Dental health is important for everyone, especially Veterans with teeth-related injuries and disabilities. If you don’t care for your teeth or get proper dental health care, you could pay much more for dentures and other expensive replacements in older age.
Many Veterans wonder whether the Department of Veterans Affairs covers dental benefits for disabled Veterans. It does, but the details are complex. Let’s take a closer look.
The U.S. Department of Veterans Affairs does cover dental care costs and insurance for Veterans under certain circumstances. Unlike other benefits programs, VA outpatient dental care separates different Veterans into classes. For example, a Class I Veteran is eligible for all necessary dental care to maintain or restore oral health. This includes repeat care. Other classes of Veterans may only qualify for limited dental care benefits or a one-time course of treatment.
Specifically, if you have a service-connected and compensable dental disability or condition (a 10% VA rating or higher), you are a Class I disability Veteran under the outpatient dental program. Eligible Veterans may have any needed dental care covered, including:
Put another way, if the VA has already assigned you service connection for a 10% rated dental disability, the VA will likely cover your dental care. That’s great for many Veterans, as standard health insurance policies don’t usually include dental care. Dental care is normally a separate insurance package you have to purchase.
This dental care from the VA only applies so long as you have a service-connected dental disability, however. If your service-connected condition is remediated by VA treatment or goes away by itself, you will likely no longer qualify for this coverage. You’ll then have to acquire dental insurance coverage elsewhere, such as through the VA insurance program or through a third-party dental plan.
The VA also covers dental care for other eligible Veterans, such as:
Active duty military members, of course, receive eligibility for dental treatment and other VA benefits for the duration of their service. This can extend to dental coverage for family members and other beneficiaries.
In addition to covering standard dental care charges and expenses, the VA does allow Veterans to benefit from the VA Dental Insurance Program (VADIP). The VADIP is intended for former service members who:
The VA dental insurance program could allow you to receive dental insurance at a reduced cost without shopping for a different policy. Therefore, even if you don’t have a dental service-connected disability, you should still try to apply for the VA’s dental insurance program to take advantage of its many benefits.
One of the best elements of getting dental care through the VA is the ease of access to knowledgeable specialists and dental clinics. In fact, the VA offers dental care to all qualified Veterans at well over 200 distinct clinic locations throughout the US, including Puerto Rico and Alaska.
Of course, if you live in a dense metropolitan area, you’ll have an easier time finding a VA-supported dental clinic. Still, many Veterans can take advantage of VA dental care services at these accessible clinics without driving far.
When a disabled Veteran qualifies for dental care benefits, they receive full coverage for any necessary dental care that relates to their disabilities.
For example, if a Veteran loses some or all of their teeth because of an in-service event, injury, or illness, the VA will likely cover the cost of medical and dental procedures to replace those teeth and ensure the Veteran has functioning dentition.
Furthermore, any follow-up care necessary for those new teeth or procedures will likely be covered by Veterans benefits. If a Veteran has to wear dentures because of a service-connected disability, the VA will likely cover the cost of denture maintenance, follow-up appointments, and much more.
In this way, Veterans don’t have to worry about long-term dental care costs saddling their bank accounts if those dental costs were due to a service-connected disability or injury.
The VA rates dental disabilities using many different diagnostic codes. For example, diagnostic code 9901 represents the complete loss of a mandible between angles. It receives a VA disability rating of 100%.
As another example, Veterans who experience malunion of the jaw, such as displacement that causes moderate to severe open bite, will likely receive a disability rating between 10% and 20%. These disability ratings can be added to a Veteran’s overall disability rating if the Veteran in question also has other disabilities or injuries rated by the VA.
Applying for VA dental care benefits follows a distinct process instead of filing for traditional disability benefits.
First, you’ll want to ensure eligibility for disability benefits enrollment. You’ll also need to gather information beforehand, including your Social Security number for you, your spouse, and any qualified dependents. Don’t forget to gather your military discharge information and insurance cards for any health insurance company that covers you. This includes insurance coverage you receive through a spouse or significant other.
The enrollment application for health benefits for dental care is the VA Form 10-10EZ.
Dental care benefits are considered disability benefits but don’t eat into your monthly disability benefits if you already have a VA disability rating.
For example, say you have a major disability rating for a jaw-related disorder or injury. Your disability rating is 50%. Thus, the VA will likely provide you with monthly compensation to help you cover the cost of medical bills, lost job opportunities, and more.
If you receive VA dental care, such as coverage to restore the functionality of your teeth or jaw, that does not decrease your benefits. Therefore, you can still recover monthly compensation for your assigned disability rating.
Keep in mind, however, that if your VA dental care results in significant improvements to your dental disability, your disability rating could decrease over time. For instance, if you are the subject of a successful dental operation surgery, and your disability rating decreases from 50% to 20%, your monthly disability compensation will likely also decrease.
The VA does cover dental health care benefits and provides dental insurance for disabled and non-disabled Veterans. If you have a service-connected dental disability, you can rest assured that the VA will likely help you cover all the dental care you need in the future.
But what happens if your initial claim is denied? If you need to appeal a denial, increase your disability rating, or dispute your effective date, It’s a good idea to contact Berry Law. Our experienced Veterans law attorneys can walk you through the process and answer any questions. Contact us today to get started.
Our monthly newsletter features about important and up-to-date veterans' law news, keeping you informed about the changes that matter.