Estimates reveal that more than 10 million Americans suffer from temporomandibular joint and muscle disorders, or TMJ.
This is a painful condition that affects your jaw joint, as well as the surrounding muscles that control your jaw movement. It can be caused by a number of factors, ranging from genetics and arthritis to bone injuries and stress.
In veterans, TMJ is often linked to Post-Traumatic Stress Disorder (PTSD), and the anxiety and tension associated with this condition. If you believe you fall into this category, you could be eligible to receive TMJ VA disability benefits.
In this article, we’ll also explain how the VA rates TMJ, so you can understand exactly how you qualify.
In this article about VA benefits for TMJ:
- What Is TMJ?
- How Does TMJ Impact Your Life?
- Is TMJ a Disability?
- What Is the Disability Rating for TMJ?
- Direct Service Connection: TMJ VA Disability Ratings
- TMJ as a Secondary Service Condition
- TMJ Secondary to Wisdom Teeth Residual Condition
- Apply For VA Benefits for TMJ-Related Pain
What Is TMJ?
It isn’t uncommon to experience short-term, temporary pain in your jaw area. This type of fleeting discomfort usually occurs in cycles and isn’t chronic.
However, some people develop long-term symptoms that begin to impede their quality of life.
What exactly is your temporomandibular joint? In short, it’s the hinge-like joint that connects your lower jaw (mandible) to your temporal bone, located on the side of your head. To feel this joint for yourself, place your fingers on your face, in front of your ears. Then, open your mouth.
This joint is flexible, allowing you to move your jaw open and shut, as well as side to side. Yet, it isn’t indestructible. There are many different types of TMJ disorders, or TMD. Let’s take a look at a few of the most common ones.
TMJ Myofascial Pain
Myofascial pain refers to pain or discomfort centralized in the muscles responsible for controlling your jaw function. Categorized as a chronic pain disorder, it can occur as a result of muscle trauma, muscle overuse, or psychological stress.
Internal Joint Derangement
Internal joint derangement occurs when a dislocation or injury occurs to or around your temporomandibular joint. This could include a displaced disc or a dislocated jaw. It could also mean an injury to the rounded end of your jawbone, known as your condyle.
Degenerative Joint Disease
Sometimes, TMJ pain doesn’t occur as a sudden onset. Rather, it happens over time due to a degenerative condition. This is the case when osteoarthritis or rheumatoid arthritis settles in your jaw joint, leading to dull, nagging pain.
Note that each of these conditions can strike individually, or someone can suffer from all of them at once. In addition, there are several co-occurring health issues that can develop alongside TMJ. These can include:
- Chronic fatigue syndrome
- Chronic headaches
- Lower back pain
- Irritable bowel syndrome
- Interstitial cystitis
- Sleep disturbances
- Ear pain or ringing (tinnitus)
According to the TMJ Association, around 85% of people who suffer from TMD also experience pain in another part of their body. These conditions are considered comorbid because they can exist simultaneously.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
How Does TMJ Impact Your Life?
If you live with TMJ, you know that the pain associated with this condition can make it difficult to perform many routine, everyday functions. From talking to chewing, every action that requires moving your mouth can be affected.
Some of the symptoms you can expect to experience include:
- Pain in one or both of your temporomandibular joints
- Inflammation and tenderness around your jaw
- Pain inside or around your ears
- Facial pains and aches
- Pain while chewing or difficulty chewing
- Difficulty swallowing
- A locked jaw joint, impacting your ability to open or close your mouth
- A clicking or grating sound when you activate the jaw joint
As you might imagine, any of these symptoms can be debilitating to live with. This is especially the case if you’re also grappling with one of the comorbid conditions listed above.
Is TMJ a Disability?
Yes, the VA does consider TMJ to be a disability. What about benefits? Can you get a VA rating for TMJ?
That answer is also “yes”. This condition can be rated as either a direct service connection or a secondary service connection, depending on any other health issues that may be present.
