Bruxism as a VA Disability or Secondary Condition to PTSD (2024)

Are you a veteran experiencing bruxism or teeth grinding? If so, you may be eligible for VA disability benefits for this condition.

Bruxism is a disability that impacts veterans who may already be dealing with other service-connected issues, such as PTSD or sleep apnea. A veteran can only receive VA compensation for this disorder as a secondary service-connected condition. That means applying for this as a disability the wrong way can get your VA claim denied and waste years before you can appeal your claim and get the benefits you deserve.

All veterans need to do these things to get VA disability benefits:

• Get a medical diagnosis for a ratable condition (like grinding your teeth in your sleep).
• Establish that you have another disability that is directly connected to your military service.
• Prove that this directly connected disability is linked to your bruxism.

However, even after establishing bruxism as a secondary condition, there is no guarantee that a veteran will receive benefits. Bruxism is rated under the VA Schedule of Ratings for Dental and Oral Conditions, and a veteran would only be eligible for a compensable rating if they suffer severe symptoms such as temporomandibular joint disorder (TMJ) from this condition.

Therefore, if you are seeking disability benefits for bruxism, this post will help you to understand the causes and effects of this condition, how to properly establish this disorder as a secondary condition, and the symptoms that the VA will assess to assign you a disability rating.

What is bruxism?

Bruxism is a tooth grinding disorder. This condition can cause you to reflexively gnash, grind, or clench your teeth. Bruxism can occur while you are awake but, in most cases, it occurs during sleep.

Common symptoms of bruxism

Bruxism symptoms include:

• Loud teeth grinding, gnashing, or clenching
• Loose, fractured, or worn teeth
• Tenderness or discomfort in jaw, neck, face, or ears
• Tightened or locked jaw
• Headaches

Keep in mind that if you are experiencing sleep bruxism, you may be unaware that you have this disorder because you may grind your teeth while you are in an unconscious state. Therefore, if you are uncertain about whether you have this condition, some of these symptoms may indicate that you experience bruxism while sleeping.

And trust us, if your partner says you grind your teeth in your sleep, you should trust them. You don’t want to be one of those “I don’t grind my teeth while I sleep,” people. If he or she says you do it, you do it.

Causes of teeth grinding (bruxism)

Bruxism causes may be related to a blend of mental, emotional, or physical issues. Common causes of this condition include:

• Anxiety
• Frustration
• Internalized anger
• Sleep disturbances

These emotions can also be triggered by PTSD, a condition that many veterans experience. For example, a veteran who experiences sleep disturbances such as insomnia or nightmares due to their PTSD can suffer from sleep bruxism in response to these disturbances.

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Long-term effects of grinding your teeth

Severe bruxism can lead to long-term effects that can negatively impact your lifestyle. These effects include:

• TMJ: Jaw clicking/popping, issues chewing, or the inability to open your mouth completely
• Jaw or teeth damage
• Serious facial or jaw discomfort

These effects can prevent you from working or being able to carry out daily tasks. Therefore, if you suffer from bruxism you should pursue disability compensation to supplement lost income due to this condition.

How veterans find treatment for bruxism

There is treatment available for bruxism that could help to reduce the symptoms of this condition.

Bruxism treatment includes:

• Wearing a mouth guard to reduce discomfort and teeth damage.
• Stress reduction exercises eliminate the stress and anxiety that causes bruxism.
• Cognitive-behavioral therapy to manage the stress, anxiety, or depression that causes this condition.

Even if you are pursuing treatment for this condition, do not miss out on the disability benefits you can receive until your condition is addressed.

Bruxism as a secondary condition

A veteran can only receive disability benefits for bruxism as a secondary service-connected condition. The VA made this determination because this disorder occurs as a symptom of a pre-existing condition. Therefore, a veteran can receive compensation for the pre-existing condition as a direct service-connected disorder, and then seek compensation for bruxism as secondary to the primary condition.

Accordingly, receiving disability benefits for bruxism is a two-part process, requiring a veteran to establish a direct service-connected condition and then prove that their bruxism was caused or aggravated by this condition.

In this video from one of our VA disability lawyers, we explain how to service connect your disability that was caused by your military service.

Direct service-connected condition

A direct service-connected condition is a disability that is directly linked to an incident a veteran incurred during their military service. A veteran can establish a direct service condition by:

• Providing the VA with a diagnosis for a current condition.
• Proving that the in-service event that caused their condition occurred.
• Proving that their current condition was caused or aggravated by this in-service event.

For example, a veteran pursuing disability benefits for bruxism may be eligible for compensation by first establishing that they have a direct service-connected condition such as PTSD. However, this veteran would first have to show that they have a current diagnosis for PTSD, that they suffered a traumatic in-service event, and that this event caused or aggravated their PTSD.

Secondary service-connected condition

A secondary service-connected condition is a disability that is caused or aggravated by a direct service-connected condition. A veteran can establish a secondary condition by:

• Providing the VA with a medical diagnosis for a current condition.
• Providing the VA with evidence that this condition was caused or aggravated by an established direct service-connected condition.

For example, a veteran currently diagnosed with bruxism can establish this as a secondary condition if it occurs as a stress response to the anxiety they suffer from direct service-connected PTSD.

How to prove bruxism as a secondary condition

A veteran applying for disability benefits for their bruxism will have to prove to the VA that this condition is secondary service-connected. The below pieces of evidence are great records that can help to justify this claim.

A veteran can provide:

• Medical records that show your bruxism diagnosis and treatment for this condition.
• Lay statements from family i.e. a spouse that can validate your symptoms of this condition. This is especially helpful for sleep bruxism as you may be unaware of your teeth grinding at night, but your spouse can verify this.
• Doctor reports that show the medical nexus between your bruxism and an established direct service-connected condition.

