Malignant Neoplasm (Oral/Dental) — VA Disability Rating (DC 9918)
Diagnostic Code 9918 · 38 CFR §4.150
What Is It?
DC 9918 covers malignant (cancerous) tumors of the hard and soft tissue of the mouth and jaw. These include osteosarcoma, squamous cell carcinoma, ameloblastic carcinoma, mucoepidermoid carcinoma, and other cancers affecting the jawbone, gums, palate, tongue, or other oral structures. For veterans, oral cancers may be linked to toxic exposures during service — Agent Orange, burn pit fumes, industrial chemicals, or radiation — as well as tobacco use that began during military service. The VA assigns a mandatory 100 percent rating while the cancer is active or during treatment. Six months after treatment ends, the VA re-evaluates and rates based on the residual damage left behind, such as bone loss, tooth loss, scarring, and functional impairment.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active malignancy or during treatment (surgery, radiation, chemotherapy, or other therapeutic procedures) for a malignant neoplasm of the oral hard or soft tissue. The 100% rating continues for six months after the last treatment ends. The VA then conducts a mandatory re-examination, and subsequent ratings are based on residual effects such as bone loss, tooth loss, scarring, and functional impairment, each rated under the appropriate diagnostic code. If the cancer recurs, the 100% rating is reinstated. |
Evidence Needed
Pathology reports confirming the malignant diagnosis are essential. Treatment records including surgery, radiation, and chemotherapy documentation are needed. Service records documenting toxic exposure or other service-connected risk factors help establish the nexus to military service. After treatment ends, comprehensive records documenting residual effects — bone loss, nerve damage, difficulty eating, speech problems, disfigurement, scarring — are important for the post-treatment rating evaluation.
C&P Exam Tips
During active treatment, the 100% rating should be straightforward based on the pathology report and treatment records. After treatment ends and the six-month period passes, the re-evaluation exam will focus on residuals. Describe every remaining functional limitation: eating difficulties, speech problems, numbness or nerve damage, pain, disfigurement, scarring, and psychological impact. Provide details on all follow-up care and monitoring. Each residual impairment may be rated separately, so comprehensive documentation of every deficit maximizes your combined rating.
How to File
File on VA Form 21-526EZ with DC 9918. Submit pathology reports, treatment records, and a nexus opinion connecting the cancer to military service. If related to toxic exposure (burn pits, Agent Orange, etc.), submit deployment records, unit histories, and toxic exposure registry enrollment if applicable. The PACT Act expanded presumptive conditions for certain toxic exposures, so check whether your cancer qualifies for presumptive service connection.
Common Mistakes
Not filing during active treatment delays the 100% rating. After treatment ends, not comprehensively documenting every residual effect leads to a lower post-treatment combined rating. Not connecting the cancer to military toxic exposure or other service-related risk factors weakens the nexus. Not filing for each individual residual (bone loss, scarring, nerve damage, disfigurement) under its specific diagnostic code means some impairments go uncompensated.
Frequently Asked Questions
What happens after cancer treatment ends?
The 100% rating continues for six months after your last treatment session. Then the VA conducts a mandatory re-examination. If the cancer has not recurred, your subsequent rating is based on the residual damage — bone loss, scarring, nerve damage, functional impairment — with each residual potentially rated under its own diagnostic code. If the cancer comes back, the 100% rating is reinstated.
Can oral cancer be linked to burn pit exposure?
Potentially yes. The PACT Act significantly expanded presumptive conditions for veterans exposed to burn pits and other toxic substances. Head and neck cancers may qualify. Even if your specific cancer is not on the presumptive list, you can still establish individual service connection with a nexus opinion from a medical professional linking the cancer to documented toxic exposures during your service.