As with all claims for a service connection, the VA will require a diagnosis of TMJ, and a connection between the disorder and your time in active military service. This connection is known as a nexus.
One example of an in-service event that might cause TMJ is an IED blast, which can cause severe and significant injury to the muscles and bones in your head and neck. Or, you may experience tension in this area as a result of PTSD or chronic pain associated with your time in the military.
In all, the three criteria you’ll need to present to qualify for a direct service connection for TMJ include:
- A current diagnosis
- An in-service event, injury, or illness
- A medical nexus that links your diagnosis to the in-service event
Both your doctor and your dentist are capable of providing a formal TMJ or TMD diagnosis. In most cases, this will require an assessment of your jaw movement to identify key symptoms. Other key pieces of evidence that can strengthen your veteran’s disability case include:
- An X-ray of your jaw
- A CT scan
- An MRI
What Is the Disability Rating for TMJ?
The VA rates TMJ under 38 CFR § 4.150, Schedule of Ratings: Dental and Oral Conditions, Diagnostic Code 9905.
This specific code is designed to measure the “millimeters of maximum unassisted vertical opening”.
This is known as the joint’s interincisal range, or IR. In other words, the VA looks at the degree to which TMJ alters the motion of your jaw joint. How far can you open your mouth or move your jaw side-to-side? Your IR is how many millimeters high you can open your mouth.
In addition, your rating is also based on your ability to eat regular or mechanically altered food.
In this context, mechanically altered food refers to physically changing the makeup of food to make it easier to eat or swallow. Common measures include:
If you have to alter your food to make it easier or more comfortable to consume, this will also affect your final VA disability rating. You’ll note that the VA includes various different kinds of foods in these ratings, including:
- Soft foods
- Semi-solid foods
- Pureed foods
- Full liquid foods
Simply preparing a texture-modified diet at home isn’t enough to claim these benefits. Rather, your physician or dentist will need to record or verify that you are officially on a mechanically-altered diet. If you have a difficult time eating regular, non-modified food, be sure to bring this up at your appointment.
Here are some tips on your C&P exam from one of our VA disability lawyers.
Direct Service Connection: TMJ VA Disability Ratings
Next, let’s dive into the actual rating system under Diagnostic Code 9905 and how to understand it.
- IR of 0 to 10 millimeters, with dietary restrictions to all mechanically altered foods: 50% rating
- IR of 0 to 10 millimeters, without dietary restrictions to all mechanically altered foods: 40% rating
- IR of 11 to 20 millimeters, with dietary restrictions to all mechanically altered foods: 40% rating
- IR of 11 to 20 millimeters, without dietary restrictions to all mechanically altered foods: 30% rating
- IR of 21 to 29 millimeters, with dietary restrictions to full liquid and pureed foods: 40% rating
- IR of 21 to 29 millimeters, with dietary restrictions to soft and semi-soft foods: 30% rating
- IR of 21 to 29 millimeters, without dietary restrictions to mechanically altered foods: 20% rating
- IR of 30 to 34 millimeters, with dietary restrictions to full liquid and pureed foods: 30% rating
- IR of 30 to 34 millimeters, with dietary restrictions to soft and semi-soft foods: 20% rating
- IR of 30 to 34 millimeters, without dietary restrictions to mechanically altered foods: 10% rating
The above ratings measure your degree of limited interincisal movement (IR), or how big you can open your jaw measured up and down.
There’s also another limitation that the VA will consider, known as limited lateral excursion. This measures how easily your jaw can slide from side-to-side. It’s important to understand that you cannot combine these ratings.
Under this schedule, the VA rating for lateral excursion range of motion is as follows:
- 0 to 4 millimeters: 10% rating
What if you can fully open your jaw and move it laterally? Even without such functional loss or range of motion, you could still qualify to receive VA disability benefits related to your TMJ.
Why? You could still feel pain when you make these motions, even if you are capable of making them successfully.
If this is the case, you could evoke the VA’s Painful Motion Principle. This principle maintains that if a veteran experiences pain while moving a joint, the rating is 10%.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.
