Osteonecrosis of the Jaw VA Disability Rating (DC 9900)

Claiming Osteonecrosis of the Jaw?

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VA Rating Tiers

40%

active frequent

20%

moderate episodes

10%

mild episodes

Meets minimum criteria

Rating Notes

›40%: More than 6 weeks of incapacitating episodes (physician-prescribed bed rest) per year — or chronic active disease with repeated hospitalization. DC 9900.
›20%: 4–6 weeks of incapacitating episodes per year. DC 9900.
›10%: Less than 4 weeks of incapacitating episodes per year. DC 9900.
›0%: Documented but below compensable threshold — service connected but non-compensable.
›DC 9900: Osteomyelitis/osteonecrosis of the jaw — rated on incapacitating episodes and disease activity.
›Osteomyelitis and osteonecrosis share DC 9900.
›Medication-related osteonecrosis (MRONJ) from bisphosphonates used for service-connected cancer is commonly filed as a secondary claim.
›Clinical C&P examination with imaging required for accurate rating.

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Current symptoms

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In-service event

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Diagnosis or lay evidence

•DC 9900 — osteonecrosis of the jaw; rated based on disease activity and incapacitating episodes.
•Medication-related osteonecrosis of the jaw (MRONJ/BRONJ) can be a secondary condition to service-connected cancer treatment.
•Service connection may be direct (jaw trauma) or secondary to service-connected cancer requiring bisphosphonate or antiresorptive therapy.
•Exposed necrotic bone in the jaw that doesn't heal is the hallmark finding.
•A nexus letter from an oral surgeon or maxillofacial surgeon is required.

Service Records

•records of cancer treatment (chemo, bisphosphonates) for service-connected malignancy
•records of jaw trauma during service
•medication records for bisphosphonates or antiresorptive drugs

Medical Evidence