Tmj Is Not Considered A Chronic Condition?

[Corinne]

I spent 10 years in the Marine Corps and was told early on that I had TMJ - I had 2 mouth guards/splints made while in service and one after service from my private dentist, then another one while I was under voc rehab.

I filed a claim for TMJ and was granted 20%. I am happy with that, but I asked for an earlier effective date - the date of my original claim. The reasoning behind it was when I filed my original claim, I did not ask for UTI's (urinary tract infections) but was granted at 10%. I was happy with the rating but again, never asked for it. They found that "the veteran continued to have urinary infections all through service and was cotinuously treated with antibiotics", so they made the grant.

I received my denial on the earlier effective date because "TMJ is not listed as a chronic disease under 38 CFR 3.307 or 3.309." Well neither are UTI's! How can they grant one and not the other? I clearly had TMJ through service and my treatment was to wear the guard every night and during the day.

My understanding is that TMJ is, in fact, a chronic condition (I deal with it daily) and it does not heal itself - the damage is done to the jaw joint. Between you me, and the lamp post, my TMJ is more "chronic" than my UTI's. I may never have another UTI again in my life but I deal with TMJ issues every day.

Maybe when I filed my origial claim the person reviewing my records did not think to review my dental records so he or she missed it. I know, I know, I should have listed the condition on the original claim but I only listed "medical" items and did not know they would service connect for "dental" issues. Kinda my error but does this compute??

Does anyone have any words of wisdom for me or any suggestions on how I can argue this point? Any input would be helpful.

Thank you in advance, Corinne

[Rockhound]

Have you talked to your dentist about your TMJ? What does he say as to whether it is a chronic condition or not. Is the condition listed in the DSM IV? If it is, what does it say about the condition?

If the DSM lists it as possibly a chronic or life long problem, then the VA can not say it is not a chronic condition given the ongoing and continueous problems and use of a mouth guard/splint.

A simple statement from your treating Dentist with a bit of medical rationale behind it, should be probitive enough to show chronicity and check under the DC criteria to check if the problems you have now meet the current level of rating or whether an increase is warrented.

Rockhound Rider

p.s. addendum: this is but one item I found on the subject and it does mention that it can be chronic in nature.

Temporomandibular joint disorder (TMJD, TMJ or TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the lower jaw to the skull. The disorder and resultant dysfunction can result in significant pain and impairment. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of quite different treatment approaches.

The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, and neoplasia.

Edited October 15, 2008 by Rockhound

[Ricky]

Chronic in VA speak is length of time. If they denied based upon 3.307 and 3.309 it appears to me that they were way out in left field alone as these two sections deal with presumptive issues.

You need to go back and point out the start of the issue during service, its presense at the time of discharge, your continued treatment and its current diagnosis. Remind them that this is not a request for service connection due to presumptive conditions as it was and still is a request for service connection service connection due to a direct basis.

If the diagnosis was in service, you had continued treatment during service and there was a current diagnosis at the time of discharge then the effective date was and is the first day after your release from service. Now with all of that said could you please answer a few questions so we can help you:

Date of entry into service:

Date of diagnosis in service:

Was there and ongoing treatment regime up till your discharge:

Was there a CURRENT diagnosis at the time of discharge:

Did you continue seeking and receiving medical treatment for the issue from discharge up until the time you filed the claim:

What was the date of you discharge:

What date did you file the claim:

Sorry for all of the questions but it will help clarify the issue and facilitate some accurate recommendations.

[Hoppy]

I like Ricky's approach. If they service connected and denied the EED citing such a code that implies there was no medical evidence at the original filing, then something is fishy.

[00Help]

Hello My name is Bishop, I am a Army Veteran with a current 10% disabilitly for TMJ. I have been having alot of muscle joint pain since service in 2000. Back, neck, lower and upper, shoulders (tinnitus) and knees. I was finally diagnosed with fibromylgia today at the atlanta VA center. I was denied chronic pain for back, neck, shoulders in 2001, but I reopened it in 2005 and again in 2008 for an increase in TMJ.

