Diagnostic Code 9903 · 38 CFR §4.150
Mandible nonunion occurs when a fracture of the lower jaw fails to heal, leaving the bone segments unjoined. This can happen after severe combat injuries, blast trauma, or complications following jaw surgery during military service. The result is an unstable jaw where the broken ends move independently — a phenomenon called false motion. This makes chewing difficult and painful because the jaw cannot generate the stable biting force needed to break down food. The condition often requires additional surgical intervention such as bone grafting or fixation hardware. The VA rates mandible nonunion based on imaging confirmation and whether false motion is present. Nonunion must be confirmed by diagnostic imaging studies like CT scans or X-rays.
| Rating | Criteria |
|---|---|
| 30% | Severe nonunion of the mandible with false motion — the bone segments move independently at the fracture site, confirmed by diagnostic imaging. This causes significant instability and substantially impairs chewing function. |
| 10% | Moderate nonunion of the mandible without false motion — the bone segments have not fully joined but there is no abnormal movement between them, confirmed by diagnostic imaging. Some functional impairment is present but the jaw is relatively stable. |
Diagnostic imaging studies (CT or X-ray) confirming the nonunion are required — the VA regulation specifically states that nonunion must be confirmed by imaging. Clinical evaluation demonstrating the presence or absence of false motion is critical since it determines the rating level. Surgical records from the original jaw fracture treatment and any subsequent repair attempts should be included. Service treatment records documenting the original injury establish service connection.
Nonunion (DC 9903) means the bone fragments never joined together at all, potentially causing false motion. Malunion (DC 9904) means the bone healed but in an incorrect position, causing bite misalignment (open bite). Both affect jaw function but are rated under different diagnostic codes with different criteria.
False motion means the bone segments at the fracture site move independently of each other — essentially, you have abnormal movement where solid bone should be. It indicates a complete failure of healing and causes significant jaw instability. The presence of false motion elevates the rating from 10% to 30%.