Maxilla Malunion or Nonunion — VA Disability Rating (DC 9916)
Diagnostic Code 9916 · 38 CFR §4.150
What Is It?
DC 9916 covers two distinct conditions of the maxilla (upper jaw): nonunion (the fracture never healed) and malunion (the fracture healed in the wrong position). Both can result from combat injuries, blast exposure, falls, or vehicle accidents during military service. Maxillary nonunion causes abnormal mobility of bone fragments — called false motion — making the upper jaw unstable. Maxillary malunion causes the upper jaw to heal crooked, creating bite misalignment known as an open bite where the upper and lower teeth do not meet properly. The VA rates nonunion based on whether false motion is present, and malunion based on the severity of the resulting open bite. Importantly, maxillary nonunion must be confirmed by diagnostic imaging studies.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Nonunion of the maxilla with false motion (abnormal mobility of bone fragments confirmed by imaging), or malunion of the maxilla with displacement causing a severe anterior or posterior open bite. Both scenarios represent major structural problems that significantly impair chewing function. |
| 10% | Nonunion of the maxilla without false motion (the fracture has not fully healed but the fragments are stable, confirmed by imaging), or malunion of the maxilla with displacement causing a moderate anterior or posterior open bite. |
| 0% | Malunion of the maxilla with displacement that does not cause an anterior or posterior open bite, or malunion causing only a mild open bite. The misalignment exists but does not significantly affect bite function. |
Evidence Needed
Diagnostic imaging studies (CT or X-ray) are required — the VA regulation specifically mandates imaging confirmation for maxillary nonunion. For nonunion, clinical examination demonstrating the presence or absence of false motion (abnormal fragment mobility) is critical. For malunion, imaging showing the degree of displacement and clinical evaluation of the resulting open bite are needed. Service treatment records documenting the original facial fracture establish service connection.
C&P Exam Tips
For nonunion: the examiner will check for abnormal mobility of maxillary fragments. If you can feel your upper jaw shift or move abnormally, describe exactly when it happens and how it affects eating. For malunion: the examiner will assess your bite alignment and the severity of any open bite. When asked to close your mouth, close naturally and do not force your teeth together. Describe difficulties with eating, any pain, and cosmetic concerns. Make sure the examiner documents whether the open bite is anterior (front teeth gap) or posterior (back teeth gap) and the severity.
How to File
File on VA Form 21-526EZ with DC 9916. Submit imaging studies, dental evaluations, and service records documenting the original injury. For nonunion claims, imaging confirmation is a regulatory requirement. For malunion claims, evidence of the open bite and its functional impact is key. Consider secondary claims for TMD problems and cosmetic disfigurement.
Common Mistakes
Not providing the required diagnostic imaging for nonunion claims is a critical error — the VA cannot rate maxillary nonunion without imaging confirmation. For malunion, not documenting the severity of the open bite (mild, moderate, or severe) means the VA cannot accurately assign a rating level. Confusing maxilla malunion/nonunion (DC 9916) with mandible malunion (DC 9904) or mandible nonunion (DC 9903) leads to filing under the wrong code.
Frequently Asked Questions
How is maxilla malunion different from mandible malunion?
The maxilla is the upper jaw and the mandible is the lower jaw. They are rated under different diagnostic codes (DC 9916 for maxilla, DC 9904 for mandible). The rating approach is similar — both look at displacement and open bite severity — but they are separate conditions.
What is false motion in the context of maxillary nonunion?
False motion means the bone fragments of the maxilla move abnormally relative to each other because the fracture never fully healed. This is distinct from malunion, where the bone healed but in the wrong position. False motion makes the upper jaw unstable and significantly impairs chewing. It must be confirmed by diagnostic imaging.