TMJ VA Rating: Temporomandibular Disorder (DC 9905) Criteria

Complete TMJ VA rating table (38 CFR 4.150, Diagnostic Code 9905)

The table below sets out every rating percentage and criterion for Diagnostic Code 9905 (Temporomandibular disorder) under 38 CFR 4.150, along with the painful motion standard under 38 CFR 4.59 and monthly payment rates for a veteran without dependents.

Notice how the regulation treats the upper and lower opening brackets differently when applying physician-verified dietary restrictions:

• 21 to 29 mm and 30 to 34 mm brackets: Diagnostic Code 9905 splits modified diets into two tiers—restrictions to soft and semi-solid foods add 10 percentage points (raising 30–34 mm from 10% to 20%, and 21–29 mm from 20% to 30%), whereas restrictions to full liquid and pureed foods add 20 percentage points (raising 30–34 mm from 10% to 30%, and 21–29 mm from 20% to 40%).
• 0 to 10 mm and 11 to 20 mm brackets: The schedule provides a single dietary step-up—with dietary restrictions to all mechanically altered foods—which raises 11–20 mm from 30% to 40%, and raises 0–10 mm from 40% to the 50% schedular maximum.

Understanding the three binding notes to Diagnostic Code 9905

Three mandatory notes under Diagnostic Code 9905 in 38 CFR 4.150 govern how VA raters apply the schedule:

• Note (1) — No combining interincisal and lateral excursion ratings: “Ratings for limited interincisal movement shall not be combined with ratings for limited lateral excursion.” If you have 25 mm of unassisted vertical opening without dietary restrictions (20%) and 3 mm of lateral excursion (10%), you cannot receive both ratings under Diagnostic Code 9905. Under 38 CFR 4.7, the VA assigns the single higher rating (20%). Lateral excursion of 0 to 4 mm establishes 10% when vertical opening is 35 mm or greater.
• Note (2) — Normal maximum unassisted vertical opening (35 to 50 mm): “For VA compensation purposes, the normal maximum unassisted range of vertical jaw opening is from 35 to 50 mm.” The measurement reflects active opening without the examiner pushing your teeth apart. Any unassisted opening of 34 mm or less falls below normal range and qualifies for at least 10%.
• Note (3) — Mechanically altered foods and physician verification: “For VA compensation purposes, mechanically altered foods are defined as altered by blending, chopping, grinding or mashing so that they are easy to chew and swallow. There are four levels of mechanically altered foods: full liquid, puree, soft, and semisolid foods. To warrant elevation based on mechanically altered foods, the use of texture-modified diets must be recorded or verified by a physician.” Self-reported diet changes do not satisfy Note (3) unless a physician has recorded or verified the texture-modified diet in your records or exam report.

Related jaw and mandibular diagnostic codes in 38 CFR 4.150

When a jaw disability involves structural bone loss, fracture nonunion or malunion, or condylar loss rather than—or in addition to—joint limitation under Diagnostic Code 9905, 38 CFR 4.150 provides separate diagnostic codes:

• DC 9900 (Maxilla or mandible, chronic osteomyelitis, osteonecrosis, or osteoradionecrosis): Rated as chronic osteomyelitis under DC 5000.
• DC 9901 (Complete loss of mandible between angles): 100%.
• DC 9902 (Partial loss of mandible including ramus, unilateral or bilateral): When involving the temporomandibular articulation (whether loss is one-half or more, or less than one-half), rated at 70% (not replaceable by prosthesis) or 50% (replaceable by prosthesis). When not involving the temporomandibular articulation, loss of one-half or more is rated at 40% (not replaceable) or 30% (replaceable), and loss of less than one-half is rated at 20% (not replaceable) or 10% (replaceable).
• DC 9903 (Mandible nonunion, confirmed by diagnostic imaging): 30% (severe, with false motion) or 10% (moderate, without false motion).
• DC 9904 (Mandible malunion): 20% (displacement causing severe anterior or posterior open bite), 10% (moderate open bite), or 0% (not causing open bite).
• DC 9908 (Loss of condyloid process, one or both sides): 30%.
• DC 9909 (Loss of coronoid process): 20% (bilateral) or 10% (unilateral).

Under General Note (1) to 38 CFR 4.150, diagnostic imaging studies include X-ray, CT, MRI, PET, radionuclide bone scanning, or ultrasonography.

Painful motion (38 CFR 4.59), repetitive use, and C&P exam DBQ

Veterans whose unassisted jaw opening reaches 35 mm or more during a single measurement may still experience severe pain, locking, or fatigue when chewing. Under 38 CFR 4.59, objective evidence of painful motion—such as wincing, crepitus, or localized tenderness on active motion, passive motion, or mastication—warrants at least the minimum compensable rating of 10%. In addition, under 38 CFR 4.40, 38 CFR 4.45, DeLuca v. Brown, and Sharp v. Shulkin, the VA must account for additional limitation of motion in millimeters after repetitive use and during flare-ups.

