lower teeth30
All upper and lower posterior teeth missing20
All upper and lower anterior teeth missing20
All upper anterior teeth missing10
All lower anterior teeth missing10
All upper and lower teeth on one side missing10
Where the loss of masticatory surface can be restored by suitable prosthesis0
Note—These ratings apply only to bone loss through trauma or disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, since such loss is not considered disabling
9914 Maxilla, loss of more than half:
Not replaceable by prosthesis100
Replaceable by prosthesis50
9915 Maxilla, loss of half or less:
Loss of 25 to 50 percent:
Not replaceable by prosthesis40
Replaceable by prosthesis30
Loss of less than 25 percent:
Not replaceable by prosthesis20
Replaceable by prosthesis0
9916 Maxilla, malunion or nonunion of:
Nonunion,
With false motion30
Without false motion10
Malunion,
With displacement, causing severe anterior or posterior open bite30
With displacement, causing moderate anterior or posterior open bite10
With displacement, causing mild anterior or posterior open bite0
Note: For VA compensation purposes, the severity of maxillary nonunion is dependent upon the degree of abnormal mobility of maxilla fragments following treatment (i.e., presence or absence of false motion), and maxillary nonunion must be confirmed by diagnostic imaging studies
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, malignant100
Note: A rating of 100 percent shall continue beyond the cessation of any surgical, radiation, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals such as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring
[59 FR 2530, Jan. 18, 1994, as amended at 82 FR 36083, Aug. 3, 2017]
Notes of Decisions
Cited in 44 cases (5 in the last 5 years), 1993–2023 · leading case: Mary Vilfranc v. Robert A. McDonald, 28 Vet. App. 357 (Vet. App. 2017).
Mary Vilfranc v. Robert A. McDonald, 28 Vet. App. 357 (Vet. App. 2017). · cites it 6× “Because we find the Secretary's regulation ambiguous and his interpretation is not plainly erroneous or inconsistent with the language of the regulation, we defer to that interpretation.”
Regis J. Byrd v. R. James Nicholson, 19 Vet. App. 388 (Vet. App. 2005). · cites it 5× “He argues that the schedule of ratings under 38 C.F.R. § 4.150 sets forth the conditions that are considered “disabling” and that periodontal disease is not included but, instead, is excluded with an explanation that it is not considered to be a disabling condition.”
Gary D. Bradley v. James B. Peake, 22 Vet. App. 280 (Vet. App. 2008). “Additionally, the rating schedule provides ratings for a pain disorder under a mental disorders section, see 38 C.F.R. § 4.150 , DC 9422 (2008), and a January 2003 compensation and pension examination included a mental evaluation as well as a physical evaluation of Mr.”
Floyd v. Brown, 9 Vet. App. 88 (Vet. App. 1996). “Under the former DC, malunion of the mandible warrants a 10% rating for moderate displacement, and a 20% rating for severe displacement; in addition, this DC provides that the rating is dependent on the “degree of motion and loss of mastica-tory function.”
Breland v. McDonough, 22 F.4th 1347 (Fed. Cir. 2022). “If the VA were to interpret these identical or nearly identical notes contrary to the majority’s interpretation of the note to DC 7343, that would be the definition of an ar- bitrary interpretation which the VA is not permitted to make.”
Simington v. West, 11 Vet. App. 41 (Vet. App. 1998). · cites it 2× “149 , but the loss of teeth as described in the latter provision is rated, in accordance with the diagnostic code, when their loss is service connected, and may be rated anywhere from 0% to 100% disabling, 38 C.”
Mays v. Brown, 5 Vet. App. 302 (Vet. App. 1993). “Furthermore, because the veteran’s claim for service-connected disability compensation for a dental condition raised a claim to which the provisions of section 17.”
James Woodson, Claimant-Appellant v. Jesse Brown, Sec'y of Vets. Affairs, 87 F.3d 1304 (Fed. Cir. 1996). “at 354 ; see 38 C.F.R. § 4.150 , Code 9913; see also 38 C.”
Woodson v. Brown, 8 Vet. App. 352 (Vet. App. 1995). “” 38 C.F.R. § 4.150 , Diagnostic Code (DC) 9913 (1994); see also 38 C.”
Grovhoug v. Brown, 7 Vet. App. 209 (Vet. App. 1994). · cites it 2× “In January 1989, the RO issued a rating decision implementing the BVA’s grant of service connection for periodontal disease, assigning a noncompensable (0%) rating under 38 C.F.R. § 4.150 , Diagnostic Code 9999-9913 (1988).”
Roby v. McDonough (Fed. Cir. 2021). · cites it 5× “The Veterans Court also pointed out that, in a different diagnostic code concerning temporomandibular disorders ( 38 C.F.R. § 4.150 , DC 9905), the VA had defined “full liq- uids” consistently with how it defined “liquids” under DC 7203.”
06-12 124 (Board of Vet. App. 2016). · cites it 4× “Under current VA regulations, compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150 . These conditions include various problems of the maxilla, mandible, or temporomandibular articulation, loss of whole or part of the…”
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