Benign Neoplasm (Oral/Dental) — VA Disability Rating (DC 9917)
Diagnostic Code 9917 · 38 CFR §4.150
What Is It?
DC 9917 is the entry in 38 CFR 4.150 for "Neoplasm, hard and soft tissue, benign" — ameloblastoma, odontogenic keratocyst, central giant cell tumour, ossifying fibroma, odontoma, and the range of non-cancerous growths that arise in the jawbone, gums, palate and soft tissue of the mouth. Benign does not mean minor. These lesions expand, destroy bone, loosen and displace teeth, and are treated by resection that can take a segment of mandible or maxilla with them. The code assigns no percentage. Its rating cell is empty and the instruction reads "Rate as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring," so the evaluation is assembled from whichever structural codes match what was actually lost. This is worth understanding as an advantage rather than a gap: the dental schedule contains graded codes for mandible, maxilla, ramus, condyloid and coronoid process, hard palate and teeth, and Note (2) to 38 CFR 4.150 directs that loss of vocal articulation, loss of smell, loss of taste, neurological impairment, respiratory dysfunction and other impairments each be evaluated under the appropriate code and combined under 38 CFR 4.25. One tumour can therefore support several evaluations. The malignant counterpart, DC 9918, works differently: a flat 100 percent that continues beyond the end of treatment, with a mandatory VA examination six months after it stops.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 9917 carries no percentage column in 38 CFR 4.150 — the rating cell is empty. The instruction is to rate as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring. The graded destinations are the mandible codes (DC 9901 through 9904), temporomandibular disorder (DC 9905), loss of the condyloid process (DC 9908) or coronoid process (DC 9909), loss of the hard palate (DC 9911), loss of teeth (DC 9913), the maxilla codes (DC 9914 through 9916), and the scar codes at DC 7800, 7804 and 7805. Note (2) to 38 CFR 4.150 adds separate evaluations for loss of vocal articulation, smell, taste, neurological impairment and respiratory dysfunction, combined under 38 CFR 4.25. |
Evidence Needed
Start with the pathology report establishing that the lesion is benign, and the imaging that shows its extent. Note (1) to 38 CFR 4.150 defines diagnostic imaging studies broadly for VA purposes — conventional radiography, CT, MRI, PET, radionuclide bone scanning or ultrasonography — so panoramic films, a cone-beam CT or a conventional CT all qualify. Then document each residual as its own measurable fact: which segment of mandible or maxilla was resected and whether continuity was lost; whether the bone was replaced by graft or prosthesis; exactly which teeth are missing and whether the lost masticatory surface can be restored by a suitable prosthesis, because that clause gates every row of DC 9913; inter-incisal opening and lateral excursion in millimetres for DC 9905; and scar measurements plus the characteristics of disfigurement for DC 7800.
C&P Exam Tips
Bring the operative report and the imaging, and ask the examiner to describe the defect anatomically rather than functionally — which bone, how much, continuity preserved or not. Have the inter-incisal range and lateral excursion measured in millimetres; those two numbers are the whole of DC 9905. On teeth, the decisive question is not how many are missing but whether the lost masticatory surface can be restored by a suitable prosthesis, so say plainly whether your prosthesis works and whether the remaining bone will hold one. Name each separate function affected — chewing, speech articulation, taste, smell, numbness in the lip or chin from nerve involvement — because Note (2) directs each to its own code.
How to File
File the claim as the tumour plus a list of residuals, not as the tumour alone: name the bone loss, the missing teeth, the restricted jaw opening, the scarring, and any numbness or speech change as separate issues in the same application. Attach the pathology report, the imaging, the operative notes and the prosthodontic records. VA will route DC 9917 to the codes that carry figures — the mandible, maxilla, palate and teeth codes for structural loss, DC 9905 for the temporomandibular restriction, and DC 7800, 7804 or 7805 for the scar — and combine the results under 38 CFR 4.25. If the lesion was treated with radiation and the jaw later develops osteoradionecrosis, that is DC 9900, which rates as chronic osteomyelitis under DC 5000.
Common Mistakes
Waiting for a percentage from DC 9917 itself, which has none. Filing a single undifferentiated claim, which is what causes several ratable residuals to be collapsed into one evaluation. Missing the prosthesis clause in DC 9913 — the rows apply where the lost masticatory surface cannot be restored by suitable prosthesis, so the state of the supporting bone and the fit of the prosthesis are the argument, not the count of absent teeth. Leaving jaw motion unmeasured, which leaves DC 9905 with nothing to grade. And overlooking Note (2), which is explicit authority for separate evaluations of speech, taste, smell, neurological and respiratory residuals.
Frequently Asked Questions
What percentage does DC 9917 pay?
None by itself. The rating column for DC 9917 in 38 CFR 4.150 is empty. The instruction is to rate as loss of supporting structures (bone or teeth) and/or functional impairment due to scarring, and every percentage comes from those destination codes.
If the tumor is benign, is it still worth claiming?
Yes. What gets rated is the damage — resected bone, lost teeth, restricted jaw opening, scarring, nerve injury — and that damage is identical whether the lesion was benign or malignant. The pathology only determines which code you enter through.
How is this different from DC 9918?
DC 9918, malignant neoplasm of hard and soft tissue, carries a flat 100 percent, and its note continues that rating beyond the cessation of surgery, radiation or antineoplastic chemotherapy, with a mandatory VA examination six months after treatment ends. DC 9917 has no automatic rating and is built entirely from residuals.
Why did my missing teeth not produce a rating?
Because DC 9913 applies "where the lost masticatory surface cannot be restored by suitable prosthesis." If a bridge, partial or implant-supported prosthesis restores the chewing surface, the rows are not met. Where the supporting bone was resected and will not hold a prosthesis, they are.
Can I get separate ratings for the bone loss and the scar?
Yes. They are different impairments under different codes, so both are evaluated and combined under 38 CFR 4.25. Note (2) to 38 CFR 4.150 goes further and directs separate evaluation of loss of vocal articulation, smell, taste, neurological impairment and respiratory dysfunction as well.
The tumor was removed years ago and I feel fine. Is there anything to claim?
Possibly a 0 percent evaluation, which still establishes service connection and preserves your effective date. Benign jaw lesions recur, and reconstructed bone and prostheses fail over decades — an established connection is what lets a future claim be an increase rather than a fresh start.