The Department of Veterans Affairs pays veterans disability benefits for injuries the veteran suffered during active duty service. One of the injuries you can collect VA disability for is a temporomandibular joint disorder, commonly known as TMJ. If you are a veteran and suffer from TMJ because of your service, contact a VA disability lawyer for a case evaluation. We can help even if you’ve already received a denial of veteran disability benefits for your temporomandibular joint disorder claim.
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Have You Received a Denial From Veteran Affairs for Your Temporomandibular Joint Disorder Claim?
If you filed a veteran disability claim for temporomandibular joint disorder and received a denial, you can file a supplemental claim, higher-level review, or Notice of Disagreement straight to the Board of Veterans Appeals. If you file a supplemental claim, you must submit new and relevant information to supplement your original claim.
If you do not have new and relevant information but believe the VA was incorrect in denying your claim, you can request a higher-level review. If the VA denies your supplemental claim, you can ask for a higher-level review or file a Notice of Disagreement; you can also file a Notice of Disagreement if the VA denies your higher-level review.
Most people will file a supplemental claim or a higher-level review before filing a Notice of Disagreement; however, you can skip those steps and file the appeal to the Board first, depending on your circumstances. Filing a Notice of Disagreement means you will be waiting substantially longer to receive a decision; however, it still may be the best choice for your specific situation.
How Does the VA Rate Temporomandibular Joint Disorder?
Disabilities paid by the VA are codified in the Code of Federal Regulations. TMJ is listed under 38 CFR §4.150 (dental/oral conditions) under Diagnostic Code 9905. The VA will look at how much motion your jaw has and if you have the ability to eat regular food. Some people who have TMJ can only eat ground, mashed, pureed, soft, chopped, blended, liquid, or semi-solid foods.
You can open your jaw or move it side to side and front to back for chewing. The VA only rates one of those directions. If you have trouble with more than one, the VA will rate you based on which direction gives you the highest disability rating. Most people can open their jaws from 35 to 50 mm. The ratings are as follows:
- If you can open your jaw up to 10 mm unassisted, the VA pays 50 percent if you have dietary restrictions as recommended by your doctor and 40 percent if you do not have dietary restrictions.
- If you can open your jaw from 11 to 20 mm without assistance, the VA will pay 40 percent if you have dietary restrictions recommended by your doctor and 30 percent for no dietary restrictions.
- If you can open your jaw from 21 to 29 mm without assistance, the VA will pay 40 percent if your diet is restricted to liquid or pureed foods, 30 percent if you have dietary restrictions of soft and semi-solid food, and 20 percent if you do not have dietary restrictions.
- If you can open your jaw from 30 to 34 mm without assistance, the VA will pay 30 percent if you are restricted to liquid and pureed foods, 20 percent if your dietary restrictions include soft and semi-solid food, and 10 percent if your doctor did not recommend dietary restrictions.
Common Causes of Service-Related Temporomandibular Joint Disorder (TMJ)
Some of the common causes of service-related TMJ include IED blasts and other events that could cause severe injuries to bones and muscles in your head and neck. Tension from post-traumatic stress syndrome could also cause tightening of the muscles and TMJ.
If you are currently in the service and believe that you could have issues with TMJ later or are already suffering from pain related to TMJ, be sure to seek medical care and keep all of your medical records relating to jaw pain, eye pain, and face pain.
How Is Service Connection Established for Temporomandibular Joint Disorder (TMJ)?
In order to prove entitlement to service connection, you must show that:
- You currently have TMJ.
- You suffered an injury or illness or other event while you were on active duty.
- There is a connection, or medical nexus, between the event, injury, or illness in service and your current TMJ diagnosis.
Your doctor can give you a formal diagnosis of TMJ, as can your dentist. Either can perform an assessment of jaw movement and determine the key symptoms. Documents that can help with your claim include x-rays, a CT scan, or an MRI of your jaw. In some cases, buddy statements and lay statements can also help your claim.
Frequently Asked Questions
Yes, but you have to prove that the TMJ is service-connected – that you suffer from TMJ because of an injury or illness you sustained during active duty.
Compensation varies depending on how far you can open your mouth and whether your doctor recommended a restrictive diet and the type of diet. You could receive from 10 percent to 50 percent for service-connected TMJ.
Your doctor or dentist will take x-rays, a CT scan, or an MRI of your jaw to determine whether you have TMJ. You then have to show that you suffer from TMJ because of your service. You will have to obtain your medical records from when you were in the service to show that you sustained injuries to your head, neck and/or face.
If you suffer from TMJ caused by post-traumatic stress disorder, your doctor will have to show that the TMJ is caused by the stress pressure you put on the bones and muscles in your face and neck.
Contact a VA Disability Lawyer Today
A VA Disability Lawyer’s role is to assist you throughout the confusing and often frustrating appeals process if you have been denied benefits for your service-connected temporomandibular joint disorder. Generally, you need to be denied at least once before an attorney can assist, but once a veteran’s physical condition lawyer is involved, they will often be able to quickly determine what needs to be done in order to prove entitlement.
If your VA disability claim for temporomandibular joint disorder has been denied, be sure to contact the VA Accredited Attorneys at VetLaw right away to help make sure you get the entitlement you deserve.
