Oral Lichen Planus

DC 9913Dental/Oral38 CFR 4.150, DC 9913

A chronic autoimmune condition that causes white lacy patches, red inflamed areas, or painful sores on the inside of your cheeks, gums, and tongue. It can make eating spicy or acidic foods very painful and increases the risk of oral cancer.

How the VA rates this condition

The VA rates this condition based on how often symptoms occur and how severe each episode is. The examiner will ask about the frequency, duration, and intensity of your episodes, as well as how they affect your ability to work.

Diagnostic code

DC 9913

Rating range

0% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.150, DC 9913. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe, widespread erosive oral lichen planus with constant pain, inability to eat normal foods, and the condition has caused tooth loss from gum involvement or has required multiple biopsies for cancer surveillance.

What the VA looks for

Severe widespread oral ulceration
Constant oral pain documented
Severe dietary limitation (liquid or soft diet)
Tooth loss from desquamative gingivitis
Multiple biopsies for cancer surveillance
Maximum immunosuppressive therapy

Common Pitfalls

⚠Not getting a biopsy to confirm the diagnosis — the VA requires histologic confirmation of lichen planus, not just a clinical impression, since other conditions can look similar.
⚠Not documenting the type (reticular vs. erosive) at each visit — the erosive type with active sores supports a higher rating than the painless reticular type.
⚠Not connecting to hepatitis C, medications, or stress during military service — all are known triggers for oral lichen planus.
⚠Not requesting oral cancer screening — oral lichen planus has a 1-2% malignant transformation rate, and cancer surveillance requirements demonstrate the ongoing severity of the condition.

Related DBQ Forms

DBQ Dental and Oral Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 9913

Rating range

0% – 30%

Rating levels

Rating Levels

What the VA looks for

Severe widespread oral ulceration
Constant oral pain documented
Severe dietary limitation (liquid or soft diet)
Tooth loss from desquamative gingivitis
Multiple biopsies for cancer surveillance
Maximum immunosuppressive therapy

Common Pitfalls

⚠Not getting a biopsy to confirm the diagnosis — the VA requires histologic confirmation of lichen planus, not just a clinical impression, since other conditions can look similar.

⚠Not documenting the type (reticular vs. erosive) at each visit — the erosive type with active sores supports a higher rating than the painless reticular type.

⚠Not connecting to hepatitis C, medications, or stress during military service — all are known triggers for oral lichen planus.

⚠Not requesting oral cancer screening — oral lichen planus has a 1-2% malignant transformation rate, and cancer surveillance requirements demonstrate the ongoing severity of the condition.