Maxilla Loss (More Than Half) — VA Disability Rating (DC 9914)
Diagnostic Code 9914 · 38 CFR §4.150
What Is It?
DC 9914 covers loss of more than half of the maxilla (upper jaw). The maxilla forms the roof of the mouth, the floor of the nose, and houses the upper teeth. Losing more than half of this bone is a severe injury, typically resulting from combat blast injuries, gunshot wounds, or surgical removal due to extensive tumors. This degree of maxilla loss devastates eating, speaking, and breathing function, and causes severe facial disfigurement. Whether the lost bone can be replaced by a prosthesis determines whether the rating is 50% or 100%. When prosthetic reconstruction is not possible, the condition warrants a total disability rating because the functional impact is so profound.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Loss of more than half of the maxilla that cannot be replaced by a prosthesis. The structural defect is too extensive for prosthetic reconstruction, resulting in severe and permanent impairment of eating, speaking, and breathing. |
| 50% | Loss of more than half of the maxilla that can be replaced by a prosthesis. While the bone loss is extensive, prosthetic reconstruction can restore some degree of function. |
Evidence Needed
CT scans documenting the extent of maxilla loss are critical. Surgical records from the original injury or tumor removal are needed. Service treatment records establishing the in-service cause are required. A prosthodontist or maxillofacial surgeon evaluation assessing whether prosthetic replacement can adequately restore function is the key piece of evidence that determines the rating level.
C&P Exam Tips
The examiner will assess the extent of bone loss through examination and imaging. Describe all functional limitations: inability to eat certain foods, nasal regurgitation, speech changes, breathing difficulties, and cosmetic impact. If you have a prosthetic obturator or other reconstruction, describe its effectiveness and any ongoing problems. If prosthetic replacement has been attempted and failed, make sure those records are available.
How to File
File on VA Form 21-526EZ with DC 9914. Submit CT scans, surgical records, prosthetic treatment records, and service treatment records. The prosthetic feasibility assessment is the most important piece — it determines whether you receive 50% or 100%. File secondary claims for disfigurement (DC 7800), speech impairment, and psychological conditions.
Common Mistakes
Not getting a formal prosthetic feasibility assessment from an oral surgeon or prosthodontist is the biggest mistake, as it determines whether the rating is 50% or 100%. Not filing for disfigurement and psychological conditions as secondary claims misses significant additional compensation. Not distinguishing between DC 9914 (more than half of maxilla lost) and DC 9915 (half or less lost) can lead to filing under the wrong code.
Frequently Asked Questions
How does the VA determine if more than half or half or less of the maxilla is lost?
This is typically assessed through CT imaging and clinical evaluation by an oral and maxillofacial surgeon. The determination is based on the volume and structural extent of maxilla that is missing relative to the whole.
What is the difference between DC 9914 and DC 9915?
DC 9914 covers loss of MORE than half of the maxilla (rated 50% or 100%). DC 9915 covers loss of HALF OR LESS of the maxilla (rated 0% to 40%). The distinction matters because DC 9914 provides substantially higher ratings for the more extensive bone loss.