EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Chronic Osteomyelitis of Mandible/Maxilla
DC 9900 | 38 CFR § 4.150, DC 9900 |
Chronic Osteomyelitis of Mandible/Maxilla is rated by the U.S. Department of Veterans Affairs under DC 9900 of 38 CFR § 4.150, DC 9900 across 5 severity tiers (100% / 60% / 30% / 20% / 10%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Long-standing bone infection of the jaw requiring ongoing management. Characterized by recurring episodes of pain, swelling, and drainage. May cause pathological fractures and require multiple surgeries.
RATING CRITERIA (5 LEVELS)
100%
DC 5000 (via DC 9900 rate-as) — "Of the pelvis, vertebrae, or extending into major joints, or with multiple localization or with long history of intractability and debility, anemia, amyloid liver changes, or other continuous constitutional symptoms" = 100%. (Verbatim § 4.71a DC 5000.)
60%
DC 5000 (via DC 9900 rate-as) — "Frequent episodes, with constitutional symptoms" = 60%. (Verbatim § 4.71a DC 5000.) NOTE: Per DC 5000 Note 1, the 60% constitutional-symptoms rating is NOT subject to the amputation rule. Most well-documented chronic-recurrent jaw osteomyelitis with systemic involvement (fever, weight loss, anemia) lands at this tier.
30%
DC 5000 (via DC 9900 rate-as) — "With definite involucrum or sequestrum, with or without discharging sinus" = 30%. (Verbatim § 4.71a DC 5000.) Chronic osteomyelitis with imaging-confirmed sequestrum or involucrum — frequently the modal rating for refractory MRONJ / radiation-induced cases.
20%
DC 5000 (via DC 9900 rate-as) — "With discharging sinus or other evidence of active infection within the past 5 years" = 20%. (Verbatim § 4.71a DC 5000.) For chronic-recurrent disease, this tier captures intermittently active phases. Per Note 2: "The 20 percent rating on the basis of activity within the past 5 years is not assignable following the initial infection of active osteomyelitis with no subsequent reactivation. The prerequisite for this historical rating is an established recurrent osteomyelitis."
10%
DC 5000 (via DC 9900 rate-as) — "Inactive, following repeated episodes, without evidence of active infection in past 5 years" = 10%. (Verbatim § 4.71a DC 5000.) Per Note 2: requires 2 or more documented episodes following the initial infection.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026