During a C&P exam, a dentist (DDS/DMD) or physician completes the Temporomandibular Disorders (TMDs) Disability Benefits Questionnaire (DBQ):

1. Sections I & II (Diagnosis and Flare-Ups): Records your TMD diagnosis, ICD code, onset, flare-up frequency and duration, and functional loss with repeated use.
2. Section III, Item 3A (Initial Range of Motion): Measures active and passive Interincisal distance (greater than 34 mm, 30–34 mm, 21–29 mm, 11–20 mm, or 0–10 mm) and Right and Left lateral excursion (greater than 4 mm or 0–4 mm) for both TMJs, plus pain on motion or mastication, crepitus, and localized tenderness on palpation.
3. Section III, Items 3B–3D (Repetitive Use and Flare-Up Estimates): Tests at least three repetitions of jaw opening and records post-repetition millimeter brackets, then estimates range of motion in millimeters after repeated use over time and during flare-ups. Stop opening where pain or locking begins.
4. Section IV (Dietary Restrictions): Records whether you require a physician-verified mechanically altered diet, checking either restrictions to all mechanically altered foods (full liquid, puree, soft, and semi-solid) or restrictions to soft and semi-solid foods. Bring physician records documenting any prescribed diet modification.
5. Sections V & VI (Other Findings, Scars, and Imaging): Records facial/jaw scars (38 CFR 4.118) and X-ray, CT, or MRI evidence of TMJ arthritis.

Direct and secondary service connection (including bruxism)

• Direct service connection (38 CFR 3.303): Requires a current TMD diagnosis, an in-service injury or dental event, and a medical nexus. Common causes include blunt jaw trauma during combatives, airborne or vehicle accidents, blast exposure, difficult wisdom tooth extractions, or service dental records documenting TMJ clicking, locking, or splint therapy.
• Secondary service connection via bruxism (38 CFR 3.310): Many veterans establish TMD secondary to PTSD, anxiety, depression, or chronic pain via bruxism (teeth grinding and jaw clenching). While bruxism is not a standalone diagnostic code in 38 CFR Part 4, the VA recognizes bruxism as a secondary symptom of psychiatric or neurological conditions—or a side effect of SSRI/SNRI medications—that overloads the articular disc and mandibular condyle, causing or aggravating temporomandibular disorder (DC 9905). TMD may also be claimed secondary to a service-connected neck condition or traumatic brain injury (TBI).

Conditions secondary to TMJ and VA dental eligibility

Under 38 CFR 3.310 and General Note (2) to 38 CFR 4.150—which directs the VA to “separately evaluate loss of vocal articulation, loss of smell, loss of taste, neurological impairment, respiratory dysfunction, and other impairments under the appropriate diagnostic code and combine under § 4.25”—service-connected TMD may support separate or secondary ratings with a medical nexus:

• Migraines and tension headaches (38 CFR 4.124a, DC 8100): Trigeminal nerve irritation and temporalis/masseter spasm may trigger or aggravate headaches, rated at 0%, 10%, 30%, or 50%.
• Trigeminal (Fifth) and Facial (Seventh) cranial nerve impairment (38 CFR 4.124a, DCs 8205–8405, 8207–8407): Evaluated separately under General Note (2) of 38 CFR 4.150. Fifth cranial nerve paralysis, neuritis, or neuralgia (DCs 8205, 8305, 8405) is rated at 10% (incomplete, moderate), 30% (incomplete, severe), or 50% (complete); seventh cranial nerve impairment (DCs 8207, 8307, 8407) is rated at 10%, 20%, or 30%.
• Tinnitus (38 CFR 4.87, DC 6260): Because the TMJ sits immediately anterior to the ear canal and shares ligaments and nerve supply with middle-ear structures, TMD inflammation may cause or aggravate recurrent tinnitus (10%).
• Cervical spine strain (38 CFR 4.71a) and mental health conditions (38 CFR 4.130): Chronic jaw clenching and facial pain may aggravate cervical muscle spasm or cause secondary depression or anxiety.

Holding a compensable (10% or higher) rating under Diagnostic Code 9905 also qualifies a veteran for VA outpatient dental care needed to treat the service-connected jaw condition under 38 U.S.C. 1712 and 38 CFR 17.161.

Combining TMJ ratings and getting accredited help

Because the mandible moves as one single bone, Diagnostic Code 9905 assigns one single evaluation whether TMD affects one or both sides of the jaw, and the bilateral factor under 38 CFR 4.26 does not apply. Your TMJ rating combines with other service-connected disabilities under 38 CFR 4.25. For example, combining 70% for PTSD with 30% for secondary TMD adds 30% of the remaining 30% efficiency (9%), reaching 79%, which rounds to 80% ($2,102.15 per month alone, effective 2025-12-01). Model your combined percentage with our VA combined rating calculator and estimate retroactive pay with our VA back pay calculator.

If you need help preparing a claim or appealing an underrated C&P exam, accredited Veterans Service Organizations (VSOs)—such as the DAV, VFW, and American Legion—provide representation free of charge, while VA-accredited claims agents and attorneys handle appeals under federal fee rules. No representative can guarantee an outcome; verify credentials through the VA Office of the General Counsel Accreditation Search.