Traumatic Brain Injury (TBI)
Traumatic brain injury results from events such as IED blasts, car accidents, concussive artillery fire, falls, or gunshot wounds. TBI is rated under Diagnostic Code 8045 based on residual symptoms across 10 areas of impairment: executive functioning, judgment, social interaction, orientation, motor activity, visual-spatial orientation, neurobehavioral effects, communication, consciousness, and subjective symptoms. The area with the highest level of impairment determines the single TBI rating, unless it would be more favorable to break symptoms into individual separate ratings. TBI ratings are 0%, 10%, 40%, 70%, or 100%. Due to the overlapping nature of PTSD and TBI symptoms, the VA commonly lumps them together into a single rating unless an examiner can separate the symptoms.
VA Rating Levels
TBI is diagnosed (even if acute or resolved) but no current residual symptoms are present.
Impairment level 1 in the highest-rated area. Examples include subjective complaints without objective evidence, occasional inappropriate social interaction, or 3 or more subjective symptoms mildly interfering with work or relationships.
Impairment level 2 in the highest-rated area. Examples include objectively confirmed mild cognitive issues, frequently inappropriate social interaction, or 3 or more subjective symptoms moderately interfering with work or relationships.
Impairment level 3 in the highest-rated area. Examples include moderate cognitive impairment affecting ability to work or care for oneself, inappropriate social interaction most or all of the time, or neurobehavioral effects preventing work or relationships on most days.
Total impairment in the highest-rated area. Examples include severe cognitive impairment equating to inability to work or care for oneself, persistent vegetative state or coma, or inability to communicate basic needs.
Exam Tips & Key Evidence
- →TBI can be one of the most complicated conditions to rate, and it is fairly easy for a rater to make mistakes. If you feel your rating is incorrect, a Higher Level Review may be worthwhile.
- →If your PTSD and TBI symptoms cannot be separated by the examiner, they will typically be combined into a single rating. Be aware that filing for TBI could potentially affect an existing mental health rating if it has been less than 5 years.
- →Five conditions are presumptive secondary to moderate or severe TBI: Parkinson's disease, seizures, dementia/Alzheimer's, depression, and pituitary hormone deficiencies. Each has its own timeframe requirement.
- →Common secondary conditions include headaches/migraines, hearing loss, tinnitus, vision problems, mental health conditions, seizures, and scars.
- →If TBI causes loss of use of a body part or requires regular aid and attendance, you may qualify for Special Monthly Compensation.
- →If your TBI and other service-connected disabilities prevent you from maintaining gainful employment, consider applying for TDIU.
Commonly Related Conditions
38 CFR Reference
38 CFR $ 4.124a, Diagnostic Code 8045