Bruxism VA Rating: Learn more about Bruxism and Veterans

Understanding the Bruxism VA Rating is essential for veterans seeking compensation and support from the VA.

Bruxism, commonly known as teeth grinding or clenching, is a condition that can significantly impact a veteran’s oral health and overall well-being. Recognized by the Department of Veterans Affairs (VA) as a service-connected disability, bruxism falls under the broader category of Temporomandibular Joint (TMJ) Syndrome. This guide provides an accurate overview of how the VA evaluates bruxism, the rating criteria, and strategies to enhance your claim.

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Understanding Bruxism

What Is Bruxism?

Bruxism is the involuntary or habitual grinding and clenching of the teeth. It can occur during the day (awake bruxism) or at night (sleep bruxism). Chronic bruxism can lead to various dental and muscular issues, including:

• Tooth Damage: Worn-down, fractured, or loose teeth.
• Jaw Pain: Discomfort or pain in the jaw muscles.
• Headaches: Frequent tension headaches resulting from muscle strain.
• TMJ Disorders: Issues with the temporomandibular joint, leading to clicking or locking of the jaw.

Symptoms and Causes

Symptoms

Common symptoms of bruxism include:

• Grinding or Clenching Sounds: Audible during sleep or detected by a partner.
• Jaw Soreness or Tightness: Persistent discomfort in the jaw muscles.
• Tooth Wear: Noticeable flattening, chipping, or cracking of teeth.
• Headaches: Frequent tension-type headaches.
• Earaches: Pain resembling ear infections due to jaw muscle strain.
• Facial Pain: Discomfort in the facial muscles.

Causes

Bruxism can result from a combination of physical and psychological factors, including:

• Stress and Anxiety: High levels of stress can lead to unconscious clenching or grinding.
• Sleep Disorders: Conditions like sleep apnea are associated with increased bruxism.
• Medications: Certain antidepressants and other medications may contribute to bruxism.
• Malocclusion: Misalignment of the teeth can cause improper jaw function.
• Lifestyle Factors: Excessive caffeine or alcohol consumption can increase the likelihood of bruxism.

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Bruxism VA Rating Prevalence

Bruxism is prevalent among veterans due to the unique stresses and demands of military service. Factors contributing to its high prevalence include

• Psychological Stress: Exposure to combat, high-stress environments, and post-traumatic stress disorder (PTSD) can increase the risk of bruxism.
• Physical Strain: The physical demands of military duties can lead to jaw muscle tension.
• Sleep Disruptions: Irregular sleep patterns and sleep disturbances during service can exacerbate bruxism symptoms.

Studies indicate that a significant percentage of veterans experience bruxism, which can severely impact their quality of life, oral health, and overall functioning. A majority of Gulf War Illness veterans reported both grinding (77.8%) and clenching (85.2%) teeth on a weekly or daily basis according to an NIH study.

Bruxism VA Rating List

How the VA Assigns Disability Ratings

Bruxism is rated under Code 9905 in 38 CFR §4.150, which covers Temporomandibular Joint Disorders (TMD). The VA evaluates bruxism based on the severity of symptoms, range of motion (ROM) limitations in the jaw, and the degree to which symptoms interfere with daily activities and employment. The ratings for bruxism (as part of TMD) range from 10% to 40%.

Rating Scale

Based on 38 CFR §4.150, Code 9905, the VA disability rating for bruxism (as part of TMD) is as follows:

• 10% Rating:
  • Criteria: TMD with limited opening.
  • Range of Motion: Unable to fully open the mouth by more than 10 degrees from normal.
  • Symptoms: Mild pain or discomfort in the jaw with occasional muscle spasms.
  • Impact: Minimal interference with daily activities and employment.
• 20% Rating:
  • Criteria: TMD with deviation.
  • Range of Motion: Opening of the mouth is limited by more than 20 degrees from normal with deviation of the jaw to one side.
  • Symptoms: Noticeable pain or discomfort with frequent muscle spasms.
  • Impact: Some limitation in performing physical tasks and daily activities.
• 30% Rating:
  • Criteria: TMD with pain.
  • Range of Motion: Limited opening of the mouth by more than 30 degrees without deviation.
  • Symptoms: Considerable pain with frequent muscle spasms and possible neurological symptoms (e.g., numbness).
  • Impact: Noticeable impact on daily functioning and mobility; may affect ability to work.
• 40% Rating:
  • Criteria: TMD with deviation and pain.
  • Range of Motion: Limited opening of the mouth by more than 40 degrees with deviation of the jaw to one side.
  • Symptoms: Severe pain with constant muscle spasms and significant neurological involvement.
  • Impact: Significant limitation in mobility and daily activities; may severely affect ability to work.

Note:
TMD involves both structural (range of motion) and symptomatic (pain, muscle spasms) evaluations. The presence of deviation indicates a more severe impairment and justifies a higher rating.

Determining the Appropriate Rating

The VA assesses the severity of bruxism by evaluating:

1. Range of Motion (ROM): Measurement of how much the veteran can open their mouth compared to normal.
2. Symptom Severity: Intensity and frequency of pain, presence of muscle spasms, and any neurological symptoms.
3. Functional Impact: How bruxism affects daily activities, employment, and overall quality of life.