TMJ as a Secondary Service Condition
Sometimes, TMJ can result as a secondary condition following another, direct service-related condition. As we’ve mentioned, TMJ and PTSD are often linked, especially for veterans.
Let’s review a few of the primary service-related conditions that count TMJ among their secondary conditions.
TMJ Secondary to PTSD
Exposure to certain military experiences can trigger the onset of PTSD, a condition that affects a significant number of veterans. Specifically, researchers estimate that up to 20 out of every 100 veterans who served in Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) experience PTSD in a given year.
Conditions such as PTSD can heighten your stress levels, which can lead to a host of other medical conditions, including heart disease and hypertension. It can also lead to tension in your jaw, as you’re more likely to clench those muscles when you’re stressed.
If you have already received a VA rating for PTSD, you could increase your rating by applying for TMJ as a secondary, service-related condition.
TMJ Secondary to Bruxism
Does your partner complain that you grind your teeth at night? Even if you aren’t aware that you’re doing it, you’ll likely feel the effects the next morning! Teeth grinding, or bruxism, can cause your neck, jaw, and even your teeth to feel sore when you awaken.
You can grind or gnash your teeth both during the day and overnight, with other symptoms that include:
- Tooth deformities (chipping, flattening, loosening)
- Tooth sensitivity
- Ear pain
- Sleep disruption
- Inner cheek damage
Bruxism can play a role in the development of TMJ. If your physician or dentist can help you establish a nexus between your bruxism diagnosis and your TMJ, you could apply to claim the one as a secondary condition to the other.
The Nexus Letter is like the missing link to a successful VA disability compensation claim. In this video, one of our veteran’s disability lawyers explains the importance of the Nexus Letter.
TMJ Secondary to Wisdom Teeth Residual Condition
Sometimes, a veteran will develop TMJ after having their wisdom teeth extracted. Most of the time, this happens to patients who already have pre-existing issues with their jaw joints. These issues are exacerbated by wisdom tooth surgery.
At the same time, deciding to keep your wisdom teeth can also worsen TMJ symptoms. When these teeth erupt, they can cause occlusal issues and overcrowding, which can affect the way your teeth make contact. Over time, this can place an excessive amount of stress on your temporomandibular joint.
As such, it’s often recommended that these teeth are removed as they erupt. If this occurs during your time in service, this extraction could occur on-site.
The VA allows disability ratings for residual conditions that occur after wisdom teeth extraction. For instance, an infection could occur that leads to TMJ pain. Or, as in this case, a bony protrusion could be leftover from the surgery, which could cause pain in your jaw that only surgery can correct.
In both instances, you could claim TMJ discomfort as a secondary, service-related condition to a wisdom teeth residual condition.
A behind the scenes look at who works for you at Woods and Woods, The Veteran’s Firm.
Apply For VA Benefits for TMJ-Related Pain
As we’ve discussed, TMJ is a disorder that can affect not only your jaw, but your entire life. If you’re a veteran who suffers from this condition, you should apply to receive TMJ VA disability benefits.
Depending on the severity of your TMJ and its occurrence with any other service-related condition, you might receive up to a 50% rating. If you need assistance navigating any part of the benefits application process, we’re here to help. Woods and Woods, The Veteran’s Firm, has helped thousands of veterans get the VA disability they deserve.
Get in touch with us for free today for the legal advice and guidance you need.
There are no conclusive studies that show that braces cause TMJ. That means that the stress of the battlefield or some other event while you served may have caused your TMJ or even made it worse. Both circumstances count on your VA disability application.
If you have medical records of your wisdom teeth surgery and you have mouth or jaw problems because of it, you should apply for some kind of VA disability. Your doctor or dentist can diagnose you symptoms, but the hindrance to your normal life is what matters. TMJ, arthritis, medical malpractice, or whatever the cause, your rating will be based on the impact on your daily life. Give us a call and let’s go over your file for the best application.