Affecting nearly 12% of the population, temporomandibular joint (TMJ) disorders are common. But studies show TMJ is common in veterans with post-traumatic stress disorder (PTSD).
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If you’re a veteran with a TMJ diagnosis or experiencing symptoms, you may be eligible for a TMJ VA rating. This article explains the condition’s causes and how a VA rating for TMJ is determined.
In this article about the TMJ VA rating:
What is TMJ?
On each side of your jaw, you have one temporomandibular joint. This flexible joint connects your jawbone to your skull, allowing you to open and close your jaw, and move it side to side.
TMJ disorders can cause pain in your jaw joint and the muscles that control jaw movement. Since the parts of your jaw and mouth comprise a single unit, a problem in one area can cause pain and tenderness elsewhere.
Symptoms of TMJ disorders include difficulty chewing, jaw stiffness and pain, headaches, dizziness, tinnitus, trouble opening or closing your mouth, and sinus congestion.
Sometimes, painful symptoms of TMJ can be managed through medications, changes in habits, and non-surgical treatment. Other times, surgery may be required. Chronic symptoms can reduce your quality of life.
What causes TMJ disorders?
There is no singular cause of TMJ disorders, but experts believe it may be a combination of genetics and stress.
Other causes may include:
- Broken or dislocated jaw
- Injury to the face
- Joint damage from arthritis
- Osteoarthritis
- Bruxism (teeth grinding)
- PTSD
Veterans may be especially at risk of developing TMJ due to the nature of military life. A blow to the head or neck could impact the health of the bones and muscles that control jaw movement. Additionally, psychological damage from service can lead to increased anxiety levels and jaw clenching.
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TMJ VA rating
In the Schedule of Ratings for Dental and Oral Conditions, the VA uses diagnostic code 9905 to evaluate and assign TMJ disability ratings.
TMJ VA ratings range from 10% to 50% disabling. Your rating is based on three factors: your joint’s interincisal range (IR), lateral excursion range, and your ability to eat regular food.
Your IR measures how wide you can open your mouth. This helps the VA understand how much your TMJ alters the motion of your jaw joint. The lateral excursion range is how well you can move your jaw from side to side.
The VA also measures how well you can eat based on dietary restrictions: Are you able to eat semi-solid foods or do you require full liquid food?
“Mechanically altered foods” are foods broken down by blending, chopping, grinding, or mashing, making them easier to chew and swallow. There are four levels of mechanically altered foods:
- Full liquid
- Puree
- Soft
- Semisolid
If you’re on a texture-modified diet, it must be recorded or verified by a medical professional.
Description of Interincisal range: | VA Rating | Monthly payment (vet only) |
---|---|---|
0 to 10 millimeters (mm) of maximum unassisted vertical opening. | ||
With dietary restrictions to all mechanically altered foods | 50% | $1,075.16 |
Without dietary restrictions to mechanically altered foods | 40% | $755.28 |
11 to 20 mm of maximum unassisted vertical opening. | ||
With dietary restrictions to all mechanically altered foods | 40% | $755.28 |
Without dietary restrictions to mechanically altered foods | 30% | $524.31 |
21 to 29 mm of maximum unassisted vertical opening. | ||
With dietary restrictions to full liquid and pureed foods | 40% | $755.28 |
With dietary restrictions to soft and semi-solid foods | 30% | $524.31 |
Without dietary restrictions to mechanically altered foods | 20% | $338.49 |
30 to 34 mm of maximum unassisted vertical opening. | ||
With dietary restrictions to full liquid and pureed foods | 30% | $524.31 |
With dietary restrictions to soft and semi-solid foods | 20% | $338.49 |
Without dietary restrictions to mechanically altered foods | 10% | $171.23 |
Lateral excursion range of motion: | ||
0 to 4 mm | 10% | $171.23 |
TMJ and related conditions
A secondary condition is one that is caused by another service-connected condition. For example, any condition caused or worsened by service-connected TMJ is considered a secondary condition.
Headaches secondary to TMJ VA disability
When the muscles in your jaw are tense, the pain can spread to other TMJ muscles along your cheeks and head, causing headaches. Headaches are one of the most common conditions associated with TMJ disorders.
Usually, veterans who experience headaches caused by TMJ have other symptoms that accompany it such as jaw or facial pain.
Tinnitus secondary to TMJ
Tinnitus, described as hearing a ringing or buzzing sound that isn’t really there, is closely related to problems with the TMJ. Studies show that people with a TMJ disorder are more likely to develop tinnitus.
Medical professionals believe this may be due to the proximity of the inner ear, specifically the cochlea, to the TMJ. If the hair cells in the cochlea are damaged, this can be a catalyst for tinnitus.
Tinnitus is the most common VA disability claim among veterans. If you have tinnitus as a result of service-connected TMJ, you may be able to claim tinnitus secondary to TMJ.
TMJ secondary to PTSD
Sometimes, TMJ is a secondary condition caused by another directly service-connected condition like PTSD.
PTSD, a common condition among veterans, is the second most common psychological disorder among people with face and mouth discomfort.
PTSD is known to heighten stress levels and keep your body in a state of tension. You’re more likely to tense your jaw when you’re stressed or in fight or flight mode. Over time, the tension can lead to issues with your jaw.
If you have already received a VA rating for PTSD, you may be able to increase your rating by applying for TMJ as a secondary service-connected condition.
How Veterans get TDIU for TMJ
If you’re living with a TMJ disorder, the pain and tenderness in your jaw may make it difficult to eat, and if your jaw locks up, speaking clearly also becomes a problem. If headaches accompany your TMJ issues, it can be hard to focus at work and complete normal tasks.
If your TMJ symptoms lead to increased absences at work or have made it difficult to work at all, total disability based on individual unemployability (TDIU) may be a solution.
TDIU pays at the same level as a 100% disability rating, even when the veteran’s combined rating is below 100%.
Veterans will typically be eligible for TDIU if they have:
- One service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
Since the highest rating you can receive for a TMJ disorder is 50%, a TMJ rating alone won’t make you eligible for TDIU. However, when combined with other service-connected disabilities, you could meet the criteria.
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FREQUENTLY ASKED QUESTIONS
VA disability ratings for TMJ range from 10% to 50% disabling. Your rating is based on three factors: how wide you can open your mouth, your ability to move your jaw from side to side, and your ability to eat regular food versus soft or pureed foods.
PTSD is the second most common psychological disorder among people with face and mouth discomfort and is associated with the development of TMJ disorders. Veterans with PTSD are more likely to tense their jaw when they’re stressed or in fight or flight mode. Over time, the tension can lead to issues with the jaw.
Neil Woods
VA disability lawyer
Woods and Woods
Neil Woods is the firm’s owner and president. He received his law degree from Western Michigan University.