Claiming Osteoradionecrosis of the Jaw?
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VA Rating Tiers
40%
active frequent
20%
moderate episodes
10%
mild episodes
0%
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/osteoradionecrosis of the jaw.
- ›Osteoradionecrosis is typically filed as secondary to a service-connected head/neck malignancy.
- ›Radiation records and nexus from radiation oncologist or oral surgeon are critical.
- ›HBO therapy records can document severity of the condition.
- ›Clinical C&P exam with imaging is required for accurate rating.
Eligibility Basics
✅
Current symptoms
✅
In-service event
✅
Diagnosis or lay evidence
- •DC 9900 — osteoradionecrosis of the jaw; rated based on disease activity and incapacitating episodes.
- •Osteoradionecrosis occurs when radiation treatment damages jaw bone blood supply, causing bone death.
- •Most commonly filed as a secondary condition to a service-connected head/neck malignancy.
- •Radiation must be documented — the jaw bone is typically within or adjacent to the radiation field.
- •A nexus letter from a radiation oncologist or oral surgeon is essential.
Evidence to Gather
Service Records
- •records of head/neck cancer treatment during or secondary to service
- •radiation oncology records documenting radiation to jaw area
Medical Evidence
- •oral surgery or maxillofacial records documenting osteoradionecrosis
- •imaging (CT scan) showing jaw bone necrosis from radiation
- •radiation dosimetry records
- •surgical debridement or resection records
Lay Evidence (Buddy Statements)
- •personal statement describing radiation treatment and subsequent jaw necrosis
- •statement noting ongoing jaw pain, exposed bone, and eating difficulty
Diagnostic Tests
- •CT scan of jaw showing bone necrosis
- •panoramic X-ray
- •bone biopsy if needed to rule out recurrent tumor
- •hyperbaric oxygen therapy evaluation
C&P Exam Preparation
Exam type: Oral Medicine / Maxillofacial Surgery — Osteoradionecrosis
Be ready to describe
- •the service-connected cancer requiring radiation and when it was treated
- •when jaw osteoradionecrosis was diagnosed
- •current exposed bone and jaw symptoms
- •frequency of flare-ups and all treatments received
Prep notes
- •Bring radiation treatment records and dosimetry showing jaw area was included in the radiation field.
- •Bring CT imaging showing bone necrosis.
- •Bring service-connected cancer documentation if filing as secondary.
- •Describe worst-day symptoms — pain, difficulty eating, exposed bone.
- •Bring records of all HBO sessions and surgeries.
Quick Facts
- Diagnostic Code
- DC 9900
- Category
- Dental / Oral
- Subcategory
- Jaw Bone Disease
- Typical Claim Type
- secondary
- Rating Range
- 0% – 40%
Also Known As
osteoradionecrosis jawradiation jaw bone deathORN jawradiation necrosis jawjaw radiation bone necrosispost-radiation jaw necrosis
Related Conditions
Secondary to
Commonly leads to
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