Diagnostic Code 9900 · 38 CFR §4.150
DC 9900 covers chronic osteomyelitis, osteonecrosis, or osteoradionecrosis of the maxilla (upper jaw) or mandible (lower jaw). Osteomyelitis is a bone infection; osteonecrosis is bone death from loss of blood supply; and osteoradionecrosis is bone death caused by radiation therapy. For veterans, jaw osteomyelitis may develop from combat injuries to the face, dental infections that went untreated during deployments, or complications from dental procedures during service. Osteoradionecrosis can develop after radiation treatment for service-connected head and neck cancers. The key thing to know is that DC 9900 does not have its own specific rating levels — instead, the VA rates the condition using the criteria from DC 5000 (chronic osteomyelitis of any bone), which is found under the musculoskeletal rating schedule.
| Rating | Criteria |
|---|---|
| 60% | Rated under DC 5000 (chronic osteomyelitis). Frequent episodes with constitutional symptoms such as fever, chills, weight loss, and the need for ongoing antibiotic therapy or repeated surgical procedures. The condition significantly limits your ability to function. |
| 30% | Rated under DC 5000. Definite involucrum (new bone formation around dead bone) or sequestrum (dead bone fragments), with or without draining sinus tract. Recurrent episodes requiring treatment. |
| 20% | Rated under DC 5000. Discharging sinus or other evidence of active infection within the past five years. Treatment history showing ongoing management of the condition. |
| 10% | Rated under DC 5000. Inactive osteomyelitis following repeated episodes, without evidence of active infection for five or more years. |
Dental and oral surgery records documenting the diagnosis with imaging (panoramic X-ray or CT scan) showing bone involvement are essential. Service treatment records documenting the original injury, infection, or radiation exposure help establish the service connection. Records of ongoing treatment — antibiotics, surgical debridement, hyperbaric oxygen therapy, or other interventions — demonstrate the chronic nature and severity. Since the condition is rated under DC 5000, evidence showing the pattern of episodes, any constitutional symptoms (fever, chills, weight loss), and the presence of involucrum, sequestrum, or draining sinuses is important.
The 2017 revision of the dental rating schedule streamlined DC 9900 to reference the existing chronic osteomyelitis criteria under DC 5000 in the musculoskeletal section. This ensures consistent evaluation of osteomyelitis regardless of which bone is affected. The DC 5000 criteria focus on infection activity, frequency of episodes, and systemic impact.
Yes. If the infection resulted from a dental injury during service, untreated dental problems during deployment, or complications from service-connected radiation treatment, it can be service-connected. A nexus letter from an oral surgeon explaining the connection is typically needed.