Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

Va Dental Eligibility For 0% Means Dental From Va

Rate this question


Navy4life

Question

The loss of teeth by themselves are not ratable since they are not truly disabling and are easily replaced by false teeth. Teeth also cannot be rated if they are lost from naturally occurring diseases related to ageing. They must be lost as a result of injury, accident, or diseases such as osteomyelitis.

If the loss of teeth is caused by part of either the maxilla or mandible missing, then it can either be rated under the following code or under the codes for the missing maxilla or mandible, whichever code provides the higher rating. If not enough of the mandible or maxilla is missing to qualify for a rating under their codes, then the condition is simply rated here. The condition cannot be rated twice, once for the maxilla or mandible and once for the teeth. Only one or the other.mouth%206.png

Code 9913: Regardless of how many teeth are missing, if they can be replaced by a prosthesis or false teeth, then it is rated 0%. If, however, they cannot be replaced, they are rated as follows:

All teeth missing is rated 40%. The loss of all the upper teeth or all the lower teeth is rated 30%. If all the upper and lower posterior teeth or all the upper and lower anterior teeth are missing, it is rated 20%. If only all the upper anterior teeth or all the lower anterior teeth are missing, it is rated 10%. If all the upper and lower teeth on one side are missing, then it is also rated 10%.

After reading the above I think I am going to be 0% S/C for my Mouth Condition claim secondary to my Anorexia Nervosa. I sure hope so b/c I just found out that if I am even 0% S/C for dental I am eligible for dental at my local VA.

I found this:

Dental Benefits for Veterans Dental benefits are provided by the Department of Veterans Affairs (VA) according to law. In some instances, VA is authorized to provide extensive dental care, while in other cases treatment may be limited. This Fact Sheet describes dental eligibility criteria and contains information to assist Veterans in understanding their eligibility for VA dental care. Outpatient Dental Program The eligibility for outpatient dental care is not the same as for most other VA medical benefits and is categorized into classes. If you are eligible for VA dental care under Class I, IIA, IIC, or IV you are eligible for any necessary dental care to maintain or restore oral health and masticatory function, including repeat care. Other classes have time and/or service limitations.

Have a service-connected compensable dental disability or condition. Any needed dental care Class I (This would be me if I get the above 0%)

Are a former prisoner of war. Any needed dental care. Class IIC

Have service-connected disabilities rated 100% disabling, or are unemployable and paid at the 100% rate due to serviceconnected conditions. Any needed dental care. [Please note: Veterans paid at the 100% rate based on a temporary rating, such as extended hospitalization for a serviceconnected disability, convalescence or pre-stabilization are not eligible for comprehensive outpatient dental services based on this temporary rating]. Class IV

Apply for dental care within 180 days of discharge or release (under conditions other than dishonorable) from a period of active duty of 90 days or more during the Persian Gulf War era. One-time dental care if your DD214 certificate of discharge does not indicate that a complete dental examination and all appropriate dental treatment had been rendered prior to discharge.* Class II

Come on 0% S/C for my teeth!!!!!

US Navy Desert Storm Veteran
Proudly served my Country!!! :biggrin:

Link to comment
Share on other sites

Recommended Posts

  • 0
  • HadIt.com Elder

Well the VA extracted all of my ''posterior'' teeth.& One Aterior tooth (front)

Nothing was said about service connection % or anything.??

However I'm rated 100% TDIU P&T

..................Buck

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0

Well the VA extracted all of my ''posterior'' teeth.& One Aterior tooth (front)

Nothing was said about service connection % or anything.??

However I'm rated 100% TDIU P&T

..................Buck

Were your teeth extraction due to in service or related to an already service connected disability? My teeth were due to an already service connected injury but like you said you don't need to worry about that since you are 100% TDIU P&T

US Navy Desert Storm Veteran
Proudly served my Country!!! :biggrin:

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

Iam not sure it was sc or not ? just bad teeth to big cavity's to fill so they pulled them.

had two root canals done and they ended up pulling those too...this was back when the VAMC had some private Dentist come in and help with the back-log to help speed up the process of veterans in pain and having to wait. back around 2008 09

Navy4life, The VA made me some partials but they don't fit good I been back several times for them to fix that problem but the only thing is when I do they fit better and stay tight but when I eat with them for about a week they start to get lose again and they have made me two pair, and they still don't fit right..I just got tired of going to them they seem to think there's nothing wrong with them and said I just have to get use to them...I've tried and tried and they still get lose when I eat ...so I don't wear them anymore.

If I had private Insurance I's sure go see one of them dentist.

Don't get me wrong the VAMC is a nice dentistry &it could just be that particular Dentist...its the only one at my VAMC that does that specialty. They seem to have nice new medical equipment up to date ect,,ect,,....its just hard to fit partials when your a snaggle tooth eh!

I wish you the best and I hope you get to use the VA Dentist, they are good Dentist...most of them anyway.

............Buck

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0

Buck;

Thank you! I have been in PFN for a few days so I am sure it's done just need it to close and get the brown envelope in the mail! I am so sorry you are having issues with your teeth :(

I have had outside dental insurance and none of them are the greatest! Most of them you wind up paying out of pocket over 50%...

I have CareCredit which helps me - credit card that offers dental charges for 0% so that helped me with this huge $4500 bill I had! Paid 550+ for 8 months to get it paid off! I am hoping to recoup the out of pocket money....That will be another adventure in itself!

US Navy Desert Storm Veteran
Proudly served my Country!!! :biggrin:

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

Buck you are covered for the dental. Now what are they going to do to replace the teeth they pulled?

Standard Practice seems to be the cheapest way out, false teeth (Dentures)

My area VAMC touts implants, but seldom does them. There are such things as

false teeth mounted on posts anchored into the jawbone, or posts that Dentures clip into.

These cost more. Some dental insurance provides partial coverage some not.

I'm hoping that the 40 mile rules get amended such that I can see local dentists rather

than those at the VAMC.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • spazbototto earned a badge
      Week One Done
    • Paul Gretza earned a badge
      Week One Done
    • Troy Spurlock went up a rank
      Community Regular
    • KMac1181 earned a badge
      Week One Done
    • jERRYMCK earned a badge
      Week One Done
  • Our picks

    • These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.

      Service Connection

      Frost v. Shulkin (2017)
      This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected. 

      Saunders v. Wilkie (2018)
      The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.

      Effective Dates

      Martinez v. McDonough (2023)
      This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.

      Rating Issues

      Continue Reading on HadIt.com
      • 0 replies
    • I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful.  We decided I should submit a few new claims which we did.  He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims.  He said that the VA now has entire military medical record on file and would find the record(s) in their own file.  It seemed odd to me as my service dates back to  1981 and spans 34 years through my retirement in 2015.  It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me.  He didn't want my copies.  Anyone have any information on this.  Much thanks in advance.  
      • 4 replies
    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
×
×
  • Create New...

Important Information

Guidelines and Terms of Use