If you can successfully prove that your bruxism is secondary to a direct service-connected condition then you may be eligible to receive a VA disability rating and monthly disability compensation.

In this video, one of our VA disability lawyers talks about the VA Rating Formula for Mental Disorders and Disabilities like PTSD.

VA disability rating for bruxism

The VA Schedule of Ratings for Dental and Oral Conditions does not provide a specific diagnostic code for Bruxism. However, this condition is usually rated under diagnostic code 9905 or 9913 depending on the symptoms the veteran is experiencing.

Diagnostic code 9905 provides the disability ratings for TMJ (temporomandibular disorder)

This is a condition that impacts your jaw. It typically causes pain within the jaw joint and the muscles controlling jaw motion. This pain can then lock the jaw joint, impeding your ability to open or close your mouth.

Bruxism and TMJ are related conditions. A veteran with bruxism can also develop TMJ because the prolonged clenching from teeth grinding can damage the articular disc leading to TMJ. Therefore, a veteran who experiences the TMJ symptoms outlined under diagnostic code 9905 may be eligible for benefits.

The TMJ disability ratings are as follows:

• 10% rating for interincisal range opening of 30 to 34mm without dietary restrictions or lateral excursion range of 0 to 4 mm.
• 20% rating for interincisal range opening of 21 to 29mm without dietary restrictions or an interincisal range opening of 30 to 34mm with dietary restrictions.
• 30% rating for interincisal range opening of 21 to 34mm with dietary restrictions or an interincisal range opening of 11 to 20mm without dietary restrictions.
• 40% rating for interincisal range opening of 11 to 29mm with dietary restrictions or an interincisal range opening of 0 to 10 mm without dietary restrictions.
• 50% rating for interincisal range opening of 0 to 10mm with dietary restrictions.

If you are experiencing any of the above TMJ symptoms, then you may be eligible to receive a compensable disability rating from the VA. The VA has stated in rulings that a veteran’s interincisal range of jaw motion would need to be limited to 34mm or less before they could receive a compensable rating.

Diagnostic code 9913 provides the disability ratings for teeth loss

Bruxism can wear down our teeth and in chronic cases, this condition can lead to teeth loss. If you are a veteran who has lost teeth due to this condition, you could pursue a disability rating under diagnostic code 9913 to receive VA compensation.

The teeth loss disability ratings are as follows:

• 10% rating if all upper and lower teeth on one side are missing, all lower anterior teeth are missing, or all upper anterior teeth are missing.
• 20% rating if all upper and lower anterior or posterior teeth are missing.
• 30% rating if all upper or lower teeth are missing.
• 40% rating if all teeth are missing.

If your bruxism has caused you to lose teeth, then you may be eligible for disability compensation if you have suffered the above symptoms.

Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.

How to calculate compensation for a secondary condition

The VA calculates compensation for secondary conditions by calculating a combined disability rating for the veteran’s direct service-connected condition and secondary condition.

A combined rating is a percentage that captures the disability rating for all of a veteran’s service-connected conditions. This percentage is not calculated by adding all these ratings together. Instead, the VA reaches this number based on referencing their Combined Ratings Table. This is what you’ll see on Veteran’s Reddit as VA Math.

The VA calculates a combined rating by identifying the highest rated disability on the left column of the Combined Ratings Table and then identifying the second-highest rated disability at the top of the chart. The number at which these ratings intersect within the chart is the combined rating.

For example, if a veteran pursuing compensation for bruxism that is secondary to sleep apnea, receives a 50% disability rating for sleep apnea and a 20% disability rating for bruxism, the VA will assign a combined disability rating of 60% based on the Combined Ratings Table. This rating would make the veteran eligible for monthly compensation of $1,3161.88 a month and more if the veteran has dependents.

Calculating a disability rating is complex. Furthermore, estimating a combined disability rating is even more difficult. Check out our free disability calculator if you need help calculating your estimated rating.

Secondary disability rating vs. pyramiding

When estimating a disability rating, it is important to remember that calculating a rating for a secondary service-connected condition is very different from pyramiding or stacking a rating.

Secondary disability rating

As discussed in the prior section, the rating that the VA assigns to a veteran with a secondary condition is a combination of a direct service-connected rating and a secondary rating.

Before combining a rating, for a primary and secondary condition, the VA assigns an initial rating to each of these conditions based on the different symptoms of each disability. If the primary and secondary condition has overlapping symptoms, the VA will only consider the symptoms under one of the conditions, not both, when assigning a rating.

For example, if you are pursuing a combined rating for your service-connected PTSD and secondary bruxism condition. If anxiety is a symptom under the diagnostic code for both of these conditions, then the VA would assign the disability rating for anxiety towards PTSD, not bruxism.

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Pyramiding/stacking

Pyramiding or stacking means that the VA factors in the same symptoms for multiple conditions when assigning a rating to each condition. In other words, if you have multiple disabilities with overlapping symptoms the VA would factor in the same symptom for each condition when assigning a rating.

For example, if you experience sleeplessness as a symptom of your service-connected PTSD and secondary bruxism, pyramiding would mean that the VA factors in this symptom for both your PTSD and bruxism when calculating your disability rating for each condition.

Pyramiding violates federal law which provides that, “the evaluation of the same disability under various diagnoses is to be avoided.” Therefore, if you are estimating your disability rating for multiple conditions, be sure to seek guidance from a VA disability lawyer to help you avoid stacking your ratings.

At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the COVID pandemic to serve disabled veterans better in difficult times.

Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.

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