Calculating Combined Ratings

When multiple service-connected conditions are present, the VA uses a combined ratings table to determine the overall disability percentage. The Bruxism VA Rating under Code 9905 can be combined with other disabilities to reflect the cumulative impact on a veteran’s life. Disability ratings do not simply add up; instead, they are combined using a specific formula that accounts for the diminishing returns of adding multiple ratings.

Determination Process

The VA follows a systematic process to determine the Bruxism VA Rating:

1. Medical Evaluation: Comprehensive assessment by a VA healthcare provider, including a review of the veteran’s medical history and current condition related to bruxism and TMD.
2. Record Review: Examination of medical records, dental reports, service history, and any documentation related to bruxism and associated symptoms.
3. Functional Impact Assessment: Evaluation of how bruxism affects the veteran’s daily activities, work performance, and overall quality of life.
4. Rating Assignment: Based on the severity and impact, a disability rating is assigned according to the VA’s criteria under 38 CFR §4.150 Code 9905.

How to File a Claim

Step-by-Step Guide

1. Obtain a Diagnosis: Secure a formal diagnosis of bruxism from a qualified dental or medical professional.
2. Gather Documentation: Compile all relevant medical records, service history, and evidence of how bruxism affects your life, including dental reports and personal statements.
3. Obtain a Nexus Letter: A nexus letter from a healthcare provider can strengthen your claim by linking bruxism to military service. The letter should clearly state that your bruxism is “at least as likely as not” connected to your military service.
4. Complete VA Form 21-526EZ: Fill out the application form for disability compensation, providing detailed information about your condition and its impact.
5. Submit Claim Online: Use the VA’s online portal to submit your completed application. Alternatively, you can submit your claim through a paper application or with the assistance of a Veterans Service Officer (VSO).
6. Attend C&P Exam: Participate in a Compensation and Pension exam where a VA examiner evaluates your bruxism condition. The examiner will assess the severity of your symptoms and their impact on your daily life.
7. Await VA Decision: The VA will review your claim and medical evidence to assign a disability rating. This process may take several months, depending on the complexity of your case and the VA’s current workload.

Tips for Success

• Provide Comprehensive Evidence: Include all medical records, dental reports, service documents, treatment histories, and personal statements that detail your bruxism symptoms and their impact on your life.
• Be Detailed: Clearly describe how bruxism affects your daily activities, ability to work, and overall quality of life. Specific examples can help illustrate the severity of your condition.
• Stay Organized: Keep copies of all submitted documents and correspondence with the VA. Organized records can help streamline the claims process.
• Seek Professional Assistance: Consider working with a Veterans Service Officer (VSO) who can provide guidance, help prepare your claim, and ensure that all necessary documentation is included. Find a VSO through the Find a VA-Accredited Representative link.

Common Mistakes

• Incomplete Documentation: Failing to provide all necessary medical and dental records can weaken your claim and delay the rating process.
• Weak Nexus Letter: Submitting a poorly written or unsupported nexus letter may not effectively link your bruxism to military service. Ensure the letter is detailed and signed by a qualified medical professional.
• Missing Deadlines: Not adhering to submission deadlines or failing to provide requested information promptly can delay or jeopardize your claim.
• Vague Descriptions: Providing unclear or insufficient information about your condition can result in a lower rating. Be specific about your symptoms and their impact on your life.

Understanding Pyramiding

Definition

Pyramiding occurs when a veteran receives multiple disability ratings for the same condition or symptom, which is not allowed by the VA. This practice can lead to inflated disability ratings and is prohibited under VA regulations.

Avoidance Tips

• Ensure Distinct Conditions: Each condition claimed must be separate and distinct. For example, rating bruxism separately from other TMJ disorders is acceptable as long as they are individually evaluated.
• Proper Documentation: Clearly differentiate the symptoms and impacts of each condition in your claim to avoid overlap.
• Review Ratings: Check existing ratings to ensure that you are not inadvertently claiming multiple ratings for the same condition.

Examples

• Correct Claim: Rating bruxism separately from a diagnosed anxiety disorder if both conditions are distinct and have separate impacts on your life.
• Incorrect Claim: Claiming both bruxism and general chronic jaw pain for the same underlying issue, leading to multiple ratings for the same symptom.

For more information, refer to the VA Pyramiding Regulations.

Combining with Other Conditions

Bruxism often coexists with other conditions such as chronic pain, headaches, temporomandibular joint disorders (TMJ), and mental health issues like depression and anxiety. The VA allows for secondary service connections, where one condition aggravates another, potentially increasing your overall disability rating. For instance, bruxism-related chronic jaw pain may exacerbate migraines, leading to a higher combined disability rating.

Additional Resources and Trustworthy Links

• How to File a VA Disability Claim
• Find a VA-Accredited Representative
• VA Claim Exam
• Official VA Bruxism Rating Criteria (Code 5010)
• VA Pyramiding Regulations

This comprehensive guide outlines the Bruxism VA Rating under Code 5010, helping veterans understand how bruxism is evaluated and how to effectively file a claim. By providing detailed evidence and following the VA’s procedures, you can maximize your disability rating. For personalized assistance, consult a Veterans Service Officer (VSO) or visit the How to File a VA Disability Claim page for further support.