Dental

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Fact Sheet 164-3 April 2010

Veteran Dental Benefits
Benefit Description: Dental benefits are provided by the Department of Veterans Affairs according to law. In some instances, VA may provide extensive dental care, while in other cases treatment may be limited. This Fact Sheet describes dental eligibility criteria and contains information Veterans should know in order to understand eligibility for VA dental care.

Outpatient Dental Program
Outpatient Dental Care is separated into six dental benefit ‘classes’ noted below in brackets. You are eligible for any necessary dental care to maintain or restore oral health and masticatory function, including repeat care If You: • Have a schedular VA service connected disability rating of 100% (total)* [Class IV] • Are receiving the 100% service connected compensation rate by reason of individual unemployability [Class IV] • Are an former prisoner of war (POW) [Class IIC], or • Have a compensable (10% or greater) service connected dental disability or condition [Class I] Note: Veterans paid at the 100% rate based on a temporary rating (extended hospitalization for a service connected disability, convalescence or pre- stabilization) are not eligible for comprehensive outpatient dental services. You are eligible for treatment as reasonably necessary for the one-time correction of the noncompensable, service connected dental disability [Class II] If You: • Are recently discharged from a period of active military service of not less than 90 days under conditions other than dishonorable • Apply for dental treatment within 180 days of discharge or release from active duty, and • Have a DD214, Certificate of Discharge or Release from Active Duty (line 17), certifying that you were not provided a complete dental examination and all appropriate dental treatment within the 90 day period immediately before discharge or release If you are actively engaged in a 38 USC Chapter 31 vocational rehabilitation program you are eligible for dental care [Class V] to the extent necessary to: • • • • • Make possible your entrance into a rehabilitation program Achieve the goals of your vocational rehabilitation program Prevent interruption of your rehabilitation program Hasten the return to a rehabilitation program if you are in interrupted or leave status Hasten the return to a rehabilitation program if you are placed in discontinued status because of a dental condition, or
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Secure and adjust to employment during the period of employment assistance, or enable you to achieve maximum independence in daily living.

If you have a noncompensable, service connected dental disability adjudicated by VA as resulting from: • combat wounds, or • service trauma Note: Public Law 83 amended VA's eligibility for Outpatient Dental services and treatment. This amendment relates to a one time episode of outpatient dental services and treatment. The amendment required that the dental condition must be service connected and is shown to have been in existence at time of discharge or release from active service, but only if application for treatment is made within one year after discharge or release, or by December 31, 1954, whichever last occur. Therefore, any Veteran who received a dental award letter from VBA dated before 1955 which VBA determined the dental conditions to be noncompensable, are only eligible for a one time episode of outpatient dental treatment and services. You are eligible for repeat care and maintenance or replacement of the involved tooth/teeth. [Class IIA] A Dental Trauma Rating (VA Form 10-564-D) or VA Regional Office Rating Decision letter (VA Form 10-7131) identifies the tooth/teeth eligible for care. If you have a dental condition determined by a VA clinical professional to be aggravating or complicating the management of a service connected medical condition under active treatment, you may receive limited dental care. You are only eligible for focused care to treat the oral conditions that directly impact the management of your existing medical condition. [Class III] If you are scheduled for admission or you are receiving outpatient care as an eligible Veteran you may receive limited dental care if the dental condition is clinically determined to be complicating the medical condition currently under VA treatment. You are only eligible for focused care to treat the oral conditions that directly impact the management of your existing medical condition. [Class VI] If you are enrolled for VA care, in a VA homeless program for at least 60 consecutive days, or receiving care in a setting described in 38 USC 2062 (domiciliary, therapeutic residence, or community residential care) you may be provided one-time course of dental care [Class VI] to: • Relieve pain • Gain employment Treat moderate, severe, or complicated gingival and periodontal conditions

Inpatient Dental Program
Patients receiving hospital care will be provided dental services that are professionally determined by a VA dentist, in consultation with the referring physician, to be essential to the management of the patient’s medical condition. Treatment may be provided for the improvement of oral conditions that directly compromise the medical condition under active treatment. For more information about eligibility for VA medical and dental benefits, contact VA at 1-877222-8387 or www.va.gov/healtheligibility.

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