November is "JAW JOINT AWARNESS MONTH" check out the site below to see the congressional record for TMJ claiming it is a disorder that causes depression, chronic pain, financial, emotional instability. This is a life time condition. Also the second link is a very informative pamplet about all the connections of several disorders with TMJ. There is also a sttement from a VA Dentist verifying the TMJ disorder or DDS.

www.tmjoints.org/proclam.html (Congressional Record)

www.tmjoints.org/newslets/SUMMER98.htm (JJAMD EVIDENCE)

After taking these pamplets with me to my appointments for the following month my doctors are becoming more acceptable to my conditions. Rhem. clinic diagnosed me with Fibro. after showing them a pamplet after on two seperate occassions they denied my claim due to rhem. claiming I did not have the condition. So it may not be as if they are not wanting to compensate the veterans they are not knowledged of the condition.

Check it out I hope it helps and closes alot of unaswered questions. 4 all.

[00Help]

B) Hello its Bishop again...I went to C&P for exam for fybromylgia (appeal)...I also have continued to see several physicians about my continued fatigue and wide spread body pain..It has altered my life in so many ways...Still not working, unable to maintain strength to do regular day to day activities.

In 2005 I was diagnosed with possible fybromylgia by an outside physicians records have been transferred into VA medical files. Then after my first denial of benefits (even after representative was sure claim would be rated and he put in for unemployability as well back in 2007) the denial read the reason was because the prior doc in 2005 said possible fybromylgia. Then VA diagnosed with Fybromylgia in 2008

While in service I was diagnosed with TMJ in Jun 1999, after falling from the the ladder basket weave exercise. I had troubles with my vision, headaches, jaw pain immediately after and was seen in TMC for these issues. Following this event still in the service I was in a car accident Apr 00 that brought the pain in my jaws, back, shoulders, and knees become more painful and more apparent to docs...MRI showed inflammation in the spine and tail bone area...I continued to complain of back pains, irritable bowels, abdominal pain, pain in shoulders and back throughout service, but there was no diagnosis of any chronic issue, and docs noted pain may be caused due to car accident.

During my exit medical eval and my initial claim for benefits filed during my exit from military it was noted with complaints of wide spread muscle and joint pain, knee pain, wrist pain, shoulders, jaw, headaches and abdominal pains.

Dates of Service Jun 10 1999 to Oct 30, 2001 Gulf, and Iraqi Era

I currently still only have 10% disability for TMJ...I've had MRI done within the last year showing chronic inflammation/fibrosis head to toe...Inflammation is not caused by fibromylgia..lil confused...I have set an appointment to see specialist for CFS...Any suggestions or comments on my matter would be greatly appreciated

Bishop

[Vync]

Bishop,

Check your 10% TMJ award letter. Look at your range of motion. In some cases, you have sufficient evidence of injury that they will ignore it and grant you the 10%.

The VA does not rate TMJ based on pain, it rates it on range of motion. There are some other dental ratings which may apply if you have more advanced problems, but let's look at generic TMJ for now:

What's your current range of motion for your jaw, both vertical and horizontal?

You measure the vertical (inter-incisal) range by the distance between the incisors when you open as wide as you can. Don't try to pry your mouth open. Just open it as far as you can.

You measure the horizontal (lateral excursion) range by the maximum distance you can move your jaw left right. Measure from between your two front teeth, but add the distances for left and right movement together.

Compare your totals (in mm) against this table.

§4.150 - Schedule of Ratings - Dental and Oral Conditions

9905 Temporomandibular articulation, limited motion of:

Inter-incisal range:

0 to 10 mm 40

11 to 20 mm 30

21 to 30 mm 20

31 to 40 mm 10

Range of lateral excursion:

0 to 4 mm 10

Note: Ratings for limited inter-incisal movement shall not be combined with

ratings for limited lateral excursion.