Diagnostic Code 9914 · 38 CFR §4.150
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 |
|---|---|
| 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. |
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.
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.
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.