Secondary Sc Claims While Still In Appeal Process

[michaelr5343]

My original PTSD claim is in the appeal process at the RO, hopefully soon to get a bump from 70% to 100%. Recently, I was diagnosed with bruxium (teeth grinding) due to nightmares. Obviously, I want to add this to the list of service connected disabilities. However, my reading suggests any additions to my claim at this time might have a slowing effect in the adjudication of my original claim. On the other hand, I think the claim of bruxium adds to the totality of circumstances which evidences the exacerbation of my condition and thus, bolsters my original claim. What are your thoughts and/or experiences in this area?

If yes to submitting claim now, what is the best way to introduce this claim to the RO? (I'm in the process of completing the Dental DQB with my civilian dentist and I'm holding a completed VA Form 21-526b, as well as other supporting documentation)

[VADDS]

I assisted a veteran that was granted SC for bruxism, we tied it into PTSD and TMJ. I believe he was awarded 20%. It is possible.

If the vet was awarded 20%, it was for the TMJ disorder, secondary to PTSD associated bruxism. There are no rating criteria for bruxism, there is no disease diagnosis code for bruxism. It is literally impossible to assign a percentage to it. Bruxism is now widely accepted to be caused or worsened by PTSD. TMJ disorders may be exacerbated by bruxism. VBA is granting bruxism/PTSD related secondary TMJ service connection. As always, the percentage is based on ROM and the Deluca Factors' impact.

The BVA decision posted here made a ruling that the bruxism was service connected. The BVA decision was probably the end point of a process that began 3-4 years before the decision, when there was still controversy about the connection between PTSD and bruxism. That issue is settled: bruxism is associated with PTSD. A rating decision is not required. It is a symptom, like insomnia or night terrors. De facto, it is service connected.

What changed for the vet as a result of the BVA ruling? The vet can't be compensated for the tooth damage. The vet did not become eligible for VA dental care. If bruxism ever becomes a compensable dental disability, the vet would have to undergo a C&P exam with rating criteria applied, along with every other vet claiming a disability for PTSD associated bruxism. But first, the VA rules would have to be amended to create a disease code for it, decide what rating series it belongs in, and establish rating criteria to assess the severity of it.

Here is the bottom line: If a vet with PTSD and bruxism develops a TMJ disorder, file for the TMJ secondary to PTSD. That is now a straight shot. Filing for bruxism alone will get you nowhere

[Berta]

"What I stated was that it will be inappropriate for VBA to rate and grant service connection for bruxism, until and unless the VA requests a rule change to to the CFRs to create a disease diagnosis code for bruxism, add it to the 9900 Series, and establish criteria to rate the severity of it."

Yes, you are correct VADDS, I got way off track on this one. Sorry.

It is like a vet claiming hyperlipidemia-a non ratable symptom ,but one that could indicate evidence of diabetes or heart disease,

Edited January 7, 2013 by Berta

[VADDS]

Berta:

Another dental example is tooth decay caused by dry mouth, which can result from medications, and most especially after head and neck radiation for cancer. There is currently no way to compensate a veteran for damage to teeth that results from the medical treatment for another disease.

The VA actually proposed rule changes last year to establish a disease diagnosis code for salivary gland disease. One of the proposed rating criteria is an increase in dental decay. A 10% rating has been proposed for dental decay caused by either primary salivary disease, or secondary to treatment of a service connected medical condition.

[Vync]

Another overlooked issue is bruxism causing migraines

[Roger Louis]

This is a request for advice. I am service conntected and rated at 40 percent. 30 percent is for PTSD, my dentist claims that my teeth are being damaged as a result of bruxism and willing to provide me with a letter state that. My question is it worth the trouble of askiing the VA to reopent my case and consider bruxism and if so what approach should I take. While I don't consider my PTSD to be serious enough to require the VA to appoint a fudicary I am concered that they might consider that as part of the process. Thanks in advance for your kind advice.

[john999]

If you want the VA to take care of your teeth then it might be worth reopening your PTSD claim. Are your symptoms worse than when you were rated 30%?